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Protracted fibrinolysis resistance following cardiac surgery with cardiopulmonary bypass: A prospective observational study of clinical associations and patient outcomes Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-18 Lucy A. Coupland, Kieran G. Pai, Sidney J. Pye, Mark T. Butorac, Jennene J. Miller, Philip J. Crispin, David J. Rabbolini, Antony H. L. Stewart, Anders Aneman
Surgery on cardiopulmonary bypass (CPB) elicits a pleiomorphic systemic host response which, when severe, requires prolonged intensive care support. Given the substantial cross-talk between inflammation, coagulation, and fibrinolysis, the aim of this hypothesis-generating observational study was to document the kinetics of fibrinolysis recovery post-CPB using ClotPro® point-of-care viscoelastometry
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Pharmacokinetics of propofol in severely obese surgical patients Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-14 Martin Rygh Braathen, Ann E. Rigby‐Jones, Johan Ræder, Olav Spigset, Tom Heier
BackgroundExisting PK models of propofol include sparse data from very obese patients. The aim of this study was to develop a PK model based on standardised surgical conditions and spanning from normal‐weight up to, and including, a high number of very obese patients.MethodsAdult patients scheduled for laparoscopic cholecystectomy or bariatric surgery were studied. Anaesthesia was induced with propofol
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Association of perioperative transfusion of fresh frozen plasma and outcomes after cardiac surgery Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-12 Jake V. Hinton, Zhongyue Xing, Calvin Fletcher, Luke A. Perry, Alexandra Karamesinis, Jenny Shi, Jahan C. Penny‐Dimri, Dhruvesh Ramson, Tim G. Coulson, Reny Segal, Julian A. Smith, Jenni Williams‐Spence, Laurence Weinberg, Rinaldo Bellomo
BackgroundFresh frozen plasma (FFP) transfusion is used to manage coagulopathy and bleeding in cardiac surgery patients despite uncertainty about its safety and effectiveness.MethodsWe performed a propensity score matched analysis of the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database including patients from 39 centres from 2005 to 2018. We investigated
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Intraoperative clonidine in endometriosis and spine surgery: A protocol for two randomised, blinded, placebo‐controlled trials Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-11 Stine Birkebæk, Louise Møller Lundsgaard, Niels Juul, Mikkel Seyer‐Hansen, Mikkel Mylius Rasmussen, Peter Gaarsdal Uhrbrand, Lone Nikolajsen
BackgroundA high proportion of patients who undergo surgery continue to suffer from moderate to severe pain in the early postoperative period despite advances in pain management strategies. Previous studies suggest that clonidine, an alpha2 adrenergic agonist, administered during the perioperative period could reduce acute postoperative pain intensity and opioid consumption. However, these studies
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Postoperative pain at Landspitali: A prospective study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-11 Andri M. Tomasson, Hilma Jakobsdóttir, Haraldur M. Gudnason, Sigurbergur Karason, Martin I. Sigurdsson
BackgroundModerate or severe postoperative pain is common despite advances in surgical technique and perioperative analgesia. This study aimed to assess the prevalence and severity of postoperative pain following procedures requiring anaesthesia and identify factors associated with increased risk of postoperative pain.MethodsSurgical patients ≥18 years of age were prospectively questioned on level
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Adherence to a restrictive red blood cell transfusion strategy in critically ill patients: An observational study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-08 Martin F. Bjurström, Ylva C. Linder, Jens Kjeldsen‐Kragh, Jesper Bengtsson, Thomas Kander
BackgroundRandomized controlled trials relatively consistently show that restrictive red blood cell (RBC) transfusion strategies are safe and associated with similar outcomes compared to liberal transfusion strategies in critically ill patients. Based on these data, the general threshold for RBC transfusion was changed to 70 g/L at a 9‐bed tertiary level intensive care unit in September 2020. Implementation
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Setting a direction for continuing professional development in anesthesiology: A synthesis of the outcome from an Utstein style meeting Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-05 J. A. Petersen, D. Østergaard, H. T. Østergaard, L. Bray, A. C. Haug
An Utstein style meeting of key stakeholders from the existing collaboration surrounding post-graduate training was arranged to set a direction for continuing professional development (CPD) of anesthesiologists in Denmark. A 2-day meeting was planned to guide discussions about competencies in anesthesiology, facilitate the development of a blueprint for a portfolio-based CPD program and provide examples
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Physicians' perceptions of intensive care patients' 1-year prognoses compared to realistic prognoses Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-04 Laura Pietiläinen, Johanna Hästbacka, Stepani Bendel, Minna Bäcklund, Matti Reinikainen
It is unknown whether physicians treating critically ill patients have realistic perceptions of their patients' prognoses.
