Leon du Toit

University of Cape Town | UCT · Department of Anaesthesia

Hypothermia during obstetric spinal anaesthesia is a common and important problem, yet temperature monitoring is often not performed due to the lack of a suitable, cost-effective monitor. This study aimed to compare a noninvasive core temperature monitor with two readily available peripheral temperature monitors during obstetric spinal anaesthesia....

Background In South Africa, hypertensive disorders of pregnancy are the leading cause of maternal mortality. More than 50% of anaesthesia-related deaths are attributed to complications of airway management. We compared the prevalence and risk factors for hypoxaemia (SpO2 <90%) during induction of general anaesthesia in parturients with and without...

Background: In Africa, maternal mortality after caesarean delivery is 50 times greater than in high-income countries. In South Africa, more than 50% of anaesthesia-related maternal mortality is attributed to failure to protect the airway. We implemented an obstetric airway management registry, to facilitate future improvements in management and out...

In a recent international cohort, post-caesarean mortality was 50 times higher amongst African countries compared to high-income countries.1 The anaesthetic-related deaths were commonly associated with hypoxaemia and aspiration.1 While pregnancy-related hypertension (PRH) is the overall leading direct cause of maternal deaths in South Africa, more...

The African Surgical Outcomes Study showed that maternal mortality after caesarean delivery is 50 times higher in Africa, predominantly from obstetric haemorrhage and anaesthesia-related hypoxaemia or aspiration. In South Africa, lack of skills and knowledge at maternity centres were recorded in 71% of anaesthesia related deaths between 2014 and 20...

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. The working hypothesis is that patients die as a result of failure to rescue following complications in the postoperative period. The African Surgical OutcomeS-2 (ASOS-2) Trial plans to test the efficacy of incre...

Pre‐operative optimisation is a heterogenous group of interventions aimed at improving peri‐operative outcomes. To understand the evidence for pre‐operative optimisation in the developing world, we systematically reviewed Cochrane reviews on the topic according to the Human Developmental Index (HDI) of the country where patient recruitment occurred...

( Anesth Analg . 2018;126(1):190–195) Maternal core temperature is difficult to monitor during cesarean delivery (CD) under spinal anesthesia (SA). A drop in maternal core temperature <36.0°C during the perioperative period is associated with increased risks of postoperative morbidity. Current knowledge of the thermal insult associated with obstetr...

Diabetes mellitus (DM) is a common multisystem disease with hyperglycaemia as the hallmark. It is a modifiable risk factor of complications after surgery. The incidence of DM and its impact on public health are steadily increasing globally. In South Africa (SA), it is estimated that a large proportion of people living with DM are undiagnosed. A num...

Background: Perioperative hypothermia may affect maternal and neonatal outcomes after obstetric spinal anesthesia. Core temperature is often poorly monitored during spinal anesthesia, due to the lack of an accurate noninvasive core temperature monitor. The aim of this study was to describe core temperature changes and temperature recovery during s...

Point-of-care testing is becoming common practice in a variety of settings, including extreme environments. Little is known about the functioning of these platforms under challenging conditions. The i-STAT (Abbott, Princeton, NJ) is a cartridge-based point-of-care system for the testing of whole blood. This pilot study compares the performance of i...

Background: Meta-analyses of the implementation of a surgical safety checklist (SSC) in observational studies have shown a significant decrease in mortality and surgical complications. Objective: To determine the efficacy of the SSC using data from randomised controlled trials (RCTs). Methods: This meta-analysis followed the Preferred Reportin...