Acta Anaesthesiologica Scandinavica

Sigurdur Benediktsson, Claudia Hansen, Attila Frigyesi, Thomas Kander
BACKGROUND: It is well known that low platelet count on admission to intensive care units (ICU) is associated with increased mortality. However, it is unknown whether prothrombin time (PT-INR) and activated partial thromboplastin time (APTT) on admission correlate with mortality and organ failure. Therefore, the aim of this study was to investigate if PT-INR and APTT at admission can predict outcome in the critically ill patient after adjusting for severity of illness measured with Simplified Acute Physiology Score 3 (SAPS 3)...
January 3, 2020: Acta Anaesthesiologica Scandinavica
P Roivainen, M H Hoikka, L Raatiniemi, T Silfvast, T I Ala-Kokko, M Kääriäinen
BACKGROUND: The increased workload in emergency medical services (EMS) is a global phenomenon in welfare states. It has been suggested that telephone triage by nurses may reduce the increasing use of EMS services, by directing patient flow to appropriate care. This study aimed to investigate whether, after an emergency medical communication centre (EMCC) provider assessed risk, a telephone nurse could assess the patient's needs and guide patients to social and health care services in non-urgent cases...
January 2, 2020: Acta Anaesthesiologica Scandinavica
Carolyn F Weiniger, Avital Cohen, Boris Aptekman, Brendan Carvalho
BACKGROUND: High body mass index (BMI) can predict difficult neuraxial block, however fat distribution may also be important. The primary study aim was to identify body habitus and fat distribution measurements that correlated with ultrasound measured epidural depth. We hypothesized that measurements such as midarm and subscapular fatpad thicknesses and length of cervical spine may correlate better with ultrasound measured epidural depth than a global measure of BMI. METHODS: Prospective IRB approved study of term pregnant women requiring neuraxial block...
December 31, 2019: Acta Anaesthesiologica Scandinavica
Myron M Kwapisz, Blaine Kent, Claudio DiQuinzio, Jean-François LeGare, Shirley Garnett, Willi Swyer, Sara Whynot, Heather Mingo, Matthias Scheffler
BACKGROUND: Perioperative blood loss is a major contributor to morbidity and mortality in cardiac surgery. Plasma fibrinogen levels play an essential role in hemostasis and deplete quickly during hemorrhage. The objective of the study was to determine whether prophylactic fibrinogen concentrate administration lowers overall blood product transfusion requirements in high-risk cardiac surgery in patients with low fibrinogen plasma levels. METHODS: The study was performed in a prospective, randomized and double-blinded design...
December 31, 2019: Acta Anaesthesiologica Scandinavica
Neil D Hauser, Yu-Ping Chen, Britta S von Ungern-Sternberg
BACKGROUND: To document the evolution of the Peripherally Inserted Central Catheter service at Princess Margaret Hospital, now Perth Children's Hospital. METHODS: Between January 2012 and June 2013 patients referred to Anaesthesia for a Peripherally Inserted Central Catheter were prospectively followed up. A repeat audit was conducted between January 2015 and June 2016, following the introduction of a number of measures aimed at improving the service. RESULTS: Audit 1: 200 Peripherally Inserted Central Catheter insertions were attempted in 138 patients...
December 30, 2019: Acta Anaesthesiologica Scandinavica
Birgitte Yndgaard Simonsen, Pernille Skovby, Marianne Lisby
BACKGROUND: Emergence Delirium (ED) is a common complication from anesthesia. Although ED has a short duration, detection is important due to the risk that ED poses for post-operative complications in the child. The Pediatric Anesthesia Emergence Delirium (PAED) scale has been translated into Danish, but it has not yet been validated. The aim of this study was to investigate the inter-rater reliability, criterion validity and responsiveness of the Danish version of the PAED scale as well as to determine the prevalence of ED...
December 30, 2019: Acta Anaesthesiologica Scandinavica
Andreas Bender Jonsson, Anders Granholm, Sofie Louise Rygård, Lars Broksø Holst, Morten Hylander Møller, Anders Perner
BACKGROUND: Use of a lower haemoglobin (Hb) threshold to guide red blood cell (RBC) transfusion is now generally recommended in critically ill patients, but uncertainty remains regarding the optimal HB-threshold for RBC transfusion in patients of different ages. METHODS: We conducted a post-hoc analysis of 998 patients with septic shock and anaemia randomised to RBC transfusion at a Hb-threshold of 7 g/dl [4.3 mmol/l] vs. 9 g/dl [5.6 mmol/l] in the Transfusion Requirements in Septic Shock (TRISS) trial...
