OAA Small Project Grant
The successful applicants for the OAA Small Project Grant were:
Principal Applicant
Dr Jeremy Campbell
Obstetric Anaesthetic Fellow, Chelsea and Westminster Hospital
Title
The performance of leucocyte filters for the safe re-transfusion of unwashed blood salvaged at caesarean section in resource-poor situations
Amount
£4,491
Scientific Abstract
In order to reduce transfusion of stored blood, cell salvage is being used increasingly in many surgical specialties. However, there have been concerns about its use in obstetrics because of contamination of salvaged blood with amniotic fluid which could lead to the syndrome of amniotic fluid embolism (AFE) when it is re-transfused. It has been shown that washing salvaged blood and then passing it through a leucocyte filter removes the cellular components of amniotic fluid which might lead to AFE. However, this cell washing apparatus is expensive and not available in the resource-poor setting. In a recent pilot study, we have shown that using a leucocyte filter alone (i.e. without the expensive cell washing process) is efficient at removing these components from pure amniotic fluid. This project will investigate the efficacy of a leucocyte filter alone on blood contaminated with amniotic fluid which has been salvaged during caesarean section. Samples of blood contaminated with amniotic fluid will be taken during planned caesarean section and analysed in the laboratory both before and after their passage through a leucocyte filter. The ability of the filter to reduce the concentration of various components of amniotic fluid will be assessed.
First year progress report from Dr J Campbell (66 KB)
Final report from Dr J Campbell.pdf (105 KB)
Principal Applicant
Dr Roshan Fernando
Consultant Anaesthetist, University College London Hospital
Title
Does a 30° head up position in term parturients with a BMI >= 35kg/m2 increase FRC?
Amount
£9,900
Scientific Abstract
Obesity in pregnancy is frequently highlighted as a risk factor in maternal confidential enquiries. Nearly 5% of our pregnant population have a BMI >= 35kg/m2, therefore we are increasingly performing general anaesthesia (GA) in this high risk group. Obese pregnant patients present a particularly difficult problem to the anaesthetist. FRC is reduced due to obesity, and this is further compounded by the presence of the gravid uterus. These changes in FRC along with a large increase in oxygen consumption, associated with the feto-placental unit, means that rapid sequence induction of anaesthesia in the obese parturient, is associated with the risk of a more rapid onset of hypoxaemia. Previous work done by our group, demonstrated a 12.5% increase in FRC from the supine to the 30° head up position in term parturients with a BMI< 35kg/m2. In this study, we will recruit 60 term singleton parturients, 30 with a BMI >= 35kg/m2 , and a control group of 30 with a BMI< 35kg/m2. Two values for FRC within 10% will be obtained by helium dilution in the supine wedged, 30° head up and sitting erect positions. Positioning order will be randomized. The primary aim of this study is to investigate whether a 30° head up position in term parturients with a BMI >= 35kg/m2 increases FRC.
Interim report from Dr R Fernando.pdf (16 KB)
Principal Applicant
Dr. Kevin McCarthy
Department of Anaesthesia, Rotunda Hospital, Dublin
Title
Changes in cytokines and neurotrophins in cerebrospinal fluid during labour pain.
Amount
£6,500
Scientific Abstract
Labour pain is unique in its intensity and involvement of multiple anatomical pain afferents. Glial cells in the spinal cord may amplify neuronal pain transmission. Pregnancy and labour may be associated with changes in cerebrospinal fluid (CSF) levels of amino acids and neurotransmitters. There have been no studies to date looking at the levels of neuroimmune modulators such as cytokines and neurotrophins and their potential role in attenuating or enhancing the analgesic effect of current therapies. We propose a descriptive study profiling the CSF levels of cytokines and neurotrophins in women undergoing elective caesarean section under spinal anaesthesia and labouring women having combined spinal-epidural for labour analgesia. Following informed consent, we intend to enrol forty women in each group. Pain scores and analgesic consumption for 24 hours will be recorded.
Final Report from Dr K McCarthy (224 KB)
First year progress report from Dr K McCarthy (60 KB)
