
Zane FarinaKwaZulu-Natal Department of Health · Department of Anaesthesia
Zane Farina
FCA (SA)
About
53
Publications
28,395
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
2,850
Citations
Introduction
Publications
Publications (53)
BACKGROUND
A proposed new global definition of ARDS seeks to update the Berlin definition and account for nonintubated ARDS and ARDS diagnoses in resource-variable settings.
RESEARCH QUESTION
How do ARDS epidemiologic characteristics change with operationalizing the new global definition of ARDS in a resource-limited setting?
STUDY DESIGN AND MET...
The illegal practice of combining organophosphates (OPs) with other compounds such as carbamates and pyrethroids, creating ‘streetpesticides’, is common in South Africa. These agents contain mostly unknown quantities of unregulated toxins and contribute to atypicaland unpredictable clinical presentations following human ingestion. We present such a...
Background
Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.
Methods
PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six c...
BACKGROUND: The COVID-19 pandemic has led to the implementation of restrictive policies on theatre procedures, with profound impacts on service delivery and theatre output.OBJECTIVES: To quantify these effects at a tertiary hospital in KwaZulu-Natal Province, South Africa.METHODS: A retrospective review of morbidity and mortality data was conducted...
Background:
The COVID-19 pandemic has led to the implementation of restrictive policies on theatre procedures, with profound impacts on service delivery and theatre output.
Objectives:
To quantify these effects at a tertiary hospital in KwaZulu-Natal Province, South Africa.
Methods:
A retrospective review of morbidity and mortality data was co...
Background:
The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a...
Background:
Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial...
Background:
A structured approach to perioperative patient management based on an enhanced recovery pathway protocol facilitates early recovery and reduces morbidity in high income countries. However, in low- and middle-income countries (LMICs), the feasibility of implementing enhanced recovery pathways and its influence on patient outcomes is sca...
Background:
There is a need to increase access to surgical treatments in African countries, but perioperative complications represent a major global health-care burden. There are few studies describing surgical outcomes in Africa.
Methods:
We did a 7-day, international, prospective, observational cohort study of patients aged 18 years and older...
Abstract
Background
The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.
Methods
Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surger...
Background As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary...
Abstract
Background
Traumatic shock cannot be diagnosed by a single physiological measurement and a number of vital sign based combined shock scores (CSS) have been proposed to identify and triage trauma patients with shock. This audit uses data from a prospectively entered electronic trauma registry to compare the ability of these CSS to predict i...
Background. Burn surgery is associated with significant blood loss and fluid shifts that cause rapid haemoglobin (Hb) changes during and after surgery. Understanding the relationship between intraoperative and postoperative (day 1) Hb changes may assist in avoiding postoperative anaemia and unnecessary peri-operative blood transfusion.
Objective. T...
Background: Anaesthesia-related maternal mortality remains unacceptably high, especially in district hospitals. Community service doctors (CSDs) play an important role in the provision of anaesthesia in these hospitals. The purpose of this study was to understand the experience of doctors providing anaesthesia during community service. Identifying...
Background: Community service doctors (CSDs) are often expected to administer anaesthesia after minimal training and with very little support, especially in rural hospitals. This leads to unnecessary stress on these junior doctors and may lead to poor anaesthesia outcomes.
Objectives: The aim of this study was to understand the experiences of CSDs...
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...
The use of standardised drug labels has been recommended by the South African Society of Anaesthesiologists to prevent drug errors in theatre and ICU. 1
(Full text available online at www.medpharm.tandfonline.com/ojaa )
South Afr J Anaesth Analg 2016;
DOI: 10.1080/22201181.2016.1168613
The continued use of “percent” in the labelling and description of many drugs used in the field of anaesthesia is an ongoing source of errors. As part of the modern drive towards safety in medicine it is proposed that the standard of labelling according to mass of the drug per millilitre be universally adopted.
Following the example of the UK and the USA, a group of interested practitioners has initiated a special interest group for obstetric anaesthesia in South Africa. This organisation will operate under the auspices of the South African Society of Anaesthesiologists (SASA), with its own constitution and elected executive committee. Its goal is to redu...
Abstract
OBJECTIVE:
To assess the effect of body mass index on ICU outcome and on the development of ICU-acquired infection.
