Acta Anaesthesiologica Scandinavica

Gunnar Strandberg, Sten Walther, Christina Agvald Öhman, Miklós Lipcsey
BACKGROUND: Recent studies have reported substantially decreased hospital mortality for sepsis, but data arescarceron outcomes after hospital discharge.We studied mortality up to one year in Swedish intensive careunit (ICU) patients with and without sepsis. METHODS: Demographic and medical data for all registered adult general ICU patients admitted between 01-01-2008 and 30-09-2016were retrieved from the Swedish Intensive Care Registryand linked with the National Patient Registerfor comorbidity data and the Cause of Death Register for death dates...
March 30, 2020: Acta Anaesthesiologica Scandinavica
Anne Siri Johnsen, Martin Samdal, Stephen Sollid, Marius Rehn
BACKGROUND: Helicopter emergency medical services (HEMS) and search and rescue helicopters (SAR) aim to bring specialised personnel to major incidents and transport patients to definite care, but their operational pattern remains poorly described. We aim to describe the use of HEMS and SAR in major incidents in Norway and investigate the feasibility of retrospectively collecting uniform data from incident reports. METHODS: We searchedHEMS medical databasesfrom three HEMS and one SAR base in South-East Norwayfor the written reportsof incidents from 2000-2016...
March 30, 2020: Acta Anaesthesiologica Scandinavica
Takahiko Kaneko, Tsuneo Tatara, Munetaka Hirose
We thank Dr. Muggleton, Dr. Janson and Dr. Woodcock for their interest in our article.1 We appreciate them pointing out the effects of posture on transcapillary fluid distribution, leading to changes in dilution of albumin and red blood cells. In our study participants, the time from lying down on the operating table to the induction of anaesthesia was approximately 10 minutes, and the time from the induction of anaesthesia to immediately before hydroxyethyl starch (HES) infusion (i.e., 0 min) was also approximately 10 minutes...
March 30, 2020: Acta Anaesthesiologica Scandinavica
Jonas Österlind, Jakob Gerhardsson, Tomi Myrberg
BACKGROUND: Deterioration after ICU discharge may lead to readmission or even death.Interventions (e.g. critical care transition programs) have been developed to improve the clinical handover between the ICU and ward.We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) according to Cochrane Handbook andGrading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology to assessthe impact of these interventionson readmission and death (PROSPERO, no CRD42019121746)...
March 30, 2020: Acta Anaesthesiologica Scandinavica
L Cabrini, M Baiardo Redaelli, A Zangrillo
Tracheal intubation in patients at risk for secondary spinal cord injury is a difficult and risky procedure. Intubation in these situations becomes even more challenging when the patient is uncooperative and requires asleep intubation, thus limiting the possibilities of neurological monitoring and increasing the risk of neck manipulation. The use of somatosensory evoked potentials was suggested, and possibly the combination with motor evoked potentials may contribute to perform a comprehensive and documentable neuromonitoring...
March 30, 2020: Acta Anaesthesiologica Scandinavica
Hyoungouk Kim, Sung-Bin Chon, Seung Min Yoo, Himchan Choi, Kwang-Yeol Park
BACKGROUND: Some researchers have reported thatapplying compressioncloser to the maximum diameter of the left ventricle (Point_max.LV) isassociated with worse clinical outcomes, challenging its traditional position as optimum compression point (Point_optimum). By locatingthe mid-sternum (the actual compression site)in terms of Point_max.LV and its right ventricular equivalent (Point_max.RV),we aimed to determine its optimumhorizontal position associated with increased chances of returnofspontaneouscirculation (ROSC)...
March 20, 2020: Acta Anaesthesiologica Scandinavica
Tayyba Naz Aslam, Thomas Lass Klitgaard, Morten Hylander Møller, Anders Perner, Kristin Hofsø, Conni Skrubbeltrang, Hilde Iren Flaatten, Bodil Steen Rasmussen, Jon Henrik Laake
BACKGROUND: In caring for mechanically ventilated adults with acute respiratory distress syndrome (ARDS), clinicians are faced with an uncertain choice between controlled or spontaneous breathing modes. Observational data indicate considerable practice variation which may be driven by differences in sedation and mobilisation practices. The benefits and harms of either strategy are largely unknown. METHODS: A scoping review will be prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews...