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Reply to Dr.'s Fang, Mu, and Fu‐Shan: An ultrasound‐guided serratus anterior plane block with continuous local anaesthetic infusion and epidural analgesia for rib fracture pain Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-06 Anna R. Lundén, Pekka Tarkkila
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Finger cuff versus invasive and noninvasive arterial pressure measurement in pregnant patients with obesity Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-05 Victoria Eley, Stacey Llewellyn, Anita Pelecanos, Leonie Callaway, Matthew Smith, Andre van Zundert, Michael Stowasser
BackgroundPregnant patients with obesity may have compromised noninvasive blood pressure (NIBP) measurement. We assessed the accuracy and trending ability of the ClearSight™ finger cuff (FC) with invasive arterial monitoring (INV) and arm NIBP, in obese patients having cesarean delivery.MethodsParticipants were aged ≥18 years, ≥34 weeks gestation, and body mass index (BMI) ≥ 40 kg m−2. FC, INV, and
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Wireless continuous single‐lead ST‐segment monitoring to detect new‐onset myocardial injury at the general ward—An exploratory subanalysis Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-01 Jonathan Attilla Koefoed Starling, Camilla Haahr‐Raunkjaer, Søren S. Rasmussen, Luna Ekenberg, Frederik Cornelius Loft, Christian Sylvest Meyhoff, Eske Kvanner Aasvang
Patients admitted for acute medical conditions and major noncardiac surgery are at risk of myocardial injury. This is frequently asymptomatic, especially in the context of concomitant pain and analgesics, and detection thus relies on cardiac biomarkers. Continuous single‐lead ST‐segment monitoring from wireless electrocardiogram (ECG) may enable more timely intervention, but criteria for alerts need
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Effect of decreasing PEEP on hyperinflation and collapse in COVID‐19: A computed tomography study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-03-01 Alessandro Santini, Alessandro Protti, Francesca Pennati, Francesca Dalla Corte, Nicolò Martinetti, Luca Pugliese, Giorgio Picardo, Chiara Chiurazzi, Michele Ferrari, Elena Costantini, Andrea Aliverti, Maurizio Cecconi
BackgroundHigh positive end‐expiratory pressure (PEEP>10 cmH2O) is commonly used in mechanically ventilated hypoxemic patients with COVID‐19. However, some epidemiological and physiological studies indirectly suggest that using a lower PEEP may primarily and beneficially decrease lung hyperinflation in this population. Herein we directly quantified the effect of decreasing PEEP from 15 to 10 cmH2O
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Prehospital point‐of‐care ultrasound in ruptured abdominal aortic aneurysms—a retrospective cohort study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-28 Signe Voigt Lauridsen, Morten Thingemann Bøtker, Nikolaj Eldrup, Peter Juhl‐Olsen
BackgroundPatients with ruptured abdominal aortic aneurysm (rAAA) require immediate vascular treatment to survive. The use of prehospital point‐of‐care ultrasound (POCUS) may support clinical assessment, correct diagnosis, appropriate triage and reduce system delay. The aim was to study the process of care and outcome in patients receiving prehospital POCUS versus patients not receiving prehospital
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Serum creatinine is an unreliable marker of renal function in patients undergoing heart transplantation Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-27 Maria Tholén, Lukas Lannemyr, Hasse Møller‐Sørensen, Sven‐Erik Ricksten
BackgroundRenal dysfunction is a common complication after heart transplantation (Htx). Glomerular filtration rate (GFR) can be assessed by various estimating equations (eGFR). We evaluated the correlation, agreement, and accuracy between eGFR and mGFR and the ability of eGFR to track changes in mGFR early after Htx.MethodsA single‐center prospective observational study on 55 patients undergoing Htx
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Beta‐lactam antibiotic concentrations in critically ill patients with standard and adjusted dosages: A prospective observational study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-26 Ilja Areskog Lejbman, Gustav Torisson, Fredrik Resman, Fredrik Sjövall
IntroductionAntibiotic concentration target attainment is known to be poor in critically ill patients. Dose adjustment is recommended in patients with altered clearance, obesity and those with bacterial species with intermediate susceptibility. The aim of this study was to investigate the variation of antibiotic concentration in critically ill patients with standard or adjusted dosing regimens.MethodsThe
