Waking the dragon: national audit in China and the benefits of having a NAP

PEACHY, another fruitful study

The results of the PErioperAtive CHildhood ObesitY (PEACHY) study showed an alarmingly high incidence of obesity amongst children presenting for surgical procedures under general anaesthesia in the UK. The study was performed by the Paediatric Anaesthesia Trainee Research Network (PATRN), a network of trainee anaesthetists seeking to quantify important clinical problems. Networks and consortia that facilitate collaboration amongst clinicians and academics working in a wide range of types of hospitals are particularly important in the current era, as they have the potential to gather data rapidly on important clinical problems, and by their size improve the power to identify factors associated with rare complications. Collaboration amongst clinicians within networks instead of competition between clinicians can have wide-ranging benefits that extend beyond research, and can include improvements in training, rapid dissemination of protocols, and knowledge concerning new problems, ultimately improving general standards of care.

Capnography use in the critical care setting: why do clinicians fail to implement this safety measure?

Tracheal intubation is among the most frequently performed manoeuvres in the critical care setting, and can be life-saving in critical illness, though also associated with serious adverse events such as oesophageal intubation or tracheal tube obstruction, displacement, or disconnection from the ventilator. A key finding of the 4th National Audit Project (NAP4) was identification of waveform capnography as the single intervention with the highest potential for reducing morbidity and mortality during tracheal intubation and maintenance of an artificial airway. In the INTUBE study, penetration of capnography into ICUs was low, and was not in use in 70% of the episodes of oesophageal intubation. To reduce harm and avoidable death, there is a need for a global initiative to increase access to and use of capnography in ICUs.