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Acta Anaesthesiologica Scandinavica

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https://read.qxmd.com/read/31290560/point-of-care-analyses-of-blood-samples-from-intraosseous-access-in-pre-hospital-critical-care
#1
Milla Jousi, Johannes Björkman, Jouni Nurmi
BACKGROUND: Intraosseous (IO) access is used for fluid and medication administration in emergency situations when difficulties with vascular access are encountered. IO access would be readily available to take samples for point-of-care (POC) analysis, but there is scarce evidence about the reliability of POC analysis of IO samples among emergency patients. The aim of this study was to evaluate the feasibility and reliability of POC analysis of IO samples in critically ill pre-hospital patients...
July 10, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31287556/the-use-of-mannitol-in-cardiopulmonary-bypass-prime-solution-prospective-randomized-double-blind-clinical-trial
#2
Magnus Ljunggren, Andreas Sköld, Alain Dardashti, Snejana Hyllén
BACKGROUND: The optimal prime solution for the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol is widely used in the priming solution for CPB despite the fact that there is no clear consensus on the role of mannitol in cardiac surgery. The aim of this study was to investigate the effect of mannitol in the CPB prime solution. METHODS: This prospective, randomized, double-blind study included forty patients with normal cardiac and renal functions, who underwent coronary artery bypass grafting...
July 9, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31287156/near-infrared-spectroscopy-monitoring-in-a-prehospital-trauma-patient-cohort-an-analysis-of-successful-signal-collection
#3
Andrew Weatherall, Elwyn Poynter, Alan Garner, Anna Lee
BACKGROUND: Non-invasive monitoring of cerebral physiology could potentially guide prehospital management of patients with traumatic injuries. Near-infrared spectroscopy (NIRS) is one such modality but the consistency of monitoring performance is unclear. This study assessed the proportion of successful signal collection during prehospital care. METHODS: As part of a prospective observational study, an independent study observer placed three sensors for a Nonin 7610 NIRS device; two on the forehead and one on the forearm...
July 9, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31287154/percutaneous-versus-surgical-emergency-cricothyroidotomy-an-experimental-randomised-crossover-study-on-an-animal-larynx-model
#4
Åke Erling L Andresen, Jo Kramer-Johansen, Thomas Kristiansen
BACKGROUND: Airway management is a paramount clinical skill for the anaesthesiologist. The Emergency Cricothyroidotomy (EC) constitutes the final step in difficult airway algorithms securing a patent airway via a front-of-neck access. The main distinction among available techniques is whether the procedure is surgical and scalpel-based or percutaneous and needle-based. METHODS: In an experimental randomised crossover trial, using an animal larynx model, we compared two EC techniques; the Rapid Four Step Technique and the Melker Emergency Cricothyrotomy Kit®...
July 9, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31286476/spinal-and-epidural-sufentanil-and-fentanyl-in-early-labour
#5
Antti Väänänen, Matti Kuukasjärvi, Aydin Tekay, Jouni Ahonen
BACKGROUND AND AIM: The analgesic effect on labour pain of either spinal or epidural sufentanil or fentanyl was tested in a total of 80 primiparousparturients at an early phase of the delivery. The aim of the study was to compare the level of analgesia achieved within 20 minutes. METHODS: The parturients were randomly assigned to groups receiving either spinal sufentanil (5ug), epidural sufentanil (20ug), spinal fentanyl (20ug), or epidural fentanyl (100ug), whereafter the parturients were monitored for reported pain during contraction and side effects for thirty minutes...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31286474/use-of-social-media-for-communicating-about-critical-care-topics-a-norwegian-cross-sectional-survey
#6
Antonija Petosic, Kjetil Sunde, Dimitri Beeckman, Hans Kristian Flaatten, Hilde Wøien
