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Acta Anaesthesiologica Scandinavica

June A Holter, Torben Wisborg
BACKGROUND: Finnmark, Northern Norway, had a mortality rate for paediatric injury in 1998-2007 that was more than twice the national average. We investigated whether this rate had decreased in 2008-2015 after improvements in emergency care. We also compared the mortality rate to rates of non-fatal injury and trauma team activation both regionally and in Norway. METHODS: The study was based on 4 national registries. Mortality and injury rates were calculated per 100 000 persons per year...
May 9, 2019: Acta Anaesthesiologica Scandinavica
Júlia N G Lima, Melissa S Fontes, Tatiana Szmuszkowicz, Alexandre M Isola, Alexandre T Maciel
BACKGROUND: Readiness for mechanical ventilation (MecV) weaning and extubation is usually assessed clinically with the use of a spontaneous breathing trial (SBT), but its accuracy is limited, and the pathophysiology of weaning failure not completely elucidated. The purpose of the present study was to describe the physiological behavior of electrical impedance tomography parameters during SBT and to propose additional variables that could be helpful in defining weaning/extubation outcome...
May 7, 2019: Acta Anaesthesiologica Scandinavica
Trine Kåsine, Luis Romundstad, Leiv Arne Rosseland, Kyrre Ullensvang, Morten Wang Fagerland, Per Kristian Hol, Paul Kessler, Axel Rudolf Sauter
BACKGROUND: The Onvision needle tip tracking (NTT) is a new technology consisting of a needle with an ultrasound sensor close to the needle tip and a console for computerised signal processing. The aim of the study was to evaluate NTT technology during ultrasound-guided simulated peripheral nerve block procedures in a porcine phantom model. METHODS: Forty anaesthesiologists performed in-plane and out-of-plane simulated nerve blocks with and without NTT guidance...
April 30, 2019: Acta Anaesthesiologica Scandinavica
A Kofoed, A Perner, S Marker, N Haase, L B Holst, M H Møller
BACKGROUND: An increasing number of trials are stopped earlier than originally planned. It has been suggested that trials stopped pre-maturely overestimate the treatment effect. With the outlined observational study, we aim to simulate the results of stopping trials before they reach their planned sample size to assess the effects on mortality estimates. METHODS AND STATISTICS: Based on 3 international, randomised clinical trials (RCTs) in critical care: Scandinavian Starch for Severe Sepsis and Septic Shock (6S) trial, the Transfusion Requirements in Septic Shock (TRISS) trial and the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial, we will estimate relative risks with 95% confidence intervals for the primary outcome 90-day mortality after the inclusion of each individual patient in each RCT...
April 29, 2019: Acta Anaesthesiologica Scandinavica
Marie Warrer Petersen, Anders Perner, Fredrik Sjövall, Andreas Bender Jonsson, Morten Steensen, Jakob Steen Andersen, Michael Patrick Achiam, Niels Frimodt-Møller, Morten Hylander Møller
INTRODUCTION: Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species...
April 24, 2019: Acta Anaesthesiologica Scandinavica
Hiromasa Irie, Keiko Kawai, Takanao Otake, Yasutaka Shinjo, Akira Kuriyama, Shigeki Yamashita
BACKGROUND: The outcomes of patients on dual antiplatelet therapy (DAPT) post-coronary stenting following emergency noncardiac surgery remain unclear. METHODS: This retrospective cohort study included patients on DAPT post-coronary stenting who underwent emergency noncardiac surgery within 24 hours of diagnosis from April 2007 to March 2018 where DAPT was discontinued within <5 days for aspirin and 7 days for P2Y12 inhibitors. Our primary outcome was 180-day mortality in these patients...
April 24, 2019: Acta Anaesthesiologica Scandinavica
Rasmus Ejlersgaard Christensen, Josefine S Baekgaard, Lars S Rasmussen
BACKGROUND: Dental injuries may occur during general anaesthesia, especially during airway management. The aim of this study was to describe cases of dental injury related to general anaesthesia, focusing on the type and extent of the injuries as well as the timing of recognition. METHOD: We reviewed the nationwide electronic database available at the Danish Patient Compensation Association and scrutinized all claims classified as possible dental injuries in relation to general anaesthesia between 2007 and 2017...
