Journals Acta Anaesthesiologica Scandin...

Acta Anaesthesiologica Scandinavica
Jaime Retamal, L Felipe Damiani, Roque Basoalto, Martín Hernán Benites, Alejandro Bruhn, Anders Larsson, Guillermo Bugedo
Using protective mechanical ventilation strategies with low tidal volume is usually accompanied by an increment of respiratory rate to maintain adequate alveolar ventilation. However, there is no robust data that support the safety of a high respiratory rate concerning ventilator-induced lung injury. Several experimental animal studies have explored the effects of respiratory rate over lung physiology, using a wide range of frequencies and different models. Clinical evidence is scarce and restricted to the physiological impact of increased respiratory rate...
April 12, 2021: Acta Anaesthesiologica Scandinavica
Carl Thomas Anthon, Praleene Sivapalan, Anders Granholm, Frédéric Pène, Kathryn Puxty, Anders Perner, Morten Hylander Møller, Lene Russell
BACKGROUND: Prophylactic platelet transfusions are frequently used to prevent bleeding in hospitalised patients with thrombocytopenia. Recommendations regarding the use of prophylactic platelet transfusions in non-haematological patients are based on extrapolations, observational studies and expert opinions, and transfusion with platelets has been associated with adverse effects. We aim to assess the overall benefits and harms of prophylactic platelet transfusions in hospitalised patients with thrombocytopenia...
April 11, 2021: Acta Anaesthesiologica Scandinavica
Mathias A Christensen, Jacob Steinmetz, George Velmahos, Lars S Rasmussen
BACKGROUND: Supplemental oxygen (SO) is one of the most commonly administered drugs in trauma patients and is recommended by guidelines. However, evidence supporting uniform administration is sparse, and excess oxygen use has been shown to be harmful in other patient populations. We hypothesized that SO may be harmful in patients with oxygen saturation>97%. METHODS: Patients with available information on SO-therapy in the American Trauma Quality Improvement Program 2017 database were included...
April 11, 2021: Acta Anaesthesiologica Scandinavica
Eliisa Nissilä, Marja Hynninen, Matti Reinikainen, Stepani Bendel, Raili Suojaranta, Anna-Maija Korhonen, Markku Suvela, Pekka Loisa, Tadeusz Kaminski, Johanna Hästbacka
BACKGROUND: Reports of the prevalence and impact of hazardous alcohol use among intensive care unit (ICU) patients are contradictory. We aimed to study the prevalence of hazardous alcohol use among ICU patients and its association with ICU length of stay (LOS) and mortality. METHODS: Finnish ICUs have been using the AUDIT-C (Alcohol use disorder identification test-consumption) to evaluate and record patients' alcohol use into the Finnish Intensive Care Consortium's Database (FICC)...
April 11, 2021: Acta Anaesthesiologica Scandinavica
Ellinor Wisén, Abdulrahman Almazrooa, Lena Sand Bown, Magnus Rizell, Sven-Erik Ricksten, Andreas Kvarnström, Kristina Svennerholm
BACKGROUND: Postoperative organ complications in liver resection surgery are not uncommon. This prospective observational pilot study was performed to evaluate the incidence, degree and timing of myocardial, renal and intestinal injury in patients undergoing liver resection surgery using the low CVP (LCVP) technique and the Pringle maneuver. METHODS: Blood samples were obtained before, during and after elective liver resection until postoperative day (POD) 5. High sensitive troponin T (hs-TnT), serum creatinine, urea, intestinal fatty acid binding protein (I-FABP), D-lactate, arterial lactate, portal lactate, amylase, as well as urine N-acetyl-ß-D-glucosaminidase (NAG), were analysed...
April 3, 2021: Acta Anaesthesiologica Scandinavica
Dagmar Mostad, Pål Klepstad, Turid Follestad, Hilde Pleym
BACKGROUND: In general anaesthesia practice a fresh gas flow of ≥ 0,5L/min is usually applied. Automated gas delivery devices are developed to reduce volatile anaesthetic consumption by limiting gas flow. This study aimed to compare desflurane consumption between automated gas control devices compared to conventional low flow anaesthesia in the Flow-I and Aisys anaesthesia machines, and to compare desflurane consumption between the two automated gas delivery devices. We hypothesised that desflurane consumption would be lower with automated gas delivery compared to conventional low flow anaesthesia, and that desflurane consumption could differ between the different gas delivery devices...
March 31, 2021: Acta Anaesthesiologica Scandinavica
Juho O Jämsä, Kimmo H Uutela, Anna-Maija Tapper, Lasse Lehtonen
BACKGROUND: Alarm fatigue is hypothesised to be caused by vast amount of patient monitor alarms. Objectives were to study the frequency and types of patient monitor alarms, to evaluate alarm fatigue, and to find unit specific alarm threshold values in a university hospital emergency department. METHODS: We retrospectively gathered alarm data from 9 September to 6 October 2019, in Jorvi Hospital Emergency department, Finland. The department treats surgical, internal and general medicine patients aged 16 and older...