BACKGROUND: Social Media (SoMe) might be an alternative platform for communicating critical care topics to implement evidence-based practice (EBP) in the intensive care unit (ICU). This survey aims to describe ICU nurses' and physicians' use of SoMe in general, and their perception of using closed Facebook-groups for receiving content on critical care topics. METHODS: A cross-sectional, web-based, anonymous survey was distributed to ICU physicians and nurses in four ICUs in autumn 2017 via an email-campaign...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31286469/myocardial-injury-and-mortality-in-patients-with-excessive-oxygen-administration-before-cardiac-arrest
#7
Kathrine S Grønbek, Sofie S Mørch, Niels E Pedersen, Tonny S Petersen, Christian S Meyhoff
INTRODUCTION: Hyperoxia after cardiac arrest may be associated with higher mortality, and trials have found that excess oxygen administration in patients with myocardial infarction is associated with increased infarct size. The effect of hyperoxia before cardiac arrest is sparsely investigated. Our aim was to assess the association between excessive oxygen administration before cardiac arrest and the extent of subsequent myocardial injury. METHODS: We performed a retrospective study including patients who had in-hospital cardiac arrest during 2014 in the Capital Region of Denmark...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31286467/availability-and-organization-of-difficult-airway-equipment-in-swedish-hospitals-a-national-survey-of-anaesthesiologists
#8
Martin F Bjurström, Karolina Persson, Louise W Sturesson
BACKGROUND: Airway complications account for almost one third of anaesthesia-related brain damage and death. Immediate access to equipment enabling rescue airway strategies is crucial for successful management of unanticipated difficult airway situations. METHODS: We conducted a nationwide survey of Swedish anaesthesiologists to analyse availability and organization of difficult airway trolleys (DATs), and multiple factors pertaining to difficult airway management, to highlight areas of potential improvement...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31283835/c-reactive-protein-for-risk-prediction-of-postoperative-delirium-and-postoperative-neurocognitive-disorder
#9
Cornelia Knaak, Gerald Vorderwülbecke, Claudia Spies, Sophie K Piper, Daniel Hadzidiakos, Friedrich Borchers, Wolf-Rüdiger Brockhaus, Finn M Radtke, Gunnar Lachmann
BACKGROUND: Postoperative delirium (POD) and postoperative neurocognitive disorder (NCD) are frequently seen in the elderly. Development of biomarkers for preoperative risk prediction is of major relevance. As inflammation present before surgery might predispose to POD and postoperative NCD development, we aim to determine associations between preoperative C-reactive protein (CRP) and the incidence of POD and postoperative NCD. METHODS: In this observational study, we analyzed 314 patients enrolled in the SuDoCo trial, who had a preoperative CRP measurement the day before surgery...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31283834/storage-time-of-red-blood-cells-among-icu-patients-with-septic-shock
#10
Sofie Louise Rygård, Lars Grønlykke, Anders Perner, Per Winkel, Theis Lange, Lars Broksø Holst, Pär I Johansson, Anders Aneman, Thorsten Brodersen, Eva Laurén, Henrik Ullum, Jørn Wetterslev
BACKGROUND: We aimed to describe the exposure to blood transfusions and mortality among patients with septic shock. METHODS: We did a retrospective cohort study of two cohorts - patients with septic shock registered in a Danish ICU database (2008-2010) and patients from the Transfusion Requirements in Septic Shock (TRISS) trial (2011-2013). We extracted information on blood transfusions issued to all patients. We investigated the number of patients receiving very fresh blood (less than 7 days), very old blood (more than 24 days) and blood with a mixture of storage time...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31283833/close-to-the-nerve-vs-interfascial-plane-blocks-sniper-rifle-vs-shotgun-which-will-hit-the-target-most-reliably
#11
EDITORIAL
Per-Arne Lönnqvist, Manoj Karmakar