April 23, 2019: Acta Anaesthesiologica Scandinavica
Knut Magne Kolstadbraaten, Ulrich Johannes Spreng, Kristin Wisloeff-Aase, Christine Gaarder, Paal Aksel Naess, Johan Raeder
BACKGROUND: Life saving measures is the main focus in the initial treatment of major trauma. In surviving patients, chronic pain may be a serious problem, but the long term incidence and potential risk factors are not very well studied. METHODS: All adult trauma patients included in the institutional trauma registry in 2007 were assessed for eligibility. Among exclusion criteria were: Injury Severity Score < 9, endotracheal intubation before or during admission, spinal cord lesion, known chronic drug or substance abuse, major surgery within 3 h after admission...
April 22, 2019: Acta Anaesthesiologica Scandinavica
Markus Heim, Frederick Schneider, Haitham Mutlak, Christian M Schulz, Thomas Hachenberg, Michael Zoller, Jens Soukup, Michael Pawlik, Julika Schön, Martin Kees, Matthias Hübler, Michael Sander, Christian Ernst, Matthias Jacob, Matthias May
BACKGROUND: High rates of multiresistant pathogens require detailed knowledge about rational utilization of antibiotics. Many physicians consider themselves uncertain about the interpretation of microbiological diagnostics. We examined whether self-confidence, self-rated knowledge, and objective knowledge regarding the use of antibiotics are associated with gender. METHODS: For this survey study, in 2017, anaesthesiologists and residents of 16 anaesthetic departments in Germany were asked to complete the Multiinstitutional Reconnaissance of practice with Multiresistant bacteria (MR2) survey...
April 22, 2019: Acta Anaesthesiologica Scandinavica
Gildas Gueret, Stéphanie Benardeau, Aurélien Binet, Marc Laffon
No abstract text is available yet for this article.
April 21, 2019: Acta Anaesthesiologica Scandinavica
Birgitte Yndgaard Simonsen, Marianne Lisby, Chani Traube, Pernille Skovby
BACKGROUND: Delirium is a serious medical problem and recognized as a common syndrome in critically ill children. Without routine screening, delirium diagnosis is often missed by the medical providers. Internationally, there are tools to assess pediatric delirium (PD), but none currently available in Danish. The aim of this project was to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Danish and determine its feasibility and reliability in a Danish clinical setting...
April 17, 2019: Acta Anaesthesiologica Scandinavica
Sílvia Castro, Isabel Jesus Pereira, Cláudia Camila Dias, Cristina Granja
BACKGROUND: Mortality is high in critically ill patients. In order to study the risk factors associated with mortality in these patients, we conducted an observational retrospective study in the general Intensive Care Unit (ICU) of Faro Hospital. METHODS: All patients discharged from the general ICU in the year 2015 were evaluated for inclusion. Mortality was characterized in the first 48 hours of ICU stay, at the time of discharge from ICU, and at discharge from hospital...
April 15, 2019: Acta Anaesthesiologica Scandinavica
Enqiang Chang, Lingzhi Wu, Joe Masters, Jie Lu, Shengli Zhou, Wenli Zhao, Mingyang Sun, Fanmin Meng, Chen Pac Soo, Jiaqiang Zhang, Daqing Ma
BACKGROUND: Tracheostomy and endotracheal intubation can result in subglottic tracheal stenosis, and predisposition to keloid scar formation can increase stenosis risk after tracheal injury. This study aims to compare the incidence and severity of subglottic tracheal stenosis in keloid and non-keloid patients following iatrogenic tracheal injury, in particular tracheostomy. METHODS: From 2012 to 2017, 218 573 patients were intubated for surgery; 2276 patients received tracheostomy in People's Hospital of Zhengzhou University, China...
April 14, 2019: Acta Anaesthesiologica Scandinavica
Hui Liu, Mang Sun, Jing Zhang, Qin Tian, Qing Yu, Yang Liu, Fei Yang, Shangyingying Li, Shengfen Tu
BACKGROUND: The intranasal route of dexmedetomidine (DEX) administration is becoming increasingly popular for providing adequate sedation during short examinations in infants and children. However, data on the 90% effective dose (ED90) of intranasal DEX are rare in children under 3 years old. METHODS: This is a double-blind trial using a biased coin design up-and-down sequential method (BCD-UDM). Fifty-three children aged under 3 years old requiring DEX for EEG were included in our study...
