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Acta Anaesthesiologica Scandinavica

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https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#1
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27900771/laparoscopic-guided-psoas-blockade-as-a-novel-analgesic-method-during-inguinal-herniorrhaphy-a-clinical-trial
#2
T F Tammam, A F Salama
BACKGROUND: Under laparoscopic guidance, block of ilioinguinal, iliohypogastric, and genitofemoral nerves can be possible with anesthetic injection in the plane between psoas major and the fasciae covering its anterior aspects [laparoscopic-assisted psoas (LAP) blockade]. This observer-blinded trial aimed to compare the opioid-sparing effect of LAP block with transversus abdominis plane (TAP) block after laparoscopic inguinal herniorrhaphy. METHODS: Forty-five male patients were randomly assigned to receive LAP block, group LAP (n = 23), or ultrasound-guided TAP block, group TAP (n = 22)...
November 30, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27900767/cumulative-changes-in-weight-but-not-fluid-volume-balances-reflect-fluid-accumulation-in-icu-patients
#3
M Köster, S Dennhardt, F Jüttner, H-B Hopf
BACKGROUND: The cumulative fluid balance of critically ill patients seems to be an outcome-relevant variable. However, there are no validated data for their reliability calculated for longer (> 5 days) periods of time. METHODS: All ICU patients ≥ 18 years, with an ICU stay ≥ 5 days and a body weight ≤ 195 kg were evaluated from 1 January 2013 to 31 December 2013. Daily standardized weighing was performed using bed-integrated scales simultaneously with the daily 24-h fluid balance...
November 30, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27900763/parecoxib-propacetamol-and-their-combination-for-analgesia-after-total-hip-arthroplasty-a-randomized-non-inferiority-trial
#4
F Camu, A Borgeat, R J Heylen, E J Viel, M E Boye, R Y Cheung
BACKGROUND: This study assessed non-inferiority of parecoxib vs. combination parecoxib+propacetamol and compared the opioid-sparing effects of parecoxib, propacetamol, and parecoxib+propacetamol vs. placebo after total hip arthroplasty. METHODS: In this randomized, placebo-controlled, parallel-group, non-inferiority study, patients received one of four IV treatments after surgery: parecoxib 40 mg bid (n = 72); propacetamol 2 g qid (n = 71); parecoxib 40 mg bid plus propacetamol 2 g qid (n = 72); or placebo (n = 38) with supplemental IV patient-controlled analgesia (morphine)...
November 30, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27892594/chloroprocaine-10-mg-ml-for-low-dose-spinal-anaesthesia-in-perianal-surgery-a-randomised-dose-finding-study
#5
V Gebhardt, L Mueller-Hansen, A Schwarz, D Bussen, C Weiss, M D Schmittner
BACKGROUND: Low-dose spinal anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery. Regarding its short duration of action and its trend to hyperbaric characteristics, plain chloroprocaine 10 mg/ml seems to be ideal to perform low-dose spinal anaesthesia. The aim of this trial was to determine the optimal dosage of chloroprocaine for this indication. METHODS: Hundred and twenty patients undergoing perianal surgery were enrolled and randomly allocated to receive 10, 20 or 30 mg of chloroprocaine 10 mg/ml intrathecally...
November 28, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27891573/nephrocheck-%C3%A2-results-should-be-corrected-for-dilution
#6
LETTER
R G Hahn, J Zdolsek
No abstract text is available yet for this article.
November 28, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27891574/termination-of-pre-hospital-resuscitation-by-anaesthesiologists-causes-and-consequences-a-retrospective-study
#7
S Mikkelsen, H M Lossius, L G Binderup, C Schaffalitzky de Muckadell, P Toft, A T Lassen
AIM: Differentiating between a newly deceased patient and the lifeless patient in whom immediate resuscitation is required may be facilitated by a pre-hospital anaesthesiologist. The purpose of our study was to investigate to what extent and why the pre-hospital anaesthesiologist pronounced life extinct in situations where an emergency medical technician (EMT) would have been required to resuscitate. METHODS: All lifeless patients seen pre-hospitally by the anaesthesiologist-manned Mobile Emergency Care Unit in Odense, Denmark, from 2010 to 2014 were retrospectively studied...
