Learn More
Donation after circulatory death (DCD) describes the retrieval of organs for the purposes of transplantation that follows death confirmed using circulatory criteria. The persisting shortfall in the availability of organs for transplantation has prompted many countries to re-introduce DCD schemes not only for kidney retrieval but increasingly for other(More)
We have compared the effect of increasing optode separation (range 0.7-5.5 cm) on the sensitivity of near infrared spectroscopy (NIRS) to discrete reductions in scalp and cerebral oxygenation in 10 healthy men (mean age 32, range 26-39 yr) using multichannel NIRS. During cerebral oligaemia (a mean reduction in middle cerebral artery flow velocity of 47%)(More)
We have studied the effects of extracranial ischaemia and intracranial hypoxia on measurement of cerebral oxygenation using near-infrared, reflectance-mode, cerebral oximetry (Invos 3100 cerebral oximeter) in healthy adult subjects. Under stable systemic conditions, scalp ischaemia induced by a pneumatic tourniquet caused an apparent reduction in mean(More)
There is growing medical consensus in a unifying concept of human death. All human death involves the irreversible loss of the capacity for consciousness, combined with the irreversible loss of the capacity to breathe. Death then is a result of the irreversible loss of these functions in the brain. This paper outlines three sets of criteria to diagnose(More)
BACKGROUND Studies on the effects of anaesthesia on event-related potentials and long latency auditory-evoked potentials (AEP) are sparse. Both provide information on cortical processing and may have potential as monitors of awareness. We studied the effect of propofol on the event-related potential mismatch negativity (MMN) and the long-latency AEP NI. (More)
We studied the impact of introducing percutaneous tracheostomy to our intensive care unit on the incidence and timing of tracheostomy and on the implications for surgical training. The proportion of patients receiving intensive care who underwent tracheostomy doubled from a median of 8.5% to 16.8% (p < 0.01) following the introduction of the percutaneous(More)
Eleven adult patients with severe head injuries caused by blunt trauma, (Glasgow Coma Score of eight or less after resuscitation), were studied while being mechanically ventilated and sedated in the intensive care unit (ICU). In a double blind randomized cross over trial each patient received a bolus of suxamethonium (1 mg kg-1) or an equal volume of saline(More)
We studied 41 patients who had previously undergone percutaneous dilational tracheostomy at least 6 months following tracheal decannulation. The patients were examined using laryngotracheoscopy and spirometry to assess the long-term anatomical and functional consequences of percutaneous dilational tracheostomy. Apart from one patient who had requested a(More)
The detection of increased cerebral oxygenation secondary to cerebral hyperaemia, induced by hypercapnia has been studied in anaesthetised patients using a near infrared, reflectance mode, cerebral oxygenation monitor (Invos 3100 Somanetics, Troy, Michigan, USA). Two studies were performed, with and without a pneumatic scalp tourniquet, to distinguish(More)
We studied the frequency with which treatment was withdrawn in intensive care patients and the primary reason for reaching the decision. The medical records of patients having had active treatment withdrawn between August 1992 and February 1996 inclusive were reviewed. Patients were classified into an imminent death group consisting of those expected to(More)