April 14, 2019: Acta Anaesthesiologica Scandinavica
Kristin Wisløff-Aase, Johan Raeder, Grethe Månum, Marianne Løvstad, Anne-Kristine Schanke, Grete Dyb, Øivind Ekeberg, Johan Kvalvik Stanghelle
BACKGROUND: On 22 July 2011, 48 people were hospitalized due to physical injuries from gun shots or explosion, following 2 terror attacks in the Oslo area, Norway. In this study, we have investigated the occurrence of chronic pain, the severity and consequences of chronic pain in these patients, 3 to 4 years after the incidents. METHODS: Totally 43 eligible terror trauma patients were invited to participate in the study, 30 patients were included. They underwent a consultation with a psychologist and a physician; containing psychological assessment, neuropsychological screening, a standardized clinical interview, medical examination, and a pain protocol...
April 9, 2019: Acta Anaesthesiologica Scandinavica
Fernande Lois, Patricia Lavand'homme, Daniel Leonard, Christophe Remue, Vanessa Bellemans, Alex Kartheuser
BACKGROUND: Enhanced recovery after surgery (ERAS) program improves immediate recovery. Beyond immediate benefits, long-term impact of ERAS implementation is not yet evident. This retrospective single-center cohort study investigates prevalence and characteristics of chronic post-surgical pain (CPSP) in patients who underwent colon surgery. METHODS: Two hundred and ninety-seven patients enrolled prospectively in our ERAS database were contacted by mail to question the presence of CPSP...
April 9, 2019: Acta Anaesthesiologica Scandinavica
Inga L Ingvarsdottir, Halla Vidarsdottir, Felix Valsson, Liney Simonardottir, Martin I Sigurdsson, Gunnar Myrdal, Arnar Geirsson, Tomas Gudbjartsson
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) treatment is generally offered in large tertiary cardiothoracic referral centres. Here we present the indications and outcome of venovenous-ECMO (VV-ECMO) treatment in a low-volume, geographically isolated single-centre in Iceland, a country of 350 000 inhabitants. Our hypothesis was that patient survival in such a centre can be similar to that at high-volume centres. METHODS: A retrospective study that included all patients treated with VV-ECMO in Iceland from 1991-2016 (n = 17)...
April 2, 2019: Acta Anaesthesiologica Scandinavica
Panuwat Promsin, Jonathan Grip, Åke Norberg, Jan Wernerman, Olav Rooyackers
BACKGROUND: A decrease in lactate concentration over time during septic shock is associated with favourable outcomes. However, if this applies to hourly intervals during the initial time period in the ICU is unknown. The aim of this study was to investigate whether there is an early hourly reduction rate of lactate that is related to clinical outcome in septic shock patients treated in the ICU. METHODS: A cohort of adult septic shock patients admitted to the ICU with an initial lactate level >2 mmol/L and receiving vasopressor was retrospectively analysed...
April 2, 2019: Acta Anaesthesiologica Scandinavica
Steven Kwasi Korang, Christian Gluud, Janus C Jakobsen
BACKGROUND: Sepsis is the primary diagnosis in more than 8% of all critically ill children and sepsis is among the ten leading causes of death in children <10 years. Glucocorticosteroids are currently recommended in septic children with fluid or catecholamine resistant refractory shock. Glucocorticosteroids are widely used for severe sepsis in paediatric intensive care units worldwide. However, the evidence on the clinical effects of glucocorticosteroids for sepsis in children is unclear...
March 28, 2019: Acta Anaesthesiologica Scandinavica
Josefine S Baekgaard, Dan Isbye, Camilla Ikast Ottosen, Mo Haslund Larsen, Jakob Hessel Andersen, Lars S Rasmussen, Jacob Steinmetz
INTRODUCTION: Hyperoxaemia is commonly observed in trauma patients but has been associated with pulmonary complications and mortality in some patient populations. The objectives of this study were to evaluate whether maintenance of normoxia is feasible using a restrictive oxygen strategy in the initial phase after trauma and to evaluate the incidence of 30-day mortality and/or major pulmonary complications. METHODS: Forty-one adult trauma patients admitted to our trauma centre were randomised to 24 hours of restrictive oxygen therapy (no supplemental oxygen if the arterial oxyhaemoglobin saturation (SpO2 ) was at least 94%, n = 21) or liberal oxygen therapy (intubated patients: FiO2 1...
March 25, 2019: Acta Anaesthesiologica Scandinavica
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