E. O'Sullivan - Academia.edu (original) (raw)

Papers by E. O'Sullivan

Research paper thumbnail of Tracheal Intubation Without Neuromuscular Block in Patients with Myasthenia Gravis

Anesthesia & Analgesia, 1998

Research paper thumbnail of Clearance of Atracurium and Laudanosine in the Urine and by Continuous Venovenous Haemofiltration

BJA: British Journal of Anaesthesia, 1991

We have measured the steady state urinary clearances of atracurium, given by constant infusion, a... more We have measured the steady state urinary clearances of atracurium, given by constant infusion, and laudanosine in eight patients undergoing artificial ventilation; all had normal renal function (mean creatinine clearance 81 ml min' 1). Mean (so) urinary clearance of atracurium was 0.55 (0.5) ml kg~' min''; that of laudanosine was 0.33 (0.2) ml kg~' min''. Simultaneous plasma clearances were 7.1 (1.4) ml kg~1 min'' and 3.8 (1.5) ml kg-' min'', respectively. Notional haemofiltration clearances of the two substances were measured also in seven critically ill patients with renal and respiratory failure undergoing continuous venovenous haemofiltration. Mean (SD) clearances of atracurium and laudanosine in the haemofi/trate fluid were 0.11 (0.06) ml kg~' min-' and 0.09 (0.02) ml kg'' min''', respectively whilst plasma clearances were atracurium 6.7 (1.8) mlkg~'min' 1 and laudanosine 4.5 (1.8) ml kg' 1 min' 1. There were no significant differences between the plasma clearances of the drugs in the two groups, despite the difference in severity of sickness. Urinary clearance rates of atracurium and laudanosine were approximately 8 and 9% of that in the plasma, but the haemofiltration clearance of both substances was only 2 %.

Research paper thumbnail of The ‘College of Anaesthetists of Ireland’—Delaney Medal Competition

British Journal of Anaesthesia, 2013

The name of the author presenting the paper is shown in bold type. All authors have certified tha... more The name of the author presenting the paper is shown in bold type. All authors have certified that, where appropriate, studies have been conducted with the approval of the relevant Human Ethics Committee or Animal Experimental Review Committee.) The College of Anaesthetists of Ireland established the Delaney Medal competition 15 yr ago to allow trainees to present their research work annually and get critical feedback. It is named after the late Dr Edmund Delaney who worked in Dr Steeven's Hospital in Dublin from 1957 to 1979. This competition is the premier research event in the college's calendar, attracting high-quality laboratory and clinical papers. As the College of Anaesthetists of Ireland is an ALL IRELAND college, in the early days many papers emanated from the Prof. Dundee stable in Belfast. With the establishment of academic departments in Dublin, Cork, and Galway, an increasing number of abstracts have emanated from these departments. The judging panel comprises leading Irish academics, with an external peer reviewer as chairperson. Winning presentations have always been of a very high standard and consistently the winners have published their findings in major international peer-reviewed journals. The eight short-listed abstracts this year are included in this month's BJA for the first time. The chair of the BJA, Prof. Nigel Webster, was the external judge and as you will see they represent a snapshot of the research being carried out presently in Ireland. The College of Anaesthetists of Ireland has developed a high academic standing and, despite our small size, it currently holds onequarter of the Irish Health Research Board (HRB)-funded academic fellowships. We are delighted that the BJA has agreed to publish these abstracts as it will further increase the popularity of the Delaney Medal, our premier research competition in Ireland. This and the adoption of the BJA as the official journal of the College of Anaesthetists of Ireland will further enhance the academic standing of anaesthesia in Ireland.

Research paper thumbnail of The Global Oximetry Initiative

Anaesthesia, 2007

Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vie... more Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vietnam. The overall aims are to promote oximetry utilisation and reduce oximetry costs in lower income countries. Research objectives include studying the feasibility of cost reduction; overcoming non-cost barriers to global oximetry including issues of prioritisation; education and guidelines; servicing and access to parts. Promotional objectives include creating new policy, influencing oximetry design, and setting new global standards for safer monitoring.