November 27, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27878815/interventions-to-reduce-cognitive-impairments-following-critical-illness-a-topical-systematic-review
#8
REVIEW
H K Nedergaard, H I Jensen, P Toft
BACKGROUND: Critical illness is associated with cognitive impairments. Effective treatment or prevention has not been established. The aim of this review was to create a systematic summary of the current evidence concerning clinical interventions during intensive care admission to reduce cognitive impairments after discharge. METHODS: Medline, Embase, Cochrane Central, PsycInfo and Cinahl were searched. Inclusion criteria were studies assessing the effect of interventions during intensive care admission on cognitive function in adult patients...
November 22, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27878813/no-cases-of-perioperative-allergy-to-local-anaesthetics-in-the-danish-anaesthesia-allergy-centre
#9
A D Kvisselgaard, M Krøigaard, H F Mosbech, L H Garvey
BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of IgE-mediated immediate type perioperative allergic reactions to LA. METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery...
November 22, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27813055/physiological-changes-associated-with-routine-nursing-procedures-in-critically-ill-are-common-an-observational-pilot-study
#10
J Engström, E Bruno, H Reinius, C Fröjd, H Jonsson, J Sannervik, A Larsson
BACKGROUND: Nursing procedures that are routinely performed in the intensive care unit (ICU) are assumed to have minimal side effects. However, these procedures may sometimes cause physiological changes that negatively affect the patient. We hypothesized that physiological changes associated with routine nursing procedures in the ICU are common. METHODS: A clinical observational study of 16 critically ill patients in a nine-bed mixed university hospital ICU. All nursing procedures were observed, and physiological data were collected and subsequently analyzed...
November 3, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27778324/intraneural-injection-of-a-test-dose-of-local-anesthetic-in-peripheral-nerves-does-it-induce-histological-changes-in-nerve-tissue
#11
T Wiesmann, T Steinfeldt, M Exner, W Nimphius, J De Andres, H Wulf, U Schwemmer
BACKGROUND & OBJECTIVES: Most anesthesiologists use the injection of a test dose of local anesthetic in order to evaluate the final needle tip position. Thus, the intraneural injection of a full dose can be avoided. The aim of this study was to analyze whether an intraneural injection of a test dose of bupivacaine could trigger histological changes. METHODS: Intraneural injections under direct vision were performed in 40 brachial plexus nerves in seven anesthetized pigs...
October 25, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27766633/inadvertent-intrathecal-injections-and-best-practice-management
#12
REVIEW
H Liu, R Tariq, G L Liu, H Yan, A D Kaye
The intrathecal space has become an important anatomic site for medical intervention not only in anesthesia practice, but also in many other medical specialties. Undesired/inadvertent intrathecal injections (UII) are generally rare. There is tremendous variation in reported inadvertent administrations via an intrathecal route in the literature, mainly as individual cases and very small case-series reports. This review aims to identify potential sources of UII, its clinical presentations, and appropriate management...
October 21, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27766613/carotid-doppler-flowmetry-correlates-poorly-with-thermodilution-cardiac-output-following-cardiac-surgery
#13
C Roehrig, M Govier, J Robinson, A Aneman
BACKGROUND: It remains unclear whether measuring carotid arterial flow by the time velocity integral using vascular Doppler ultrasound can be used to monitor cardiac output and volume responsiveness. METHODS: The carotid Doppler flow (time velocity integral and peak flow velocity variation) was assessed in triplicate by an intensivist with formal vascular ultrasound training. Thirty-three patients admitted following coronary by-pass surgery were studied before and after a passive leg-raising manoeuvre to investigate volume responsiveness (more than 10% increase in cardiac output) along with indices of arterial load measuring cardiac output by thermodilution...