December 30, 2019: Acta Anaesthesiologica Scandinavica
Akira Mukai, Koichi Suehiro, Aya Kimura, Sae Kodama, Katsuaki Tanaka, Takashi Mori, Kiyonobu Nishikawa
BACKGROUND: This study investigated the ability of stroke volume variation (SVV) during deep breathing to discriminate fluid responders among spontaneously breathing patients. METHODS: Thirty patients undergoing general anaesthesia were enrolled and assessed before anaesthetic induction. Haemodynamic variables, including stroke volume (SV) and SVV, were measured using the ClearSight system during normal breathing. After these measurements, each patient was required to maintain deep breathing (6 breaths min-1 ) and haemodynamic variables were recorded...
December 29, 2019: Acta Anaesthesiologica Scandinavica
Lenneke E M Haas, Fabian Termorshuizen, Dylan W de Lange, Diederik van Dijk, Nicolette F de Keizer
BACKGROUND: The number of very elderly ICU patients (abbreviated to VOPs; ≥80 years) with sepsis increases. Sepsis was redefined in 2016 (sepsis 3.0) using the quick SOFA (qSOFA) score. Since then, multiple studies have validated qSOFA for prognostication in different patient categories, but the prognostic value in VOPs with sepsis is still unknown. METHODS: Retrospective cohort study including patients admitted to Dutch ICUs with sepsis, in the period 2012 to 2016, evaluating the outcome and the performance of qSOFA, an extended qSOFA model, SOFA, SAPS II and APACHE IV for hospital mortality...
December 29, 2019: Acta Anaesthesiologica Scandinavica
Isabelle Chaix, Elsa Manquat, Ngai Liu, Maria Chiara Casadio, Pierre-Olivier Ludes, Audrey Tantot, Jean-Paul Lopes, Cyril Touchard, Joaquim Mateo, Alexandre Mebazaa, Etienne Gayat, Fabrice Vallée
INTRODUCTION: During anesthesia, decreases in mean arterial pressure (MAP) are common but the impact on possible cerebral hypoperfusion remains a matter of debate. We evaluated cerebral perfusion in patients with or without cardiovascular comorbidities (Hi-risk vs Lo-risk) during induction of general anesthesia and during hypotensive episodes. METHODS: Patients scheduled for neuroradiology procedure using standardized target-controlled Propofol-Remifentanil infusion were prospectively included...
December 28, 2019: Acta Anaesthesiologica Scandinavica
Federico Bilotta, Bjoern Weiss, Bruno Neuner, Sylvia Kramer, César Aldecoa, Gabriella Bettelli, Robert D Sanders, Simon M Delp, Claudia D Spies
BACKGROUND: Postoperative delirium is a severe brain dysfunction. Although data indicates a high relevance, no survey has investigated the routine practice to monitor delirium outside the ICU setting after surgery. Prior to publishing of the new ESA guidelines on postoperative delirium, a international survey was conducted to assess current practice. METHODS: ESA-endorsed online survey; Trial Registration: NCT-identifier: 02513537 RESULTS: In total 566 respondents from 62 countries accessed, and 564 (99...
December 28, 2019: Acta Anaesthesiologica Scandinavica
Robert G Hahn
The distribution and elimination kinetics of the water volume in infusion fluids can be studied by volume kinetics. The approach is a modification of drug pharmacokinetics, which uses repeated measurements of blood hemoglobin and urinary excretion as input variables in (usually) a two-compartment model with expandable walls. Study results show that crystalloid fluid has a distribution phase that gives these fluids a plasma volume expansion amounting to 50-60% of the infused volume as long as the infusion lasts, while the fraction is reduced to 15-20% within 30 min after the infusion ends...
December 20, 2019: Acta Anaesthesiologica Scandinavica
Rasmus E Christensen, Josefine S Baekgaard, Lars S Rasmussen
No abstract text is available yet for this article.
