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Acta Anaesthesiologica Scandinavica

Robert Dutkiewicz, Henrik Zetterberg, Ulf Andreasson, Kaj Blennow, Bengt Nellgård
BACKGROUND: Mortality is high after an acute hip fracture (AHF) surgery. Are cognitive impairment and/or altered levels of Alzheimer's Disease (AD)-biomarkers in cerebrospinal fluid (CSF) predictors of mortality in AHF-patients, as retrospective studies indicate? METHODS: Prospective single-center study including 373 AHF-patients, operated in spinal anesthesia. Cognitive status was evaluated by Clinical Dementia Rating (CDR); CSF was analyzed for AD-biomarker concentrations (total tau (T-tau), phosphorylated tau (P-tau), amyloid beta ratio (Aβ42/Aβ40)...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Melanie E Kemper, Philipp K Buehler, Achim Schmitz, Claudine Gysin, Thomas Nicolai, Markus Weiss
PURPOSE: To determine whether bag mask ventilation between induction of anaesthesia and tracheal intubation in children with post-tonsillectomy bleeding reduces the incidence of hypoxaemia and difficult direct laryngoscopy without increasing perioperative respiratory complications. METHODS: Medical records, anaesthesia protocols and vital sign data were analysed from February 2005 to March 2017 for patients undergoing anaesthesia for surgical revision of bleeding tonsils...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Gitte Kingo Vesterlund, Thordis Thomsen, Morten Hylander Møller, Anders Perner
BACKGROUND: Depletion of the trace elements magnesium, phosphate and zinc is common in ICU patients. Observational studies have suggested worse outcome in patients with hypomagnesaemia, hypophosphatemia or hypozincaemia, but also inverse associations with worse outcome with too high serum levels. However, it is unclear whether data from randomised clinical trials (RCTs) confirm this. Accordingly, we plan to assess the balance between benefits and harms of supplementation as compared with placebo or no supplementation in adult ICU patients...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Eric Albrecht, Sina Grape, Jonathan Frauenknecht, Laurent Kilchoer, Kyle Robert Kirkham
BACKGROUND: Opioid-induced hyperalgesia is a state of nociceptive sensitization secondary to opioid administration. The objective of this meta-analysis was to test the hypothesis that high-dose intraoperative opioids contribute to increased postoperative pain and hyperalgesia when compared with a low-dose regimen in patients under general anaesthesia. METHODS: We followed the PRISMA statement guidelines and rated the certainty of evidence with the GRADE system. Only trials investigating pain outcomes and comparing two different dosages of the same intraoperative opioid in patients under general anaesthesia were included...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Leah B Templeton, Michael J Norton, Eduardo J Goenaga-Díaz, Douglas H McLaughlin, Michael E Zpadka, T Wesley Templeton
BACKGROUND: Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia. METHODS: We reviewed the charts of all infants ≤ 6 months who underwent brain MRI at our institution between January 1, 2013 and March 3, 2016...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Lina Gannam-Somri, Ibrahim Matter, Christopher Hadjittofi, Sonia Vaida, Husein Khalaily, Jalaa Hoosein, Mostafa Somri
BACKGROUND: Postoperative ileus is a frequent complication of gastrointestinal surgery under general anaesthesia. The aim of this study was to investigate whether combined epidural-general anaesthesia is associated with expedited gastrointestinal function recovery in neonates undergoing elective gastrointestinal surgery. METHODS: A randomised controlled trial including sixty neonates who underwent gastrointestinal surgery at a university hospital was performed. Thirty neonates received combined epidural-general anaesthesia (CEGA), and thirty neonates received general anaesthesia (GA) alone...
September 11, 2019: Acta Anaesthesiologica Scandinavica
Markus B Skrifvars, Anders Aneman
Maintaining an adequate cerebral oxygenation appears intuitively as a crucial goal for the acute care of the critically injured patient1 . The concept of avoiding secondary brain injury represents a corner stone of modern neurointensive care and these principles should ideally be applied also during the pre-hospital phase and patient transport. Delivery of oxygen to the brain is governed by the cerebral perfusion pressure largely determined by mean arterial blood pressure (in the absence of significant intracranial hypertension) and the arterial blood oxygen content, partly reflected by peripheral pulse oximetry1 ...