March 11, 2020: Acta Anaesthesiologica Scandinavica
Peter Uhrbrand, Anne Phillipsen, Mikkel Mylius Rasmussen, Lone Nikolajsen
Background Patients are often prescribed opioids at discharge from hospital following surgery. Several studies have shown that a large number of patients do not taper off but continue to use opioids after surgery. Tapering plans and follow-up after discharge may reduce opioid consumption. Methods This is a single-centre, investigator-initiated, randomized, controlled trial. One hundred and ten preoperative opioid users, scheduled to undergo spine surgery at Aarhus University Hospital, Denmark, are randomized into two groups 1) an intervention group receiving an individually customized tapering plan at discharge combined with telephone counselling one week after discharge 2) a control group receiving no tapering plan or telephone counselling...
March 11, 2020: Acta Anaesthesiologica Scandinavica
Lars Mikael Broman, Anna Bernardson, Karin Bursell, Jan Wernerman, Urban Fläring, Inga Tjäder
BACKGROUND: General selenium supplementation to ICU patients in regions with Selenium rich soil does not improve outcomes. Still selenium supplementation may reduce morbidity and mortality in patients with low serum selenium concentration (S-Se) in selenium poor areas who respond to treatment. The primary aim of this observational study was to investigate S-Se in a selenium deficient region at time of intensive care admission, and in addition to monitor S-Se during high-dose selenium supplementation for safety...
March 9, 2020: Acta Anaesthesiologica Scandinavica
Jasper M Kampman, Jeroen Hermanides, Pascal R Q Boere, Markus W Hollmann
BACKGROUND: Different metrics exist to evaluate the impact of a paper. Traditionally, scientific citations are leading, but nowadays new, internet-based, metrics like downloads or Altmetric Attention Score receive increasing attention. We hypothesised a gap between these metrics, reflected by a divergence between scientific and clinical appreciation of anaesthesia literature. METHODS: We collected the top 100 most cited and the top 100 most downloaded articles in Acta Anaesthesiologica Scandinavica (AAS) and Anesthesia & Analgesia (A&A) published between 2014 and 2018...
March 9, 2020: Acta Anaesthesiologica Scandinavica
Lukas M Müller-Wirtz, Christine Godsch, Daniel I Sessler, Thomas Volk, Sascha Kreuer, Tobias Hüppe
BACKGROUND: Volatile anesthetics potentially trigger malignant hyperthermia crises in susceptible patients. We therefore aimed to identify preparation procedures for the Draeger Primus that minimize residual concentrations of desflurane and sevoflurane with and without activated charcoal filtration. METHODS: A Draeger Primus test workstation was primed with 7% desflurane or 2.5% sevoflurane for 2 hours. Residual anesthetic concentrations were evaluated with five preparation procedures, three fresh gas flow rates, and three distinct applications of activated charcoal filters...
March 9, 2020: Acta Anaesthesiologica Scandinavica
Pilvi Mannerkorpi, Lasse Raatiniemi, Kari Kaikkonen, Timo Kaakinen
The prognosis for patients with refractory cardiac arrest transferred to hospital during ongoing resuscitation is poor.1 Additionally in remote areas, the response time of the emergency medical services (EMS) may be long, which further decreases the likelihood of a good outcome. The most common reason for sudden death during cross-country skiing is acute coronary artery syndrome and subsequent ventricular fibrillation (VF).
March 9, 2020: Acta Anaesthesiologica Scandinavica
Wei Wei, Yanting Fan, Wei Liu, Tianyun Zhao, Hang Tian, Yingyi Xu, Yonghong Tan, Xingrong Song, Daqing Ma
BACKGROUND: This study is to investigate if non-intubated anaesthesia combined with paravertebral nerve block (PVNB) can enhance recovery in children undergoing video-assisted thoracic surgery (VATS). METHODS: A randomized controlled trial including 60 patients aged 3 to 8 years old who underwent elective VATS was performed. They were randomly assigned to receive non-intubated anaesthesia combined with PVNB or general anaesthesia with tracheal intubation (1:1 ratio)...
March 7, 2020: Acta Anaesthesiologica Scandinavica
Anna Milton, Anna Schandl, Iwo Soliman, Eva Joelsson-Alm, Mark van den Boogaard, Ewa Wallin, Camilla Brorsson, Ulrika Östberg, Kristine Latocha, Johanna Savilampi, Stinne Paskins, Matteo Bottai, Peter Sackey
BACKGROUND: Methods to identify patients at risk for incomplete physical recovery after intensive care unit (ICU) stay are lacking. Our aim was to develop a method for prediction of new-onset physical disability at ICU discharge. METHODS: Multinational prospective cohort study in ten general ICUs in Sweden, Denmark and the Netherlands. Adult patients with an ICU stay ≥12 hours were eligible for inclusion. Sixteen candidate predictors were analyzed with logistic regression for associations with the primary outcome; new-onset physical disability three months post-ICU, defined as a ≥10 score reduction in the Barthel Index compared to baseline...