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Haemodynamic effects of remifentanil during induction of general anaesthesia with propofol. A randomised trial Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-24 Gunnar Helge Sjøen, Ragnhild Sørum Falk, Tor Hugo Hauge, Tor Inge Tønnessen, Eldrid Langesæter
BackgroundRemifentanil may have a dose‐dependent haemodynamic effect during the induction of general anaesthesia combined with propofol. Our objective was to investigate whether systolic arterial blood pressure (SAP) was reduced to a greater extent when the remifentanil dose was increased.MethodsThis randomised, double‐blind, dose‐controlled study was conducted at the Day Surgery Unit of Haugesund
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How should respiratory depression and loss of airway patency be handled during initiation of palliative sedation? Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-23 Olav Magnus S. Fredheim, Solveig K. Torvund, Lisbeth Thoresen, Morten Magelssen
BackgroundLoss of airway patency has been reported during initiation of palliative sedation. In present guidelines the loss of airway patency during initiation of palliative sedation is not addressed. Airway patency can be restored by jaw thrust/chin lift or placing the patient in the recovery position.AimA structured ethical analysis of how respiratory depression and loss of airway patency during
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GRADE pearls and pitfalls—Part 2: Clinical practice guidelines Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-21 Anders Granholm, Zainab Al Duhailib, Waleed Alhazzani, Simon Oczkowski, Emilie Belley‐Cote, Morten Hylander Møller
BackgroundThe Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach is the de facto standard framework for summarising evidence in systematic reviews and developing recommendations in clinical practice guidelines.MethodsWe describe how the GRADE approach is used in clinical practice guidelines, including key points and examples. The intended audience of this overview of
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Lower versus higher blood pressure targets in comatose patients resuscitated from out‐of‐hospital cardiac arrest—Protocol for a secondary Bayesian analysis of the box trial Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-21 Johannes Grand, Sebastian Wiberg, Jesper Kjaergaard, Christian Hassager, Henrik Schmidt, Jacob E. Møller, Simon Mølstrøm, Anders Granholm
BackgroundThe management of blood pressure targets during intensive care after out‐of‐hospital cardiac arrest (OHCA) remains a topic of debate. The blood Pressure and Oxygenation Targets After OHCA (BOX) trial explored the efficacy of two different blood pressure targets in 789 patients during intensive care after OHCA. In the primary frequentist analysis, no statistically significant differences were
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Minimal important difference in postoperative morphine consumption after hip and knee arthroplasty using nausea, vomiting, sedation and dizziness as anchors Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-21 Anders Peder Højer Karlsen, Jens Laigaard, Casper Pedersen, Kasper Højgaard Thybo, Kasper Smidt Gasbjerg, Anja Geisler, Troels Haxholdt Lunn, Daniel Hägi‐Pedersen, Janus Christian Jakobsen, Ole Mathiesen
BackgroundMorphine‐sparing effects are often used to evaluate non‐opioid analgesic interventions. The exact effect that would warrant the implementation of these interventions in clinical practice (a minimally important difference) remains unclear. We aimed to determine this with anchor‐based methods.MethodsThis was a post hoc analysis of three studies investigating pain management after hip or knee
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Is epidural analgesia non-inferior to intrathecal fentanyl as initiation for neuraxial analgesia in early non-spontaneous labour? Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-16 Lotta Salmi, Riina Jernman, Antti Väänänen
Intrathecal fentanyl, using the combined spinal-epidural (CSE) technique, provides rapid analgesia during early labour. Because of the technique's more complex and invasive nature, as its replacement we assessed the use of epidural analgesia in primiparous parturients with induced labour. The study was registered at www.clinicaltrials.gov (NCT04645823). The aim was to compare the efficacy, duration
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Correction to ‘A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure’ Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-16
Aslam TN, Klitgaard TL, Ahlstedt CAO, et al. A survey of preferences for respiratory support in the intensive care unit for patients with acute hypoxaemic respiratory failure. Acta Anaesthesiol Scand. 2023; 67(10): 1383–1394. https://doi.org/10.1111/aas.14317 Anne C. Brøchner was added as the fifth author. The correct author list is as follows: Tayyba N. Aslam, Thomas L. Klitgaard, Christian A. O.
