Journals Acta Anaesthesiologica Scandin...

Acta Anaesthesiologica Scandinavica
Ellen Kirkegaard, Peter C Lind, Henrik Dolmer, Peter Juhl-Olsen
BACKGROUND: Mispositioning is common during insertion of peripherally inserted central catheters. Ultrasonographic visualisation of anatomical structures may enable continuous guidance during insertion. The aim was to investigate the feasibility of ultrasonographic real-time guidance of peripherally inserted central catheter placement using the supraclavicular fossa view. METHODS: An observational quality control study was performed including 20 patients. Ultrasonography was performed via the right supraclavicular fossa using a microconvex probe identifying the junction between the right internal jugular- and the subclavian vein forming the right brachiocephalic vein...
January 16, 2021: Acta Anaesthesiologica Scandinavica
Tobias Warnecke, Lisa Dauth, Anton Ahlbäck, James DuCanto, Elisabeth Fleischhammer, Carlos Glatz, Steffen Kerkhoff, Alexander Mathes, Jan Schmitz, Clement Starck, Seamus Thierry, Jochen Hinkelbein
BACKGROUND: Medical support for space exploration missions must prepare for severe medical events in conditions of microgravity. A key component to managing these events are techniques of airway management. The aim of the present trial is to compare airway management devices in simulated microgravity. METHODS: In this randomized cross-over trial (RCT), four different devices were compared under simulated microgravity conditions utilizing a neutrally buoyant free-floating underwater manikin and poolside in normal gravity (control group)...
January 13, 2021: Acta Anaesthesiologica Scandinavica
Björn Ahlström, Robert Frithiof, Michael Hultström, Ing-Marie Larsson, Gunnar Strandberg, Miklos Lipcsey
BACKGROUND: Several studies have recently addressed factors associated with severe Coronavirus disease 2019 (COVID-19); however, some medications and comorbidities have yet to be evaluated in a large matched cohort. We therefore explored the role of relevant comorbidities and medications in relation to the risk of intensive care unit (ICU) admission and mortality. METHODS: All ICU COVID-19 patients in Sweden until 27 May 2020 were matched to population controls on age and sex to assess the risk of ICU admission...
January 12, 2021: Acta Anaesthesiologica Scandinavica
Vibe Sommer Mikkelsen, Mads Christian Tofte Gregers, Ulrik Stenz Justesen, Jens Schierbeck, Søren Mikkelsen
BACKGROUND: Rapid recognition and antibiotic treatment, preferably preceded by blood cultures (BCs), is a mainstay in sepsis therapy. The objective of this investigation was to determine if prehospital BCs were feasible and drawn with an acceptably low level of contamination and to investigate whether prehospital antibiotics were administered on correct indications. METHODS: We performed a register-based study in a prehospital physician-manned mobile emergency care unit (MECU) operating in a mixed urban/rural area in Denmark...
January 6, 2021: Acta Anaesthesiologica Scandinavica
Maximilian Hammer, Friederike C Althoff, Katharina Platzbecker, Luca J Wachtendorf, Bijan Teja, Dana Raub, Maximilian S Schaefer, Karuna Wongtangman, Xinling Xu, Timothy T Houle, Matthias Eikermann, Kadhiresan R Murugappan
BACKGROUND: A substantial proportion of patients undergoing inpatient surgery each year is at risk for postoperative institutionalization and loss of independence. Reliable individualized preoperative prediction of adverse discharge can facilitate advanced care planning and shared decision making. METHODS: Using hospital registry data from previously home-dwelling adults undergoing inpatient surgery, we retrospectively developed and externally validated a score predicting adverse discharge...
January 6, 2021: Acta Anaesthesiologica Scandinavica
Eetu Loisa, Sanna Hoppu, Sari-Marja Hytönen, Joonas Tirkkonen
BACKGROUND: Despite wide implementation of rapid response teams (RRTs), no published data exist on RRT nurses' attitudes and barriers to the rapid response system (RRS). METHODS: We piloted a 5-point Likert-type scale questionnaire among all Finnish university hospitals' RRT nurses with optional open-ended comments. The impact of more frequent RRT participation was further investigated. RESULTS: The response rate was 46% (n=176/379, 34-93% between hospitals)...
