This page intentionally left blank 24 Recent Advances in Anaesthesia and Intensive Care RecentAdvancesinAnaesthesiaandIntensiveCare,volume24isthelatest book in this very successful and long-established series (originally entitled Recent Advances in Anaesthesia and Analgesia) to present a collection of cutting-edge topics for anaesthetists. It has been compiled by some of the world’s leading authorities in their subjects and builds on the successful formula ofthe previousvolumes. As thetitlesuggests, these latestvolumes haveincreasedinputfromthefieldofintensivecare,includingaparticularly topical chapter on intensive care outreach. Other chapters include deaths under anaesthesia, use of simulators in anaesthesia, and transoesophageal echocardiography.Traineeandpractisinganaesthetistsandintensivistsatall levelswillfindthisbookextremelyrelevantintheirdailyclinicalpractice. JEREMY N. CASHMAN is a Consultant Anaesthetist at St George’s Hospital, London and an Honorary Senior Lecturer in Anaesthesia at the UniversityofLondon. R. MICHAEL GROUNDS isaConsultantinAnaesthesiaandIntensiveCare Medicine at St George’s Hospital, London and an Honorary Reader in IntensiveCareMedicineattheUniversityofLondon. 24 Recent Advances in Anaesthesia and Intensive Care Editedby JeremyCashman ConsultantAnaesthetist,St.George’sHospital,London HonorarySeniorLecturerinAnaesthesia,UniversityofLondon,UK and MichaelGrounds ConsultantinAnaesthesiaandIntensiveCareMedicine,St.George’s Hospital,London HonoraryReaderinIntensiveCareMedicine,UniversityofLondon,UK CAMBRIDGEUNIVERSITYPRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB28RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521706490 © Cambridge University Press 2007 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2007 ISBN-13 978-0-511-36612-3 eBook (EBL) ISBN-10 0-511-36612-4 eBook (EBL) ISBN-13 978-0-521-70649-0 paperback ISBN-10 0-521-70649-1 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Nevertheless, the authors, editors and publisher can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publisher therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. Contents Listofcontributors pagevii Preface xi 1. Theroleofcardiopulmonaryexercisetestingin preoperativeevaluationofsurgicalpatients PaulOlderandAdrianHall 1 2. Oesophagectomyforcancer KathleenM.Sherry 21 3. Vascularsurgery MattM.ThompsonandIanLoftus 41 4. Anaesthesiafortheelderly ChristopherDodds 63 5. Deathsfollowinganaesthesia:lessonsfromNCEPOD AnthonyGray 75 6. Pelvicandacetabulartrauma ShamimUmarjiandMartinBircher 87 7. Echocardiography S.NicholasFletcher 109 8. Levosimendan ScottMercerandAndrewRhodes 131 9. Criticalcareoutreach:6yearson LesleyDurhamandBrianH.Cuthbertson 143 vi Contents 10. Criticalcareandbiologicaldisasters:lessonslearnedfrom SARSandpandemicinfluenzaplanning MichaelD.Christian,ThomasE.Stewartand StephenE.Lapinsky 159 11. Evaluatingclinicalperformance HannahBarrett,AlisonD.BullockandJulianF.Bion 179 12. Non-technicalskillsandanaesthesia RonaPatey 197 13. Simulatorsinanaesthetictrainingtoenhancepatientsafety PeterDieckmannandMarcusRall 213 Index 233 Contributors HannahBarrett UniversityDepartmentofAnaesthesia&IntensiveCareMedicine N5QueenElizabethHospital Edgbaston BirminghamB152TH UK JulianF.Bion UniversityDepartmentofAnaesthesia&IntensiveCareMedicine N5QueenElizabethHospital Edgbaston BirminghamB152TH UK MartinBircher DepartmentofOrthopaedicsandTrauma StGeorge’sHospital BlackshawRoad LondonSW170QT UK AlisonD.Bullock SchoolofEducation UniversityofBirmingham Edgbaston BirminghamB152TT UK MichaelD.Christian MountSinaiHospitalandUniversityHealthNetwork TorontoGeneral viii Listofcontributors TorontoWestern,andPrincessMargaretHospital Room18–206 600UniversityAvenue TorontoM5G1X5 Ontario Canada BrianH.Cuthbertson HealthServicesResearchUnit InstituteofAppliedHealthSciences PolwarthBuilding MedicalSchool UniversityofAberdeen Foresterhill AberdeenAB252ZD Scotland PeterDieckmann DanishInstituteforMedicalSimulation HerlevHospital HerlevRingrej75 2730Herlev Denmark ChristopherDodds Professor,ClevelandSchoolofAnaesthesia JamesCookUniversityHospital MartonRoad MiddlesboroughTS43BW UK LesleyDurham CityHospitalsSunderlandNHSFoundationTrust RoyalHospital KayllRoad SunderlandSR47TP UK S.NicholasFletcher DepartmentofAnaesthesia StGeorge’sHospital BlackshawRoad LondonSW170QT UK