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GRADE pearls and pitfalls—Part 1: Systematic reviews and meta-analyses Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-13 Zainab Al Duhailib, Anders Granholm, Waleed Alhazzani, Simon Oczkowski, Emilie Belley-Cote, Morten Hylander Møller
The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach is used to assess the certainty of evidence in systematic reviews and meta-analyses.
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Central venous catheter tip misplacement: A multicentre cohort study of 8556 thoracocervical central venous catheterisations Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-13 Emilia Ängeby, Maria Adrian, Gracijela Bozovic, Ola Borgquist, Thomas Kander
There is a paucity of data on the incidence of central venous catheter tip misplacements after the implementation of ultrasound guidance during insertion. The aims of the present study were to determine the incidence of tip misplacements and to identify independent variables associated with tip misplacement.
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Factors associated with fever after cardiac arrest: A post-hoc analysis of the FINNRESUSCI study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-13 Aki Holm, Matti Reinikainen, Jouni Kurola, Jukka Vaahersalo, Marjaana Tiainen, Tero Varpula, Johanna Hästbacka, Mitja Lääperi, Markus B. Skrifvars
Fever after cardiac arrest may impact outcome. We aimed to assess the incidence of fever in post-cardiac arrest patients, factors predicting fever and its association with functional outcome in patients treated without targeted temperature management (TTM).
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The 2024 revision of the Norwegian standard for the safe practice of anaesthesia Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-06 Ann-Chatrin Linqvist Leonardsen, Arvid Steinar Haugen, Johan Ræder, Therese Jenssen Finjarn, Erik Isern, Elin K. Aakre, Anne Marie Gran Bruun, Kristoffer Hennum, Jan Petter Ramstad, Tina Sand, Svein Arne Monsen
The Norwegian standard for the safe practice of anaesthesia was first published in 1991, and revised in 1994, 1998, 2005, 2010 and 2016 respectively. The 1998 version was published in English for the first time in Acta Anaesthesiologica Scandinavica in 2002. It must be noted that this is a national standard, reflecting the specific opportunities and challenges in a Norwegian setting, which may be different
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Risk prediction models in emergency surgery: Protocol for a scoping review Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-02-06 Anna K. Hansted, Morten H. Møller, Ann M. Møller, Jakob Burcharth, Sofie S. Thorup, Morten Vester-Andersen
Risk prediction models are used for many purposes in emergency surgery, including critical care triage and benchmarking. Several risk prediction models have been developed, and some are used for purposes other than those for which they were developed. We aim to provide an overview of the existing literature on risk prediction models used in emergency surgery and highlight knowledge gaps.
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Meropenem pharmacokinetic/pharmacodynamic target attainment and clinical response in ICU patients: A prospective observational study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-29 Elin Helset, Vesa Cheng, Hilde Sporsem, Christian Thorstensen, Ingvild Nordøy, Karianne Wiger Gammelsrud, Gorm Hanssen, Erica Ponzi, Jeffrey Lipman, Elisabeth von der Lippe
Several studies report lack of meropenem pharmacokinetic/pharmacodynamic (PK/PD) target attainment (TA) and risk of therapeutic failure with intermittent bolus infusions in intensive care unit (ICU) patients. The aim of this study was to describe meropenem TA in an ICU population and the clinical response in the first 72 h after therapy initiation.