Soon after the discovery of local anesthetics (LA), the practice and art of regional anesthesia rapidly developed. One early issue to solve was how best to place the LA close to the nerve/nerves of interest. With regards to the brachial plexus the first ever brachial plexus block reported in 1885 is attributed to Halstead who following local infiltration surgically exposed the plexus at its supraclavicular location and then under direct vision instilled LA onto the plexus (1). This obviously provided excellent precision combined with an almost maximal success rate but overall it was a cumbersome technique to allow high precision deposition of the LA at the appropriate nerve structures...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31282567/pantoprazole-in-icu-patients-at-risk-for-gastrointestinal-bleeding-one-year-mortality-in-the-sup-icu-trial
#12
Søren Marker, Mette Krag, Anders Perner, Jørn Wetterslev, Theis Lange, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Joerg C Schefold, Bodil S Rasmussen, Thomas Elkmann, Morten Bestle, Bjørn Arenkiel, Jon H Laake, Maj K Kamper, Maarit Lång, Malgorzata B Pawlowicz-Dworzanska, Sari Karlsson, Janne Liisanantti, Nilanjan Dey, Heidi Knudsen, Anders Granholm, Morten Hylander Møller
BACKGROUND: The long-term effects of stress ulcer prophylaxis with pantoprazole are unknown in ICU patients. We report one-year mortality outcome in the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. METHODS: In the SUP-ICU trial, acutely admitted adult ICU patients at risk of gastrointestinal bleeding were randomised to intravenous pantoprazole 40 mg vs. placebo (saline) once daily during their ICU stay. We assessed mortality at one year and did sensitivity analyses according to the trial protocol and statistical analysis plan...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31282566/cerebrovascular-autoregulation-following-cardiac-arrest-protocol-for-a-post-hoc-analysis-of-the-randomized-comacare-pilot-trial
#13
Anders Aneman, Johanna Laurikalla, Paul Pham, Erika Wilkman, Pekka Jakkula, Matti Reinikainen, Jussi Toppila, Markus B Skrifvars
BACKGROUND: Approximately two thirds of the mortality following out of hospital cardiac arrest is related to devastating neurological injury. Previous small cohort studies have reported an impaired cerebrovascular autoregulation following cardiac arrest but no studies have assessed the impact of differences in oxygen and carbon dioxide tensions in addition to mean arterial pressure management. METHODS: This is a protocol and statistical analysis plan to assess the correlation between changes in cerebral tissue oxygenation and arterial pressure as measure of cerebrovascular autoregulation, the tissue oxygenation index, in patients following out of hospital cardiac arrest and in healthy volunteers...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31281981/combination-of-perineural-and-wound-infusion-after-above-knee-amputation-a-randomized-controlled-multicenter-study
#14
Hanna von Plato, Marko Peltoniemi, Petteri Kauhanen, Eliisa Löyttyniemi, Katri Hamunen, Vesa Kontinen
BACKGROUND: Postoperative pain after an above-knee amputation is often severe, and in the elderly patients the adverse effects of postoperative opioids are evident. We hypothesized that continuous perineural local anaesthetic infusion (CPI) combined to a wound infusion will reduce acute pain and opioid consumption compared to placebo after above knee amputation. METHODS: Ninety-three patients going through an above knee amputation were recruited for this randomized, controlled trial...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31281958/lower-versus-higher-transfusion-threshold-in-septic-shock-patients-of-different-ages-a-study-protocol
#15
Andreas Bender Jonsson, Anders Granholm, Sofie Louise Rygård, Lars Broksø Holst, Morten Hylander Møller, Anders Perner
BACKGROUND: Current evidence indicates that it is safe to use a lower haemoglobin (Hb) threshold for red blood cell (RBC) transfusion as compared to a higher Hb-threshold. However, the recent Transfusion Requirements in Cardiac Surgery (TRICS-3) trial reported a significant interaction between patient age and the effect of lower versus higher Hb-thresholds for RBC transfusion. The interaction between patient age and transfusion strategy appears to differ between trials. METHODS: This is the protocol and statistical analysis plan for a post-hoc analysis of the Transfusion Requirements in Septic Shock (TRISS) trial...