September 10, 2019: Acta Anaesthesiologica Scandinavica
Renske Wiersema, Jacqueline Koeze, Ruben J Eck, Thomas Kaufmann, Bart Hiemstra, Geert Koster, Casper F M Franssen, Suvi T Vaara, Frederik Keus, Iwan C C Van der Horst
BACKGROUND: Acute Kidney Injury (AKI) in critically ill patients is associated with a markedly increased morbidity and mortality. The aim of this study was to establish the predictive value of clinical examination for AKI in critically ill patients. METHODS: This was a sub-study of the SICS-I, a prospective observational cohort study of critically ill patients acutely admitted to the Intensive Care Unit (ICU). Clinical examination was performed within 24 hours of ICU admission...
August 29, 2019: Acta Anaesthesiologica Scandinavica
Anna Lybeck, Tobias Cronberg, Ola Borgquist, Joachim Pascal Düring, Gustav Mattiasson, David Piros, Sofia Backman, Hans Friberg, Erik Westhall
BACKGROUND: Continuous EEG-monitoring (cEEG) in the ICU is recommended to assess prognosis and detect seizures after cardiac arrest but implementation is often limited by the lack of EEG-technicians and experts. The aim of the study was to assess ICU physicians ability to perform preliminary interpretations of a simplified cEEG in the post cardiac arrest setting. METHODS: Five ICU physicians received training in interpretation of simplified cEEG - total training duration 1 day...
August 29, 2019: Acta Anaesthesiologica Scandinavica
Anders Granholm, Theis Lange, Carl Thomas Anthon, Søren Marker, Mette Krag, Tine Sylvest Meyhoff, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Joerg C Schefold, Jørn Wetterslev, Anders Perner, Morten Hylander Møller
BACKGROUND: The aetiology and risk factors for clinically important gastrointestinal bleeding (CIB) in adult ICU patients may differ according to onset of CIB, which could affect the balance between benefits and harms of stress ulcer prophylaxis (SUP). METHODS: We assessed the time to CIB in the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. We assessed if associations between baseline characteristics including allocation to SUP and CIB changed during time in the ICU, specifically in the later (after day two) compared to the earlier (first two days) period, using Cox models adjusted for SAPS II and allocation to SUP...
August 23, 2019: Acta Anaesthesiologica Scandinavica
M Vester-Andersen, L H Lundstrøm, M H Møller
BACKGROUND: Emergency abdominal surgery carries a considerable risk of mortality and postoperative complications, including pulmonary complications. In major elective surgery, epidural analgesia reduces mortality and pulmonary complications. We aimed to evaluate the association between epidural analgesia and mortality in emergency abdominal surgery. METHODS: In this population-based cohort study with prospective data collection, we included adults undergoing emergency abdominal laparotomy or laparoscopy between 1 January 2009 and 31 December 2010 at 13 Danish hospitals...
August 22, 2019: Acta Anaesthesiologica Scandinavica
Vassilis Athanassoglou, Hannah Hughes-Jones, George Hadjipavlou, Wendy Hl Teoh, Michael S Kristensen, Richard Vanner
BACKGROUND: Knowing the likely depth to the airway before emergency cricothyroidotomy may improve success in cases where it cannot be measured. Our aim was to measure the depth to the airway at the cricothyroid membrane by ultrasound in a large group of adult patients. METHOD: Prospective, observational study in two centres, Oxford and Gloucester. Patients presenting for a large variety of surgical operations were studied. Patients under 18 years old; pregnant; critically ill; had a history of neck surgery not included...
August 22, 2019: Acta Anaesthesiologica Scandinavica
B Wódarski, R Chutkowski, J Banasiewicz, K Moorthi, S Wójtowicz, M Malec-Milewska, G Iohom
BACKGROUND: Shivering during caesarean section under spinal anaesthesia is a common phenomenon. It could not only alter patient's physiology by increasing oxygen consumption but also affect the parturient's experience of childbirth. Shivering is thought to be associated with intraoperative hypothermia, but the risk factors and exact mechanism remain unclear. METHODS: We conducted a prospective, observational study to examine the potential risk factors for intraoperative shivering, including anxiety levels...
