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Acta Anaesthesiologica Scandinavica

J Skytte Larsson, G Bragadottir, B Redfors, S-E Ricksten
BACKGROUND: Acute kidney injury is commonly seen after liver transplantation. The optimal perioperative target mean arterial pressure (MAP) for renal filtration, perfusion and oxygenation in liver recipients is not known. The effects of norepinephrine-induced changes in MAP on renal blood flow (RBF), oxygen delivery (RDO2 ), glomerular filtration rate (GFR) and renal oxygenation (=renal oxygen extraction, RO2 Ex) were therefore studied early after liver transplantation. METHODS: Ten patients with an intra- and post-operative vasopressor-dependent systemic vasodilation were studied early after liver transplantation during sedation and mechanical ventilation...
June 12, 2018: Acta Anaesthesiologica Scandinavica
M Agerskov, H Sørensen, J Højlund, N H Secher, N B Foss
BACKGROUND: In a frail patient group often suffering from dehydration, hip fracture is potentially fatal partly because of the blood loss and thus deteriorated circulation. An important goal for haemodynamic monitoring and resuscitation is early detection of insufficient tissue perfusion. "The peripheral perfusion index" reflects changes in peripheral perfusion and blood volume. We hypothesize that hip fracture patients are hypovolaemic with poor peripheral perfusion and accordingly respond to controlled fluid resuscitation...
May 30, 2018: Acta Anaesthesiologica Scandinavica
S Horst, R Kawati, J Rasmusson, A Pikwer, M Castegren, M Lipcsey
BACKGROUND: Iatrogenic fluid overload is associated with increased mortality in the intensive care unit (ICU). Decisions on fluid therapy may, at times, be based on other factors than physiological endpoints. We hypothesized that because of psychological factors volume of available fluid bags would affect the amount of resuscitation fluid administered to ICU patients. METHODS: We performed a prospective intervention cross-over study at 3 Swedish ICUs by replacing the standard resuscitation fluid bag of Ringer's Acetate 1000 mL with 500 mL bags (intervention group) for 5 separate months and then compared it with the standard bag size for 5 months (control group)...
May 30, 2018: Acta Anaesthesiologica Scandinavica
T Kratz, J Hinterobermaier, N Timmesfeld, C Kratz, H Wulf, T Steinfeldt, M Zoremba, H Aust
BACKGROUND: Haemodynamic instability during the induction of anaesthesia and surgery is common and may be related to hypovolaemia caused by pre-operative fasting or chronic diuretic therapy. The aim of our prospective, controlled, randomized study was to test the hypothesis that a predefined fluid bolus given prior to general anaesthesia for minor surgery would increase haemodynamic stability during anaesthetic induction. METHODS: Two hundred and nineteen fairly healthy adult patients requiring minor surgery were enrolled...
May 30, 2018: Acta Anaesthesiologica Scandinavica
M Zdolsek, R G Hahn, J H Zdolsek
BACKGROUND: Although hyperoncotic albumin may be used to recruit oedema, its effectiveness remains unclear. Therefore, this issue was studied during infusion experiments in healthy volunteers. METHOD: Fifteen healthy volunteers (mean age 31 years) received an infusion of 3 mL/kg of 20% albumin over 30 minutes. Their urinary excretion was recorded, and venous blood samples were taken to measure blood haemoglobin (Hb), haematocrit, colloid osmotic pressure as well as plasma albumin and sodium concentrations on 15 occasions over a period of 300 minutes...
May 29, 2018: Acta Anaesthesiologica Scandinavica
H Kangasniemi, P Setälä, H Huhtala, A Kämäräinen, I Virkkunen, E Jämsen, A Yli-Hankala, S Hoppu
BACKGROUND: Dispatching Emergency Medical Services to treat patients with deteriorating health in nursing homes and primary care facilities is common in Finland. We examined the cardiac arrest patients to describe this phenomenon. We had a special interest in patients for whom cardiopulmonary resuscitation was considered futile. METHODS: We conducted an observational study between 1 June 2013 and 31 May 2014 in the Pirkanmaa area. We included cases in which Emergency Medical Services participated in the treatment of cardiac arrest patients in nursing homes and primary care facilities...