March 31, 2021: Acta Anaesthesiologica Scandinavica
Marie Oxenbøll Collet, Gitte Meldgaard Nielsen, Benita Bang, Eva Laerkner, Susanne Fischer, Anne Langvad, Linette Thorn, Theis Lange, Ingrid Egerod
BACKGROUND: Rocking chair therapy has been explored in patients with dementia to promote the feeling of relaxation, but not in Intensive Care Unit (ICU) patients with delirium. AIM: The aim is to investigate the effect of a chair with or without rocking motion on the duration of delirium and intensity of agitation in critically ill patients admitted to the ICU. DESIGN: This is an investigator-initiated pragmatic, multicentre, parallel-grouped, centrally randomised, stratified, data analyst-blinded trial...
March 18, 2021: Acta Anaesthesiologica Scandinavica
Linus Lilja, Meena Thuccani, Sara Joelsson, Josefin Nilsson, Petra Redfors, Peter Lundgren, Christian Rylander
BACKGROUND: Anoxic-ischemic brain injury is the most common cause of death after cardiac arrest. Robust methods to detect severe injury with a low false positive rate for poor neurological outcome include the Pupillary Light Reflex (PLR) and Somatosensory Evoked Potentials (SSEP). The PLR can be assessed manually or with automated pupillometry which provides the Neurological Pupil index (NPi). We aim to describe the interrelation between NPi values and the absence of SSEP cortical response, and to evaluate the capacity of NPi to predict the absence of cortical SSEP response in comatose patients after cardiac arrest...
March 18, 2021: Acta Anaesthesiologica Scandinavica
Girish P Joshi, Henrik Kehlet
The use of gabapentinoids for perioperative pain management after total knee arthroplasty has been the subject of 9 systematic reviews and meta-analyses. A critical analysis of the clinical aspects of the methodology of these publications shows major flaws which limit the interpretation for the recommended use of perioperative gabapentinoids in pain management for unilateral primary total knee arthroplasty. Consequently, readers and authors of systematic reviews and meta-analyses should critically assess the clinical aspects of the included studies...
March 17, 2021: Acta Anaesthesiologica Scandinavica
Annette Robertsen, Hans Flaatten
It has been known for decades that survivors after intensive care frequently are prone to a number of time-limited or even chronic problems in the months and years after critical illness. Cullen and co-workers 45 years ago published one of the first papers with focus on the ICU survivors 1 . After twelve months only 12% of the ICU patients had fully recovered to their pre-ICU level, which was less than 50% of the one-year survivors at this time.
March 17, 2021: Acta Anaesthesiologica Scandinavica
Sivagowry R Mørk, Christian A Frederiksen, Roni R Nielsen, Emil Lichscheidt, Steffen Christensen, Jacob R Greisen, Mariann Tang, Henrik Ø Vase, Brian B Løgstrup, Søren Mellemkjaer, Henrik S Wiggers, Henning Mølgaard, Steen H Poulsen, Christian J Terkelsen, Hans Eiskjaer
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is commonly used to provide haemodynamic support for patients with severe cardiac failure. However, timing ECMO weaning remains challenging. We aimed to examine if an integrative weaning approach based on pre-defined haemodynamic, respiratory and echocardiographic criteria is associated with successful weaning. METHODS: All patients weaned from ECMO between April 2017 and April 2019 at Aarhus University Hospital, Denmark, were consecutively enrolled...
March 17, 2021: Acta Anaesthesiologica Scandinavica
Mette Dokken, Tone Rustøen, Lien My Diep, Frode Even Fagermoen, Rakel Iren Huse, Gudny Abrahamsen Rosland, Ingrid Egerod, Gunnar Kristoffer Bentsen
BACKGROUND: Analgesics and sedatives are key elements to reduce physiological and psychological stress associated with treatment in paediatric intensive care. Prolonged drug use may induce tolerance and development of iatrogenic withdrawal syndrome (IWS) during the tapering phase. Our primary aim was to describe the prevalence of IWS among critically ill ventilated patients in two Norwegian paediatric intensive care units (PICUs), and secondary to investigate what motivated bedside nurses to administer additional drug doses...
March 16, 2021: Acta Anaesthesiologica Scandinavica
Joakim Norderfeldt, Andreas Liliequist, Claes Frostell, Christofer Adding, Per Agvald, Maria Eriksson, Per-Arne Lönnqvist
INTRODUCTION: Critically ill Covid-19 pneumonia patients are likely to develop the sequence of acute pulmonary hypertension, right ventricular (RV) strain, and eventually RV failure due to known pathophysiology (endothelial inflammation plus thrombo-embolism) that promotes increased pulmonary vascular resistance and pulmonary artery pressure. This study aimed to investigate the occurrence of acute pulmonary hypertension (aPH) as per established trans-thoracic echocardiography (TTE) criteria in Covid-19 patients receiving intensive care and to explore whether short-term outcomes are affected by the presence of aPH...