October 21, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27726149/ssai-practice-guideline-on-pre-hospital-airway-management-emergency-surgical-airway-keep-it-safe-and-simple
#14
LETTER
J C Schaeuble, T Heidegger
No abstract text is available yet for this article.
October 10, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27726129/an-urgent-call-for-improved-quality-of-trial-design-and-reporting-in-postoperative-pain-research
#15
EDITORIAL
M L Fabritius, J Wetterslev, J B Dahl, O Mathiesen
No abstract text is available yet for this article.
October 10, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27709608/reply-from-the-authors-ssai-guideline-on-pre-hospital-airway-management-keep-it-safe-and-simple
#16
LETTER
M Rehn, P K Hyldmo, V Magnusson, J Kurola, P Kongstad, L Rognås, L K Juvet, M Sandberg
No abstract text is available yet for this article.
October 6, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27699759/severe-sepsis-in-the-icu-is-often-missing-in-hospital-discharge-codes
#17
S B Wilhelms, S M Walther, F Huss, F Sjöberg
BACKGROUND: Different International Classification of Diseases (ICD)-based code abstraction strategies have been used when studying the epidemiology of severe sepsis. The aim of this study was to compare three previously used ICD code abstraction strategies to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus criteria for severe sepsis, in a setting of intensive care patients. METHODS: All patients (≥ 18 years of age) with severe sepsis according to the ACCP/SCCM criteria registered in the Swedish Intensive Care Registry (2005-2009) were included in the study...
October 4, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27696343/low-degree-of-satisfactory-individual-pain-relief-in-post-operative-pain-trials
#18
A Geisler, J B Dahl, A P H Karlsen, E Persson, O Mathiesen
BACKGROUND: The majority of clinical trials regarding post-operative pain treatment focuses on the average analgesic efficacy, rather than on efficacy in individual patients. It has been argued, that in acute pain trials, the underlying distributions are often skewed, which makes the average unfit as the only way to measure efficacy. Consequently, dichotomised, individual responder analyses using a predefined 'favourable' response, e.g. Visual Analogue Scale (VAS) pain scores ≤ 30, have recently been suggested as a more clinical relevant outcome...
October 3, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27696339/effects-of-sugammadex-vs-pyridostigmine-glycopyrrolate-on-post-operative-nausea-and-vomiting-propensity-score-matching
#19
O H Lee, G J Choi, H Kang, C W Baek, Y H Jung, Y C Woo, J Oh, Y H Park
BACKGROUND: Sugammadex is a new agent that reverses neuromuscular blockade by aminosteroid neuromuscular blocker. This retrospective study compared the effects of sugammadex on post-operative nausea and vomiting (PONV) with those of a pyridostigmine-glycopyrrolate mixture. METHODS: We reviewed the electronic medical records of 7179 patients who had received fentanyl-based, intravenous, patient-controlled analgesia (IV-PCA) at Chung-Ang University Hospital between January 1, 2010 and December 31, 2015...
October 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27918104/quality-of-life-following-trauma-before-and-after-implementation-of-a-physician-staffed-helicopter
#20
K S Funder, L S Rasmussen, R Hesselfeldt, V Siersma, N Lohse, A Sonne, S Wulffeld, J Steinmetz
BACKGROUND: Implementation of a physician-staffed helicopter emergency medical service (PS-HEMS) in Denmark was associated with lower 30-day mortality in severely injured trauma patients and less time on social subsidy. However, the reduced 30-day mortality in severely injured patients might be at the expense of a worse functional outcome and quality of life (QoL) in those who survive. The aim of this study was to investigate the effect of a physician-staffed helicopter on long-term QoL in trauma patients...
January 2017: Acta Anaesthesiologica Scandinavica
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