February 21, 2020: Acta Anaesthesiologica Scandinavica
Niels Dalsgaard Nielsen
A significant subgroup of patients suffer from moderate or severe pain after total hip arthroplasty (THA). Regional analgesia has the potential to reduce postoperative pain and thereby spare patients from opioids, but regional analgesia of the hip is complicated as the area is innervated by multiple nerves. However, the nociceptors of the hip joint are primarily innervated by the obturator and femoral nerves. The effect of an obturator nerve block (ONB) on pain following THA has never been investigated. A femoral nerve block is known to reduce pain after THA, but is unfortunately accompanied by an increased risk of fall...
February 20, 2020: Acta Anaesthesiologica Scandinavica
Olav Lilleholt Schjørring, Thomas Lass Klitgaard, Anders Perner, Jørn Wetterslev, Theis Lange, Frederik Keus, Jon Henrik Laake, Matthew Morgan, Minna Bäcklund, Martin Siegemund, Katrin Maria Thormar, Bodil Steen Rasmussen
BACKGROUND: No solid evidence exists on optimal oxygenation targets in intensive care patients. The Handling Oxygenation Targets in the Intensive Care Unit (HOT-ICU) trial assesses the effects of a targeted arterial oxygen tension of 8 versus 12 kPa on 90-day mortality in acutely admitted adult patients with hypoxaemic respiratory failure. This article describes the detailed statistical analysis plan for the predefined outcomes and supplementary analyses in the HOT-ICU trial. METHODS: The trial will include 2,928 patients to be able to detect or reject a true 20% relative risk reduction in the primary outcome of 90-day all-cause mortality with an α of 5% and a β of 10%...
February 18, 2020: Acta Anaesthesiologica Scandinavica
Søren Marker, Marija Barbateskovic, Anders Perner, Jørn Wetterslev, Janus Christian Jakobsen, Mette Krag, Anders Granholm, Carl Thomas Anthon, Morten Hylander Møller
BACKGROUND: Acutely ill patients are at risk of stress-related gastrointestinal bleeding and prophylactic acid suppressants are frequently used. In this systematic review, we assessed the effects of stress ulcer prophylaxis (SUP) with proton pump inhibitors or histamine-2 receptor antagonists versus placebo or no prophylaxis in acutely ill hospitalised patients. METHODS: We conducted the review according to the PRISMA statement, the Cochrane Handbook, and GRADE, using conventional meta-analysis and trial sequential analysis (TSA)...
February 15, 2020: Acta Anaesthesiologica Scandinavica
Silvana Naredi
In this issue of Acta Anaesthesiologica Scandinavica, Chaix et al report results from a study where the effects of hypotension by general anaesthesia on cerebral perfusion is presented. The results given derive from a prospective observational study including patients requiring general anaesthesia during scheduled elective interventional neuroradiology procedures. The primary aim, according to the study, was to describe changes in cerebral perfusion in relation to hypotension measured with transcranial doppler (TCD)...
February 14, 2020: Acta Anaesthesiologica Scandinavica
Lena Modalsli, Kristin Liknes, Hans Flaatten
BACKGROUND: Percutaneous dilatational tracheostomy have been performed increasingly since its introduction in 1985 and is today one of the most commonly performed operative procedures in intensive care units. The aim of this study was to document patient reported outcomes from percutaneous dilatational tracheostomy after hospital discharge. METHODS: This study is based on retrospective extraction of data from the databases in the ICU at Haukeland University Hospital from 2004 to 2016...
February 14, 2020: Acta Anaesthesiologica Scandinavica
Henrik Sørensen
Protecting the brain during anaesthesia is paramount. We rely on the assumption that cerebral blood flow and oxygenation are adequate if blood pressure, blood flow, haemoglobin concentration, inspired oxygen fraction and metabolic demand are within the usual ranges. Dr. Lassen defined the static cerebral autoregulation curve in 1959,1 Dr. Aaslid gave insight to the dynamic autoregulation by transcranial Doppler ((TCD); 1982)2 while Dr. Jöbsis described cerebral oximetry ((NIRS); 1977).
February 14, 2020: Acta Anaesthesiologica Scandinavica
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