March 16, 2021: Acta Anaesthesiologica Scandinavica
Emily Brück, Anna Svensson-Raskh, Jacob W Larsson, April S Caravaca, Alessandro L Gallina, Eberhardson Michael, Peter V Sackey, Peder S Olofsson
PURPOSE: Physical impairment after critical illness is recognized as a part of the post-intensive care syndrome (PICS). About one third of intensive care unit (ICU) survivors suffer from long-term physical disability, yet the underlying pathophysiological mechanisms remains poorly understood. The pro-inflammatory alarmin, high mobility group box 1 (HMGB1), promotes muscle dysfunction in experimental models, and HMGB1 stays elevated in some patients after ICU discharge. Accordingly, we investigated the relationship between HMGB1 plasma levels and physical performance in ICU survivors...
March 16, 2021: Acta Anaesthesiologica Scandinavica
Yair Binyamin, Philip Heesen, Sharon Orbach-Zinger, Yaacov Gozal, David Halimi, Amit Frenkel, Alexander Ioscovich
BACKGROUND: We set out to examine incidence of chronic headache and back pain in women with PDPH after accidental dural puncture during labor. METHODS: Chronic headache, backache and disability were assessed 18-24 months postpartum. Women with PDPH treated with epidural blood patch (PDPH-EBP) were identified and matched with women who had a PDPH without epidural blood patch (PDPH-no EBP), with women with uncomplicated epidural analgesia and with women without epidural analgesia...
March 16, 2021: Acta Anaesthesiologica Scandinavica
Kelika Prakash, Tanvi Meshram, Priyanka Jain
BACKGROUND: Midazolam reduces postoperative nausea and vomiting (PONV) when compared to a placebo or when used as an adjuvant to other antiemetics. The present study was designed to compare midazolam with a combination of dexamethasone-ondansetron in preventing PONV. METHODS: One hundred and twenty patients undergoing laparoscopic surgeries having 2 or more risk factors for PONV (simplified Apfel score) were randomised into two groups of 60 each. Patients in group D received 8mg dexamethasone and 4 mg ondansetron for PONV prophylaxis while those in group M received 2 mg midazolam towards the end of surgery...
March 8, 2021: Acta Anaesthesiologica Scandinavica
Giacomo Monti, Carlo Leggieri, Evgeny Fominskiy, Anna Mara Scandroglio, Sergio Colombo, Margherita Tozzi, Elena Moizo, Milena Mucci, Martina Crivellari, Marina Pieri, Francesca Guzzo, Simona Piemontese, Rebecca De Lorenzo, Valentina Da Prat, Monica Fedrizzi, Carolina Faustini, Martina Di Piazza, Francesca Conte, Rosalba Lembo, Antonio Esposito, Lorenzo Dagna, Giovanni Landoni, Alberto Zangrillo
BACKGROUND: COVID-19 disease can lead to severe functional impairments after discharge. We assessed the quality of life of invasively ventilated ARDS COVID-19 survivors. METHODS: We carried out a prospective follow-up study of the patients admitted to the Intensive Care Units (ICUs) of a teaching hospital. Patients affected by COVID-19 ARDS who required invasive ventilation and were successfully discharged home were assessed through telephone administration of validated tests...
March 2, 2021: Acta Anaesthesiologica Scandinavica
Cecilia Glimelius Petersson, Liselotte Jakobsson, Albert Westergren, Ingegerd Bergbom
BACKGROUND: Follow-up for heterogeneous intensive care patients presents challenges for rehabilitation interventions and outcome measurements. The aim was to describe and explore characteristics and determinants for visiting/not visiting a nurse-led clinic (NLC) at different time-points, and to describe physical and mental health (HRQoL) over time. METHODS: Patients with a length of stay (LOS) of ≥72 hours, discharged from a general intensive care unit 2004-2014, who participated in a 6-month follow-up programme offering visits to NLC at 2 and 6 months were included...
March 1, 2021: Acta Anaesthesiologica Scandinavica
Mik Wetterslev, Peter Karl Jacobsen, Christian Hassager, Christian Jøns, Niels Risum, Steen Pehrson, Anders Bastiansen, Anne Sofie Andreasen, Klaus Tjelle Kristiansen, Morten H Bestle, Thomas Mohr, Hasse Møller-Sørensen, Anders Perner
BACKGROUND: Coronavirus disease 2019 (COVID-19) may be associated with cardiac arrhythmias in hospitalised patients, but data from the ICU setting are limited. We aimed to describe the epidemiology of cardiac arrhythmias in ICU patients with COVID-19. METHODS: We conducted a multicenter, retrospective cohort study including all ICU patients with an airway sample positive for severe acute respiratory syndrome corona-virus 2 from March 1st to June 1st in the Capital Region of Denmark (1...
February 27, 2021: Acta Anaesthesiologica Scandinavica
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