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Pulmonary superinfection diagnosed with bronchoalveolar lavage at intubation in COVID patients: A Swedish single-centre study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-28 Fredrik Hammarskjöld, Sören Berg, Herjan Bavelaar, Anna J. Henningson, Knut Taxbro
Patients with severe coronavirus disease 2019 (COVID) pneumonia and acute respiratory distress syndrome (C-ARDS) on invasive mechanical ventilation (IMV) have been found to be prone to having other microbial findings than severe acute respiratory syndrome coronavirus 2 (SARS-2)-CoV-19 in the bronchoalveolar lavage (BAL) fluid at intubation causing a superinfection. These BAL results could guide empirical
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Long-term cognitive and pulmonary functions following a lower versus a higher oxygenation target in the HOT-ICU and HOT-COVID trials: A protocol update Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-25 Elena Crescioli, Jens Østergaard Riis, Ulla Møller Weinreich, Jens Ulrik Stæhr Jensen, Lone Musaeus Poulsen, Anne Craveiro Brøchner, Theis Lange, Anders Perner, Thomas Lass Klitgaard, Olav Lilleholt Schjørring, Bodil Steen Rasmussen
The Handling Oxygenation Targets in the Intensive Care Unit (HOT-ICU) trial was a multicentre, randomised, parallel-group trial of a lower oxygenation target (arterial partial pressure of oxygen [PaO2] = 8 kPa) versus a higher oxygenation target (PaO2 = 12 kPa) in adult ICU patients with acute hypoxaemic respiratory failure; the Handling Oxygenation Targets in coronavirus disease 2019 (HOT-COVID) tested
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Postoperative nausea and vomiting at Landspitali: A prospective study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-23 Hilma Jakobsdottir, Andri M. Tomasson, Sigurbergur Karason, Martin I. Sigurdsson
In the last decade, anaesthesia practice has changed at Landspitali, where the majority of patients now receive antiemetic prophylaxis, and the use of total intravenous anaesthesia is the dominant mode for maintenance of anaesthesia. The aim of this study was to assess the incidence of postoperative nausea and vomiting (PONV) in a prospective way, the use of PONV prophylaxis, and clinical risk factors
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Traumatic cervical spinal cord injury: Comparison of two different blood pressure targets on neurological recovery Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-16 Jaakko Långsjö, Sofia Jordan, Salla Laurila, Markku Paaso, Tuomo Thesleff, Heini Huhtala, Antti Ronkainen, Sari Karlsson, Eerika Koskinen, Teemu Luoto
Controversy exists whether blood pressure augmentation therapy benefits patients suffering from spinal cord injury (SCI). This retrospective comparative study was designed to assess the impact of two different mean arterial pressure (MAP) targets (85–90 mmHg vs. 65–85 mmHg) on neurological recovery after traumatic cervical SCI.
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Transthoracic impedance variability to assess quality of chest compression in out-of-hospital cardiac arrest Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-14 Aurora Magliocca, Valentina Castagna, Carla Fornari, Gabriele Zimei, Giulia Merigo, Alessio Penna, Jonas Carlson, Francesca Fumagalli, Giuseppe Stirparo, Maurizio Migliari, Anna Coppo, Giuseppe Maria Sechi, Giacomo Grasselli, Bjarne Madsen Hardig, Giuseppe Ristagno
Chest compression is a lifesaving intervention in out-of-hospital cardiac arrest (OHCA), but the optimal metrics to assess its quality have yet to be identified. The objective of this study was to investigate whether a new parameter, that is, the variability of the chest compression-generated transthoracic impedance (TTI), namely ImpCC, which measures the consistency of the chest compression maneuver
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The effects of troponin screening among patients undergoing acute high-risk abdominal surgery: A retrospective cohort study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-12 Charlotte T. B. Kanstrup, Kristina Johansen Svarre, Maja Christine Rasmussen, Camilla Mattesen Serup, Lars Hyldborg Lundstrøm, Jakob Kleif, Claus Anders Bertelsen
Acute high-risk abdominal (AHA) surgery is associated with a high short-term mortality rate. This might be partly attributed to myocardial injury after non-cardiac surgery (MINS) defined by elevated postoperative troponin levels. The myocardial injury is often asymptomatic; thus, troponin screening seems to be the best diagnostic method.
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Incidence and risk factors of peri-operative stroke in major non-cardiovascular, non-neurologic surgery—A retrospective register-based cohort study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-11 Ryan Falck-Jones, Max Bell, Linn Hallqvist
Peri-operative stroke is a rare but serious surgical complication. Both overt and covert stroke, occurring in approximately 0.1% and 7% of cases, respectively, are associated with significant long-term effects and increased morbidity.
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Difficult intubation in syndromic versus nonsyndromic forms of micrognathia in children Acta Anaesth. Scand. (IF 2.1) Pub Date : 2024-01-02 Agnes I. Hunyady, Vera Sergeeva, Pete G. Kovatsis, Kelly N. Evans, Steven J. Staffa, David Zurakowski, John E. Fiadjoe, Nathalia Jimenez
We investigated how syndromic versus nonsyndromic forms of micrognathia impacted difficult intubation outcomes in children. Primary outcome was the first-attempt success rate of tracheal intubation, secondary outcomes were number of intubation attempts and complications. We hypothesized that syndromic micrognathia would be associated with lower first-attempt success rate.