July 8, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31276193/conservative-versus-liberal-fluid-therapy-in-septic-shock-classic-trial-protocol-and-statistical-analysis-plan
#16
Tine Sylvest Meyhoff, Peter Buhl Hjortrup, Morten Hylander Møller, Jørn Wetterslev, Theis Lange, Maj-Brit Nørregaard Kjaer, Andreas Bender Jonsson, Carl Johan Steensen Hjortsø, Maria Cronhjort, Jon Henrik Laake, Stephan M Jakob, Marek Nalos, Ville Pettilä, Iwan van der Horst, Marlies Ostermann, Paul Mouncey, Kathy Rowan, Maurizio Cecconi, Ricard Ferrer, Manu L N G Malbrain, Christian Ahlstedt, Søren Hoffmann, Morten Heiberg Bestle, Lars Nebrich, Lene Russell, Marianne Vang, Michael Lindhardt Rasmussen, Christoffer Sølling, Bodil Steen Rasmussen, Anne Craveiro Brøchner, Anders Perner
INTRODUCTION: Intravenous (IV) fluid is a key intervention in the management of septic shock. The benefits and harms of lower versus higher fluid volumes are unknown and clinical equipoise exists. We describe the protocol and detailed statistical analysis plan for the Conservative versus Liberal Approach to fluid therapy of Septic Shock in the Intensive Care (CLASSIC) trial. The aim of the CLASSIC trial is to assess benefits and harms of IV fluid restriction versus standard care in adult intensive care unit (ICU) patients with septic shock...
July 5, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31276190/intraoperative-methadone-for-postoperative-pain-after-laparoscopic-hysterectomy-protocol-for-a-randomised-double-blind-trial
#17
Kristian D Friesgaard, Lone D Brix, Christina B Kristensen, Omar Rian, Lone Nikolajsen
BACKGROUND: Hysterectomy is often carried out as same-day surgery. Treatment of postoperative pain is therefore of utmost importance to ensure timely discharge from hospital. Methadone has several desirable pharmacological features, including a long elimination half-life. Theoretically, a single intraoperative dose could provide long-lasting pain relief. METHODS: This is a single-centre, investigator-initiated, randomised, double-blind study. Two-hundred and fifty women, scheduled to undergo hysterectomy at Horsens Region Hospital, Denmark, are randomized to receive methadone (0...
July 5, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31273763/external-validation-of-the-simplified-mortality-score-for-the-intensive-care-unit-sms-icu
#18
Anders Granholm, Anders Perner, Mette Krag, Søren Marker, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
BACKGROUND: The Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) is a clinical prediction model, which estimates the risk of 90-day mortality in acutely ill adult ICU patients using 7 readily available variables. We aimed to externally validate the SMS-ICU and compare its discrimination with existing prediction models used with 90-day mortality as the outcome. METHODS: We externally validated the SMS-ICU using data from 3282 patients included in the Stress Ulcer Prophylaxis in the Intensive Care Unit trial, which randomised acutely ill adult ICU patients with risk factors for gastrointestinal bleeding to prophylactic pantoprazole or placebo in 33 ICUs in Europe...
July 4, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31271655/the-effect-of-sildenafil-on-pleural-and-peritoneal-effusions-after-the-tcpc-operation
#19
Tapio K Koski, Pertti K Suominen, Alireza Raissadati, Hanna M Knihtilä, Tiina H Ojala, Jukka T Salminen
BACKGROUND: We evaluated whether the administration of sildenafil in children undergoing TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains. METHODS: We retrospectively reviewed the data of 122 patients who had undergone the TCPC operation between 2004 and 2014. Patients were divided into two groups on the basis of their treatments. Sildenafil was orally administered preoperatively in the morning of the procedure or within 24 hours after the TCPC operation to the sildenafil group (n=48), which was compared to a control group (n=60)...
July 4, 2019: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/31270800/inhaled-prostacyclin-for-the-prevention-of-increased-pulmonary-vascular-resistance-in-cemented-hip-hemiarthroplasty-a-randomised-trial
#20
Mathias Hård Af Segerstad, Fredrik Olsen, Erik Houltz, Bengt Nellgård, Sven-Erik Ricksten
BACKGROUND: Bone cementation may cause pulmonary vasoconstriction and ventilation/perfusion abnormalities in patients undergoing cemented hip hemiarthroplasty. In this randomised trial, we tested the hypothesis that intra-operative inhalation of prostacyclin could attenuate the increase in pulmonary vascular resistance index (PVRI, primary endpoint) when compared to inhaled saline in this group of patients. METHODS: Twenty-two patients with displaced femoral neck fractures were allocated to receive inhaled aerosolised prostacyclin (20 ng/kg/min) (n = 11) or inhaled saline (NaCl, 9 mg/mL) (n = 11)...
July 3, 2019: Acta Anaesthesiologica Scandinavica
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