January 5, 2021: Acta Anaesthesiologica Scandinavica
Pär I Johansson, Christian Fenger Eriksen, Hagen Schmal, Christine Gaarder, Marlene Pall, Hanne Hee Henriksen, Pernille Bovbjerg, Theis Lange, Pål Aksel Naess, Christian Nielsen, Hans Kirkegaard, Jakob Stensballe
BACKGROUND: Traumatic injury accounts for 800.000 deaths in the European Union annually. The main causes of deaths in trauma patients are exsanguination and multiple organ failure (MOF). We have studied >1.000 trauma patients and identified shock induced endotheliopathy (SHINE) the pathophysiological mechanism responsible for MOF and high mortality. Pilot studies indicate that low dose iloprost (1 ng/kg/min) improves endothelial functionality in critically ill patients suggesting this intervention may improve patient outcome in traumatic SHINE...
January 3, 2021: Acta Anaesthesiologica Scandinavica
Hanne T Olsen, Helene K Nedergaard, Catherine L Hough, Serkan Korkmaz, Hanne I Jensen, Thomas Strøm, Palle Toft
BACKGROUND: Critical illness is associated with severely impaired health related quality of life (HRQoL) for years following discharge. The NONSEDA-trial was a multicenter randomized trial on non-sedation versus sedation with a daily wake-up trial in critically ill, mechanically ventilated patients in Scandinavia. The aim of this sub-study was to assess the effect of non-sedation on HRQoL and degree of independence in activities in daily living (ADL) three months post-ICU. METHODS: All survivors were asked to complete the Medical Outcomes Study Short-Form 36 questionnaire (SF-36) and the Barthel Index three months post-ICU...
December 29, 2020: Acta Anaesthesiologica Scandinavica
Bing Wei, Yan Feng, Wenjuan Chen, Dapeng Ren, Daishun Xiao, Bing Chen
BACKGROUND: Emergence agitation (EA) is an adverse postoperative complication that increases the risk for injury, self-extubation, hemorrhages and prolonged hospitalization. This meta-analysis aims to define the risk factors for adult EA after general anesthesia and provide recommendations for clinical practice. METHODS: Embase, PubMed, Medline, and the Cochrane Library databases were comprehensive retrieved. Observational studies that reported the risk factors for adult EA were enrolled...
December 28, 2020: Acta Anaesthesiologica Scandinavica
Kristinn Ö Sverrisson, Michelle S Chew, Klaus T Olkkola, Marius Rehn, Arvi Yli-Hankala, Morten Hylander Møller
The Scandinavian Society of Anaesthesiology and Intensive Care Medicine Clinical practice Committee endorses the BMJ Rapid Recommendation Gastrointestinal bleeding prophylaxis for critically ill patients-a clinical practice guideline. The guideline serves as a useful decision aid for clinicians caring for critically ill patients, and can be used together with clinical experience to decide whether a specific critically ill patient may benefit from gastrointestinal bleeding prophylaxis.
December 28, 2020: Acta Anaesthesiologica Scandinavica
Karen H Tollisen, Cathrine L Hadley, Marianne Bjerva, Gry T Dahl, Lisa M Högvall, Leiv Sandvik, Geir Ø Andersen, Fridtjof Heyerdahl, Dag Jacobsen
BACKGROUND: The clinical impact of chronic substance abuse of alcohol and drugs - referred to as substance use disorders (SUD) - is often overlooked in the intensive care (ICU) setting. The aims of the present study were to identify patients with SUD - regardless of cause of admission - in a mixed Norwegian ICU-population, and to compare patients with and without SUD with regard to clinical characteristics and mortality. METHODS: Cross-sectional prospective study of a mixed medical and surgical ICU-population aged ≥18 years in Oslo, Norway...
December 19, 2020: Acta Anaesthesiologica Scandinavica
Johannes Björkman, Lasse Raatiniemi, Piritta Setälä, Jouni Nurmi
BACKGROUND: The value of shock-index has been demonstrated in hospital triage, but few studies have evaluated its prehospital use. The aim of our study was to evaluate the association between shock-index in prehospital critical care and short-term mortality. METHODS: We analyzed data from the national helicopter emergency medical services database and the Population Register Centre. The shock-index was calculated from the patients' first measured parameters. The primary outcome measure was 1- and 30-day mortality...