DESIGN:
A substudy of the Intensive Care Over Nations audit.
SETTING:
Seven hundred thirty ICUs in 84 countries.
PATIENTS:
All adult ICU patients admitted between May 8 and 18, 2012, except those admitted for less than 24 hou...
Caesarean delivery is associated with a higher maternal mortality than vaginal birth. Anaesthesia complications are asignificant contributor to this fact. Reported avoidable anaesthetic mortality rates vary from 1 : 150 in Togo to 1 : 71429 in the UK. This high variation in reported rates can be ascribed to variations in skill/training and the avai...
Maternal deaths due to haemorrhage continue to increase in South Africa (SA). It appears that oxytocin and other uterotonics are not being used optimally, even though they are an essential part of managing maternal haemorrhage. Oxytocin should be administered to every mother delivering in SA. Awareness is required of the side-effects that can occur...
Background:
In the latest (2011-2013) Saving Mothers report, the National Committee for Confidential Enquiries into Maternal Deaths in South Africa (SA) (NCCEMD) highlights the large number of maternal deaths associated with caesarean section (CS). The risk of a woman dying as a result of CS during the past triennium was almost three times that fo...
Caesarean delivery is associated with a higher maternal mortality than vaginal birth. Anaesthesia complications are a significant contributor to this fact. Reported avoidable anaesthetic mortality rates vary from 1:150 in Togo1 to 1:71429 in the UK.2 This high variation in reported rates can be ascribed to variations in skill/training and the avail...
Background: Most anaesthesia-related mortality that occurs in level 1 hospitals in South Africa is avoidable. Improving training during internship, and consequently the skills of community service officers, could lead to safer anaesthesia practices.Objectives: The objectives of the study were to determine whether or not the timing of the anaesthesi...
Percutaneous transtracheal jet ventilation (PTJV) is an accepted method of rescue ventilation following unsuccessful attempts to secure the airway through conventional methods. Pre-emptive use of PTJV in the difficult airway has also been described as using either a specifically designed jet ventilation catheter, or other cannulae, such as a centra...
The number of reported deaths due to anaesthesia continues to increase. There were 121 reported this triennium. This represents 2.5% of all maternal deaths and 5.4% of deaths directly related to complications of pregnancy. One hundred and eighteen of these were available for review and 92 were assessed as being directly due to anaesthesia. Spinal a...
Background: Most anaesthesia-related mortality that occurs in level 1 hospitals in South Africa is avoidable. Improving training during internship, and consequently the skills of community service officers, could lead to safer anaesthesia practices.
Objectives: The objectives of the study were to determine whether or not the timing of the anaesthes...
Global epidemiological data regarding outcomes for patients in intensive care units (ICUs) are scarce, but are important in understanding the worldwide burden of critical illness. We, therefore, did an international audit of ICU patients worldwide and assessed variations between hospitals and countries in terms of ICU mortality.
730 participating c...
The number of women dying as a result of spinal anaesthesia during caesarean section in South Africa is steadily increasing in the triennial reports of the National Committee on Confidential Enquiry into Maternal Deaths (NCCEMD). This article postulates some of the reasons behind this phenomenon. The concern is raised that spinal anaesthesia is bei...
The National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD) has assessed maternal deaths in South Africa since 1997. Reports have been produced since 1999, culminating in the latest triennial report (2008-2010). The anaesthetic chapter from this report is published in SAJAA to improve dissemination of the information. It is impor...
Aim. To assess the impact of HIV infection on maternal deaths in South Africa from 2008 to 2010. Method. Data extracted from the National Committee on Confidential Enquiries into Maternal Deaths database of maternal deaths, numbers of births from the District Health Information System (DHIS), and the estimated prevalence of HIV infection in the gen...
Caring for trauma patients is a dynamic process, and it is often necessary to move the trauma patient around the hospital to different locations. This study attempted to document the quality of observations performed on acute trauma patients as they moved through the hospital during the first 24 hours of care.
This study was a student elective and...
Current methods of crystalloid preload administration prior to spinal anaesthesia for elective caesarean section are relatively ineffective in preventing hypotension. This study examined the relevance of the timing of the fluid administered. Fifty women were randomly allocated to receive either 20 ml.kg –1 of crystalloid solution during 20 minutes...