May 29, 2018: Acta Anaesthesiologica Scandinavica
C Miller, R Prenn, J Ausserer, P Hamm, S Neururer, P Paal
BACKGROUND: This study assessed the contribution made to research by Scandinavian university Departments of Anaesthesiology and their distribution among those departments. METHODS: We committed a PubMed search for all publications originating from Scandinavian university Departments of Anaesthesiology between 2001 and 2015. Articles were assigned to their author's affiliated university department and to 3 time periods 2001-2005, 2006-2010 and 2011-2015. The number of publications, original articles and citations were analysed...
May 29, 2018: Acta Anaesthesiologica Scandinavica
J-H Lee, Y-E Jang, E-H Kim, H-S Kim, J-T Kim
BACKGROUND: The influence of different head and neck positions on ventilation with the Ambu® AuraGain™ remains unevaluated in children. This study assessed the influence of different head and neck positions on ventilation with the AuraGain™ in paediatric patients. METHODS: In this prospective, randomised crossover study, children ≤7 years of age who were scheduled for elective surgery under general anaesthesia were enrolled. An AuraGain™ was placed in all patients; mechanical ventilation was performed using a volume-controlled mode with a tidal volume of 10 mL/kg...
May 24, 2018: Acta Anaesthesiologica Scandinavica
E Butler, M H Møller, O Cook, A Granholm, J Penketh, S L Rygård, A Aneman, A Perner
BACKGROUND: Corticosteroids are frequently prescribed to critically ill patients. However, their use may increase the risk of gastrointestinal (GI) bleeding, which is associated with morbidity and mortality. Accordingly, we aim to assess whether continued administration of corticosteroids for >24 hours increases the rate of GI bleeding in adult critically ill patients compared to placebo or no treatment. METHODS/DESIGN: We will conduct a systematic review of randomized clinical trials with meta-analysis and trial sequential analysis...
May 24, 2018: Acta Anaesthesiologica Scandinavica
P Ghorbani, L Strömmer
BACKGROUND: The wide disparity in the methodology of preventable death analysis has created a lack of comparability among previous studies. The guidelines for the peer review (PR) procedure suggest the inclusion of risk-adjustment methods to identify patients to review, that is, exclude non-preventable deaths (probability of survival [Ps] < 25%) or focus on preventable deaths (Ps > 50%). We aimed to, through PR process, (1) identify preventable death and errors committed in a level-I trauma centre, and (2) explore the use of different risk-adjustment methods as a complement...
May 24, 2018: Acta Anaesthesiologica Scandinavica
S S Mørch, S Tantholdt-Hansen, N E Pedersen, C L Duus, J A Petersen, C Ø Andersen, J O Jarløv, C S Meyhoff
BACKGROUND: Post-operative sepsis considerably increases mortality, but the extent of pre-operative sepsis in hip fracture patients and its consequences are sparsely elucidated. The aim of this study was to assess the association between pre-operative sepsis and 30-day mortality after hip fracture surgery. METHODS: We conducted a retrospective analysis of data collected among 1894 patients who underwent hip fracture surgery in the Capital Region of Denmark in 2014 (NCT03201679)...
May 24, 2018: Acta Anaesthesiologica Scandinavica
T M Koster, J Wetterslev, C Gluud, F Keus, I C C van der Horst
RATIONALE: Meta-analysed intervention effect estimates are perceived to represent the highest level of evidence. However, such effects and the randomized clinical trials which are included in them need critical appraisal before the effects can be trusted. OBJECTIVE: Critical appraisal of a predefined set of all meta-analyses on interventions in intensive care medicine to assess their quality and assessed the risks of bias in those meta-analyses having the best quality...