December 19, 2020: Acta Anaesthesiologica Scandinavica
Herman A Lonnée, Erik R Isern, Jannicke Mellin-Olsen
Norwegian anaesthesiologists use a pulse oximeter for each and every case in the operating theatre. However, we suspected that most rely on the visual scale and alarm only (routinely set at 90% at our institution), and that the variable pitch sound of the pulse oximeter is not routinely audible during anaesthesia. In order to verify this, a short survey (3 questions) was emailed to all registered anaesthesiologists (specialists and trainees) in Norway during September 2020. The sample was based on the Norwegian Society of Anaesthesiology membership register, which includes both clinically active and non-active members...
December 16, 2020: Acta Anaesthesiologica Scandinavica
Marianne Ylikoski, Jorma Lahtela, Janne J Jokinen, Markku J Kauppi, Heini Huhtala, Raine Tiihonen, Heidi Immonen
Perioperative hyperglycaemia is reported in 40%-90% of surgical patients, depending on diabetes status (2). Large cohort studies on patients with and without diabetes have identified hyperglycaemia as an independent risk factor for poor outcomes when compared to normoglycaemic patients. Despite ongoing debate about the optimal glucose target, there is strong agreement that improving glycaemic control reduces perioperative complications.
December 14, 2020: Acta Anaesthesiologica Scandinavica
Thomas P Clyde, Michael Coletta, Christopher W Jones, Hope Kilgannon, Brian M Fuller, Stephen Trzeciak, Brian W Roberts
BACKGROUND: Perform a scoping review of (1) preclinical studies testing the physiological effects of higher PaCO2 levels in the setting of sepsis models and (2) clinical investigations testing the effects of hypercapnia on clinical outcomes in mechanically ventilated patients with sepsis. METHODS: We performed a search of CENTRAL, PUBMED, CINAHL, and EMBASE. Study inclusion criteria for preclinical studies were: (1) bacterial sepsis model (2) measurement of PaCO2 , and (3) comparison of outcome measure between different PaCO2 levels...
December 14, 2020: Acta Anaesthesiologica Scandinavica
Richard A Buckley, Kelly J Atkins, Erika Fortunato, Brendan Silbert, David A Scott, Lisbeth Evered
BACKGROUND: We developed a digital clock drawing test (dCDT), an adaptation of the original pen and paper clock test, that may be advantageous over previous dCDTs in the perioperative environment. We trialled our dCDT on a tablet device in the preoperative period to determine the feasibility of administration in this setting. To assess the clinical utility of this test, we examined the relationship between the performance on the test and compared derived digital clock measures with the 4 A's Test (4AT), a delirium and cognition screening tool...
December 9, 2020: Acta Anaesthesiologica Scandinavica
Boris Mraovic, Tatjana Simurina, Jeffrey I Joseph
No abstract text is available yet for this article.
December 9, 2020: Acta Anaesthesiologica Scandinavica
Benjamin Grossmann, Andreas Nilsson, Folke Sjöberg, Lars Bernfort, Lena Nilsson
No abstract text is available yet for this article.
December 9, 2020: Acta Anaesthesiologica Scandinavica
Christopher Lotz, Ralf M Muellenbach, Patrick Meybohm, Haitham Mutlak, Philipp M Lepper, Caroline-Barbara Rolfes, Asghar Peivandi, Jan Stumpner, Markus Kredel, Peter Kranke, Iuliu Torje, Christian Reyher
BACKGROUND: Changes in pulmonary hemodynamics and ventilation/perfusion were proposed as hallmarks of Coronavirus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Inhaled nitric oxide (iNO) may overcome these issues and improve arterial oxygenation. METHODS: We retrospectively analyzed arterial oxygenation and pulmonary vasoreactivity in seven COVID-19 ARDS patients receiving 20ppm iNO for 15-30 minutes. RESULTS: The inhalation of NO significantly improved oxygenation...
December 9, 2020: Acta Anaesthesiologica Scandinavica
Monika Afzali Rubin, Nikolaj Francis Stark, Simon Julius Chamli Hårsmar, Ann Merete Møller
BACKGROUND: Hip fracture is a common, painful injury with increasing global incidence. Patients require optimal acute pain management. Systematic reviews have investigated the postoperative use of epidural analgesia and found that it may have advantages over systemic analgesia. It is of interest to determine whether pre-operative use of epidural analgesia is also advantageous. We conducted a systematic review and meta-analyses on the effect of epidural analgesia on pre-operative pain management in hip fracture patients...
December 9, 2020: Acta Anaesthesiologica Scandinavica
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