August 22, 2019: Acta Anaesthesiologica Scandinavica
Benjamin Grossmann, Andreas Nilsson, Folke Sjöberg, Lars Bernfort, Lena Nilsson
BACKGROUND: Patient-controlled sedation (PCS) with propofol accompanied by a bedside nurse anaesthetist is an alternative sedation method for endoscopic procedures compared with midazolam administered by a nurse or endoscopist. Increasing costs in health care demands an economic perspective when introducing alternative methods. We applied a hospital perspective on a cost analysis comparing different methods of sedation and the resource use that were expected to affect cost differences related to the sedation...
August 22, 2019: Acta Anaesthesiologica Scandinavica
Michelle S Chew, Marius Rehn, Klaus T Olkkola, Kristinn Örn Sverrisson, Arvi Yli-Hankala, Morten Hylander Møller
The Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) Clinical Practice Committee (CPC) endorses the recent DASAIM/DSIT guideline for prevention of rhabdomyolysis-induced acute kidney injury. However, we emphasize the low quality of evidence with only weak recommendations for all interventions, highlighting that further research is very likely to have an important impact on the confidence in the estimate of effect and is likely to change the estimates. This article is protected by copyright...
August 22, 2019: Acta Anaesthesiologica Scandinavica
S R Rasmussen, K Kandler, R V Nielsen, P C Jakobsen, N N Knudsen, M Ranucci, J C Nilsson, H B Ravn
BACKGROUND: Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL. min-1. m-2 ), during cardiopulmonary bypass on kidney function. METHODS: Patients undergoing coronary artery bypass graft surgery ± valve repair were included n=1968. Oxygen delivery was monitored during cardiopulmonary bypass...
August 22, 2019: Acta Anaesthesiologica Scandinavica
Cecilia Klingberg, Daniel Kornhall, Dan Gryth, Andreas J Krüger, Hans Morten Lossius, Mikael Gellerfors
BACKGROUND: In prehospital care, pre-intubation checklists (PICL) are widely implemented as a safety measure and guidelines support their use. However, the true value of PICL among experienced airway providers is unknown. This study aims to explore possible benefits and disadvantages of pre-intubation checklists in the prehospital setting. METHODS: We performed a subgroup analysis of a prospective, observational, multicentre study on prehospital advanced airway management in the Nordic countries between May 2015 and November 2016...
August 22, 2019: Acta Anaesthesiologica Scandinavica
Oddvar Uleberg
Morbidity and mortality following traumatic injuries constitute a substantial global health challenge. This thesis aimed to describe the current challenges of trauma on a national, regional and individual level. Study 1 was a cross-sectional study including all forty-one Norwegian hospitals receiving injured patients in 2011. Over time there was a substantial reduction of number of contributing hospitals, and many hospitals received a small number of patients. Acute care hospitals contributed substantially in the evaluation of trauma patients...
August 7, 2019: Acta Anaesthesiologica Scandinavica
Keti Dalla, Odd Bech-Hanssen, Sven-Erik Ricksten
BACKGROUND: In this observational study, the effects of norepinephrine-induced changes in mean arterial pressure (MAP) on right ventricular (RV) systolic function, afterload and pulmonary haemodynamics were studied in septic shock patients. We hypothesised that RV systolic function improves at higher doses of norepinephrine/MAP levels. METHODS: Eleven patients with septic shock requiring norepinephrine after fluid resuscitation were included <24 hours after ICU arrival...
July 30, 2019: Acta Anaesthesiologica Scandinavica
Andreas Bender Jonsson, Sofie Louise Rygård, Jacob Anhøj, Pär Ingemar Johansson, Anders Perner, Morten Hylander Møller
BACKGROUND: Red blood cell (RBC) transfusion is common in the intensive care unit (ICU). Recent trials have shown that a restrictive transfusion strategy is safe in most patients, and recent guidelines recommend such a strategy in most ICU patients. It is unknown if this has translated into a change in clinical practice. METHODS: We conducted a population-based register study of RBC transfusions in ICUs in the Danish Capital Region between 1st of January 2011 and 31st of December 2016 by linking data from the regional blood bank and the Danish Intensive Care Database...
July 30, 2019: Acta Anaesthesiologica Scandinavica
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