December 18, 2019: Acta Anaesthesiologica Scandinavica
Cecilie Petersen, Frederik C Loft, Eske K Aasvang, Morten Vester-Andersen, Lars S Rasmussen, Jørn Wetterslev, Lars N Jorgensen, Robin Christensen, Christian S Meyhoff
BACKGROUND: Myocardial injury after non-cardiac surgery occurs in a high number of patients, resulting in increased mortality in the postoperative period. The use of high inspiratory oxygen concentrations may cause hyperoxia, which is associated with impairment of coronary blood flow. Furthermore, the surgical stress response increases reactive oxygen species which is involved in several perioperative complications including myocardial injury and death. Avoidance of hyperoxia and substitution of reactive oxygen species scavengers may be beneficial...
December 17, 2019: Acta Anaesthesiologica Scandinavica
Peter Frykholm, Marcus Veijo Saastamoinen, Jan Larsson
We thank Dr J. Nielsen and Dr K-S Sim for their interest in our article 'Checking mask ventilation before neuromuscular block: a nation-wide survey of anaesthetists´ attitudes and thinking´. As Nielsen and Lim point out, several methods may be used for assessment of the feasibility of bag-mask ventilation. We agree that capnography is the only objective measurement available in routine clinical practice.
December 16, 2019: Acta Anaesthesiologica Scandinavica
Luca Cabrini, Martina Baiardo Redaelli, Martina Filippini, Evgeny Fominskiy, Laura Pasin, Margherita Pintaudi, Valentina Paola Plumari, Alessandro Putzu, Carmine D Votta, Ottavia Pallanch, Lorenzo Ball, Giovanni Landoni, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: tracheal intubation in patients at risk for secondary spinal cord injury is potentially difficult and risky. OBJECTIVES: to compare tracheal intubation techniques in adult patients at risk for secondary cervical spinal cord injury undergoing surgery. Primary outcome was first-attempt failure rate. Secondary outcomes were time to successful intubation and procedure complications. DESIGN: systematic review and meta-analysis of RCTs with trial sequential analysis (TSA)...
December 14, 2019: Acta Anaesthesiologica Scandinavica
James R Nielsen, Kar-Soon Lim
Saastamoinen's recent survey about test ventilation has broader implications: it also provides real-world data on how anaesthetists evaluate mask ventilation. Test ventilation may be optional, but all of us must assess the result when we mask-ventilate. How do our colleagues do that?
December 13, 2019: Acta Anaesthesiologica Scandinavica
Wietze Pasma, Linda M Peelen, Stefanie van den Broek, Stef van Buuren, Wilton A van Klei, Jurgen C de Graaff
BACKGROUND: Intraoperative blood pressure has been suggested as a key factor for safe pediatric anesthesia. However, there is not much insight into factors that discriminate between children with low and normal pre-incision blood pressure. Our aim was to explore if children who have a low blood pressure during anesthesia are different than those with normal blood pressure. The focus of the present study was on the pre-incision period. METHODS: This retrospective study included pediatric patients undergoing anesthesia for non-cardiac surgery at a tertiary pediatric university hospital, between 2012 and 2016...
December 12, 2019: Acta Anaesthesiologica Scandinavica
Emilie K Jensen, Lone M Poulsen, Ole Mathiesen, Stine Estrup
BACKGROUND: Numerous patients experience long-term impairments after discharge from the intensive care unit (ICU), including physical, psychological and cognitive deficiencies. This study aims to investigate knowledge and handling of post-intensive care impairments among Danish doctors and nurses in the medical and surgical wards. METHODS: An electronic questionnaire survey was distributed to consultants and development nurses, head nurses and assistant head nurses at departments of abdominal surgery and internal medicine of hospitals with an ICU in the Region Zealand of Denmark...
December 12, 2019: Acta Anaesthesiologica Scandinavica
Martin Lehmann, Beatrice Oehler, Jonas Zuber, Malzahn Uwe, Thorsten Walles, Ralf M Muellenbach, Norbert Roewer, Markus Kredel
BACKGROUND: Regional ventilation of the lung can be visualized by pulmonary electrical impedance tomography (EIT). The aim of this study was to examine postoperative redistribution of regional ventilation after lung surgery dependent on the side of surgery and its association with forced vital capacity. METHODS: In this prospective, observational cohort study thirteen patients undergoing right and thirteen patients undergoing left-sided open or video-thoracoscopic procedures have been investigated...
December 12, 2019: Acta Anaesthesiologica Scandinavica
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