Research paper thumbnail of The Difficult Airway Society ‘ADEPT’ Guidance on selecting airway devices: the basis of a strategy for equipment evaluation

Research paper thumbnail of A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK

Anaesthesia, 2013

† The survey also identified a low use of depth of anaesthesia monitoring and dearth of hospital ... more † The survey also identified a low use of depth of anaesthesia monitoring and dearth of hospital policies to manage awareness. Background. As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant and staff and associate specialist anaesthetist in the UK. Methods. The survey was designed to ascertain the number of new cases of accidental awareness that became known to them, for patients under their direct or supervised care, for a calendar year, and also to estimate how many cases they had experienced during their careers. The survey also asked about use of monitoring designed to measure the depth of anaesthesia. Results. All local coordinators responsible for each of 329 hospitals (organised into 265 'centres') in the UK responded, as did 7125 anaesthetists (82%). There were 153 new cases of accidental awareness notified to respondents in 2011, an estimated incidence of 1:15 414, lower than the 1-2:1000 previously reported in prospective clinical trials. Almost half the cases (72, 47%) occurred at or after induction of anaesthesia but before surgery, with 46 (30%) occurring during surgery and 35 (23%) after surgery before full recovery. Awareness during surgery appeared to lead more frequently to pain or distress than at induction and emergence (62% vs 28% and 23%, respectively). Depth of anaesthesia monitors were available in 164 centres (62%), but routinely used by only 132 (1.8%) of anaesthetists. Conclusion. The disparity between the incidence of awareness as notified to anaesthetists and that reported in trials warrants further examination and explanation.

Research paper thumbnail of Difficult Airway Society guidelines for management of the unanticipated difficult intubation

Anaesthesia, 2012

Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic dea... more Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic death or brain damage. The clinical situation is not always managed well. The Difficult Airway Society (DAS) has developed guidelines for management of the unanticipated difficult tracheal intubation in the non-obstetric adult patient without upper airway obstruction. These guidelines have been developed by consensus and are based on evidence and experience. We have produced flow-charts for three scenarios: routine induction; rapid sequence induction; and failed intubation, increasing hypoxaemia and difficult ventilation in the paralysed, anaesthetised patient. The flow-charts are simple, clear and definitive. They can be fully implemented only when the necessary equipment and training are available. The guidelines received overwhelming support from the membership of the DAS. It is not intended that these guidelines should constitute a minimum standard of practice, nor are they to be regarded as a substitute for good clinical judgement.

Research paper thumbnail of Guidelines for safety and quality in anaesthesia practice in the European Union

European Journal of Anaesthesiology, 2007

> External audits by peer review: J Practice facilities. J Provision and management of resources.... more > External audits by peer review: J Practice facilities. J Provision and management of resources. J Outcomes of clinical practice. J Teaching facilities. J Local QA initiatives. J Communication. J Team-determined outcomes. > Support by employing institution: J Provision of resources for CPD, teaching and research. J Systems of assessment of CPD. J Inclusion of employees in all aspects of the institution's function.

Research paper thumbnail of Tracheal Intubation Without Neuromuscular Block in Patients with Myasthenia Gravis

Anesthesia & Analgesia, 1998

Research paper thumbnail of Clearance of Atracurium and Laudanosine in the Urine and by Continuous Venovenous Haemofiltration

BJA: British Journal of Anaesthesia, 1991

We have measured the steady state urinary clearances of atracurium, given by constant infusion, a... more We have measured the steady state urinary clearances of atracurium, given by constant infusion, and laudanosine in eight patients undergoing artificial ventilation; all had normal renal function (mean creatinine clearance 81 ml min' 1). Mean (so) urinary clearance of atracurium was 0.55 (0.5) ml kg~' min''; that of laudanosine was 0.33 (0.2) ml kg~' min''. Simultaneous plasma clearances were 7.1 (1.4) ml kg~1 min'' and 3.8 (1.5) ml kg-' min'', respectively. Notional haemofiltration clearances of the two substances were measured also in seven critically ill patients with renal and respiratory failure undergoing continuous venovenous haemofiltration. Mean (SD) clearances of atracurium and laudanosine in the haemofi/trate fluid were 0.11 (0.06) ml kg~' min-' and 0.09 (0.02) ml kg'' min''', respectively whilst plasma clearances were atracurium 6.7 (1.8) mlkg~'min' 1 and laudanosine 4.5 (1.8) ml kg' 1 min' 1. There were no significant differences between the plasma clearances of the drugs in the two groups, despite the difference in severity of sickness. Urinary clearance rates of atracurium and laudanosine were approximately 8 and 9% of that in the plasma, but the haemofiltration clearance of both substances was only 2 %.

