The effect of cardiopulmonary bypass on blood thiamine concentration and its association with post-operative lactate concentration.

Objective: Cardiothoracic surgery is a large field in Australia, and evidence suggests post-cardiopulmonary bypass (CPB) hyperlactataemia is associated with higher morbidity and mortality. Low thiamine levels are a potentially common yet treatable cause of hyperlactataemia and may occur in the setting of exposure to CPB non-biological material. We hypothesized that cardiopulmonary bypass would result in decreased whole-blood thiamine levels, which may therefore result in increased whole-blood lactate levels in the post-operative period.

Australian dust storm: impact on a statewide air medical retrieval service.

Introduction: The Australian dust storm during the week of September 22, 2009, resulted in the grounding of a large portion of the air medical retrieval fleet in Queensland. We sought to determine whether during this event an increase occurred in cases requiring retrieval as a result of the dust storm, and whether the grounding of the retrieval fleet resulted in any adverse outcomes as a result of its inability to respond.

Methods: A retrospective review of respiratory and injury cases referred to the Queensland Emergency Medical System Coordination Centre from September 8 to October 5, 2009 was conducted.

Cooling in the tropics: ethylene glycol overdose.

Ethylene glycol is the active ingredient used in radiator antifreeze. Severe ingestions of ethylene glycol are uncommon in Australia, but if untreated, can result in multiorgan dysfunction, particularly renal failure and cerebral oedema. We report on a patient who consumed a large quantity of ethylene glycol.

Group B streptococcal meningitis in a middle-aged woman.

Group B streptococcal (GBS) infections are increasing in incidence as a cause of serious disease in the adult population. Risk factors for this infection include age, diabetes mellitus, liver disease, history of stroke, breast cancer and HIV infection, which are all becoming more common. We report a patient with severe GBS meningitis who made a good recovery following appropriate treatment, despite a delay in specific diagnosis of the organism.