May 24, 2018: Acta Anaesthesiologica Scandinavica
P Setälä, H Hellevuo, H Huhtala, A Kämäräinen, J Tirkkonen, S Hoppu
BACKGROUND: We aimed to determine the incidence of and associated risk factors for cardiopulmonary resuscitation (CPR)-related injuries in non-survivors of out-of-hospital cardiac arrests (OHCAs) in an emergency medical service (EMS) system in which all CPR procedures are performed on scene and patients are not routinely transported to the hospital with ongoing CPR. MATERIAL AND METHODS: We conducted this prospective observational study between 1 June 2013, and 31 May 2014...
May 24, 2018: Acta Anaesthesiologica Scandinavica
E Wallin, I-M Larsson, J Nordmark-Grass, I Rosenqvist, M-L Kristofferzon, S Rubertsson
BACKGROUND: Using cerebral oxygen venous saturation post-cardiac arrest (CA) is limited because of a small sample size and prior to establishment of target temperature management (TTM). We aimed to describe variations in jugular bulb oxygen saturation during intensive care in relation to neurological outcome at 6 months post- CA in cases where TTM 33°C was applied. METHOD: Prospective observational study in patients over 18 years, comatose immediately after resuscitation from CA...
May 24, 2018: Acta Anaesthesiologica Scandinavica
C Runge, S Bjørn, J M Jensen, N D Nielsen, M Vase, C Holm, T F Bendtsen
INTRODUCTION: An obturator nerve block (ONB) and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA) without impeding the ambulation, although the ONB produces motor blockade of the hip adductor muscles. The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating intraarticular genicular structures and the posterior capsule of the knee. We hypothesised that a popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa...
May 24, 2018: Acta Anaesthesiologica Scandinavica
D Raza, S Ismail
BACKGROUND: Mallampati class has been shown to increase during labor. There are no prospective studies evaluating airway changes in hypertensive parturients during labor. The aim of our study was to observe the frequency of change in Mallampati class during labor in hypertensive compared to normotensive parturients. METHODS: In this prospective observational cohort study, 60 parturients were enrolled and divided into two groups of 30 each: hypertensive parturients and normotensive parturients...
May 22, 2018: Acta Anaesthesiologica Scandinavica
J A Graw, C Melzer-Gartzke, R C E Francis
No abstract text is available yet for this article.
May 22, 2018: Acta Anaesthesiologica Scandinavica
S Ångerman, S Länkimäki, N Neuvonen, H Kirves, J Nurmi
BACKROUND: Near-infrared spectroscopy (NIRS) provides a non-invasive measure of cerebral tissue oxygenation. The literature on application of this method in pre-hospital setting is limited. The aims of this study were to determine the feasibility of cerebral NIRS during pre-hospital anaesthesia and to quantify the changes in front lobe regional oxygen saturation (rSO2 ) during the pre-hospital phase. METHODS: NIRS monitoring (Nonin SenSmart X-100) of front lobe regional oxygen saturation (rSO2) was initiated before induction of anaesthesia in 31 adult patients and continued until hospital arrival...
May 22, 2018: Acta Anaesthesiologica Scandinavica
S L Rygård, A Perner, J Wetterslev
No abstract text is available yet for this article.
May 21, 2018: Acta Anaesthesiologica Scandinavica
A Granholm, T Lange, C T Anthon, S Marker, M Krag, T S Meyhoff, M P Wise, M Borthwick, S Bendel, F Keus, A B Guttormsen, J C Schefold, J Wetterslev, A Perner, M H Møller
BACKGROUND: Critically ill patients are at risk of gastrointestinal bleeding, but clinically important gastrointestinal bleeding is rare. The majority of intensive care unit (ICU) patients receive stress ulcer prophylaxis (SUP), despite uncertainty concerning the balance between benefit and harm. For approximately half of ICU patients with gastrointestinal bleeding, onset is early, ie within the first two days of the ICU stay. The aetiology of gastrointestinal bleeding and consequently the balance between benefit and harm of SUP may differ between patients with early vs late gastrointestinal bleeding...
May 14, 2018: Acta Anaesthesiologica Scandinavica
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