Research paper thumbnail of The ‘College of Anaesthetists of Ireland’—Delaney Medal Competition

British Journal of Anaesthesia, 2013

The name of the author presenting the paper is shown in bold type. All authors have certified tha... more The name of the author presenting the paper is shown in bold type. All authors have certified that, where appropriate, studies have been conducted with the approval of the relevant Human Ethics Committee or Animal Experimental Review Committee.) The College of Anaesthetists of Ireland established the Delaney Medal competition 15 yr ago to allow trainees to present their research work annually and get critical feedback. It is named after the late Dr Edmund Delaney who worked in Dr Steeven's Hospital in Dublin from 1957 to 1979. This competition is the premier research event in the college's calendar, attracting high-quality laboratory and clinical papers. As the College of Anaesthetists of Ireland is an ALL IRELAND college, in the early days many papers emanated from the Prof. Dundee stable in Belfast. With the establishment of academic departments in Dublin, Cork, and Galway, an increasing number of abstracts have emanated from these departments. The judging panel comprises leading Irish academics, with an external peer reviewer as chairperson. Winning presentations have always been of a very high standard and consistently the winners have published their findings in major international peer-reviewed journals. The eight short-listed abstracts this year are included in this month's BJA for the first time. The chair of the BJA, Prof. Nigel Webster, was the external judge and as you will see they represent a snapshot of the research being carried out presently in Ireland. The College of Anaesthetists of Ireland has developed a high academic standing and, despite our small size, it currently holds onequarter of the Irish Health Research Board (HRB)-funded academic fellowships. We are delighted that the BJA has agreed to publish these abstracts as it will further increase the popularity of the Delaney Medal, our premier research competition in Ireland. This and the adoption of the BJA as the official journal of the College of Anaesthetists of Ireland will further enhance the academic standing of anaesthesia in Ireland.

Research paper thumbnail of The Global Oximetry Initiative

Anaesthesia, 2007

Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vie... more Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vietnam. The overall aims are to promote oximetry utilisation and reduce oximetry costs in lower income countries. Research objectives include studying the feasibility of cost reduction; overcoming non-cost barriers to global oximetry including issues of prioritisation; education and guidelines; servicing and access to parts. Promotional objectives include creating new policy, influencing oximetry design, and setting new global standards for safer monitoring.

Research paper thumbnail of The Difficult Airway Society ‘ADEPT’ Guidance on selecting airway devices: the basis of a strategy for equipment evaluation

Research paper thumbnail of A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK

Anaesthesia, 2013

† The survey also identified a low use of depth of anaesthesia monitoring and dearth of hospital ... more † The survey also identified a low use of depth of anaesthesia monitoring and dearth of hospital policies to manage awareness. Background. As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant and staff and associate specialist anaesthetist in the UK. Methods. The survey was designed to ascertain the number of new cases of accidental awareness that became known to them, for patients under their direct or supervised care, for a calendar year, and also to estimate how many cases they had experienced during their careers. The survey also asked about use of monitoring designed to measure the depth of anaesthesia. Results. All local coordinators responsible for each of 329 hospitals (organised into 265 'centres') in the UK responded, as did 7125 anaesthetists (82%). There were 153 new cases of accidental awareness notified to respondents in 2011, an estimated incidence of 1:15 414, lower than the 1-2:1000 previously reported in prospective clinical trials. Almost half the cases (72, 47%) occurred at or after induction of anaesthesia but before surgery, with 46 (30%) occurring during surgery and 35 (23%) after surgery before full recovery. Awareness during surgery appeared to lead more frequently to pain or distress than at induction and emergence (62% vs 28% and 23%, respectively). Depth of anaesthesia monitors were available in 164 centres (62%), but routinely used by only 132 (1.8%) of anaesthetists. Conclusion. The disparity between the incidence of awareness as notified to anaesthetists and that reported in trials warrants further examination and explanation.

Research paper thumbnail of Difficult Airway Society guidelines for management of the unanticipated difficult intubation

Anaesthesia, 2012

Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic dea... more Problems with tracheal intubation are infrequent but are the most common cause of anaesthetic death or brain damage. The clinical situation is not always managed well. The Difficult Airway Society (DAS) has developed guidelines for management of the unanticipated difficult tracheal intubation in the non-obstetric adult patient without upper airway obstruction. These guidelines have been developed by consensus and are based on evidence and experience. We have produced flow-charts for three scenarios: routine induction; rapid sequence induction; and failed intubation, increasing hypoxaemia and difficult ventilation in the paralysed, anaesthetised patient. The flow-charts are simple, clear and definitive. They can be fully implemented only when the necessary equipment and training are available. The guidelines received overwhelming support from the membership of the DAS. It is not intended that these guidelines should constitute a minimum standard of practice, nor are they to be regarded as a substitute for good clinical judgement.

Research paper thumbnail of Guidelines for safety and quality in anaesthesia practice in the European Union

European Journal of Anaesthesiology, 2007

> External audits by peer review: J Practice facilities. J Provision and management of resources.... more > External audits by peer review: J Practice facilities. J Provision and management of resources. J Outcomes of clinical practice. J Teaching facilities. J Local QA initiatives. J Communication. J Team-determined outcomes. > Support by employing institution: J Provision of resources for CPD, teaching and research. J Systems of assessment of CPD. J Inclusion of employees in all aspects of the institution's function.