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Parturients feel capable of giving informed consent for epidural analgesia: A qualitative and quantitative analysis Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-12-27 Oliver Bastian Christoffersen, Ann Merete Møller, Lærke Vinberg Moestrup, Kim Wildgaard
The patient's right to autonomy confirmed by informed consent is a cornerstone in modern medicine. Epidural analgesia is increasingly popular in obstetric analgesia, but physicians disagree whether labour pain impairs parturient decision-making. We investigated the fraction of parturients feeling capable of giving informed consent including their knowledge of risks.
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Higher versus lower oxygenation targets in adult ICU patients: A rapid practice guideline Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-12-23 Morten Hylander Møller, Anders Granholm, Zainab Al Duhailib, Waleed Alhazzani, Emilie Belley-Cote, Simon Oczkowski, Bharath Kumar Tirupakuzhi Vijayaraghavan, Fredrik Sjövall, Ethan Butler, Fernando G. Zampieri, Rob Mac Sweeney, Lennie P. G. Derde, Ally Ruzycki-Chadwick, Mervyn Mer, Karen E. A. Burns, Begüm Ergan, Abdulrahman Al-Fares, Michael W. Sjoding, Thomas S. Valley, Bodil S. Rasmussen, Olav L
The aim of this Intensive Care Medicine Rapid Practice Guideline (ICM-RPG) was to provide evidence-based clinical guidance about the use of higher versus lower oxygenation targets for adult patients in the intensive care unit (ICU). The guideline panel comprised 27 international panelists, including content experts, ICU clinicians, methodologists, and patient representatives. We adhered to the methodology
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Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-12-19 Carl Thomas Anthon, Frédéric Pène, Anders Perner, Elie Azoulay, Kathryn Puxty, Andry Van De Louw, Sanjay Chawla, Pedro Castro, Pedro Povoa, Luis Coelho, Victoria Metaxa, Matthias Kochanek, Tobias Liebregts, Thomas Kander, Mirka Sivula, Morten Hylander Møller, Lene Russell
Platelet transfusions are frequently used in intensive care unit (ICU) patients, but contemporary epidemiological data are sparse. We aim to present contemporary international data on the use of platelet transfusions in adult ICU patients with thrombocytopenia.
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Chronic post-surgical pain following gastrointestinal surgery: Protocol for a scoping review Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-12-14 Amalie Rosendahl, Thordis Thomsen, Birgitte Brandstrup, Ann M. Møller
Chronic post-surgical pain (CPSP) significantly impacts people's lives, affecting both socioeconomic aspects as well as their rehabilitation after surgery. Yet, CPSP remains an under-researched field. The prevalence varies depending on type of surgery, which highlights the importance of surgery-specific research. This scoping review aims to investigate CPSP following gastrointestinal surgery in order
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Cardiopulmonary bypass management and acute kidney injury in cardiac surgery patients Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-12-09 Mikael Barbu, Anders Hjärpe, Andreas Martinsson, Göran Dellgren, Sven-Erik Ricksten, Lukas Lannemyr, Aldina Pivodic, Amar Taha, Anders Jeppsson
Cardiopulmonary bypass (CPB) ensures tissue oxygenation during cardiac surgery. New technology allows continuous registration of CPB variables during the operation. The aim of the present investigation was to study the association between CPB management and the risk of postoperative acute kidney injury (AKI).
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Hazardous alcohol consumption and perioperative complications in a cardiac surgery patient. A retrospective study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-28 Eliisa Nissilä, Raili Suojaranta, Marja Hynninen, Sebastian Dahlbacka, Johanna Hästbacka
We investigated the prevalence and effects of hazardous alcohol consumption on perioperative complications in cardiac surgery patients. Preoperative hazardous alcohol consumption has been associated with an increased risk of postoperative complications in noncardiac patient populations.
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Validation of PRE-DELIRIC and E-PRE-DELIRIC in a Danish population of intensive care unit patients—A prospective observational multicenter study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-27 Neeliya Anton Joseph, Lone Musaeus Poulsen, Mathias Maagaard, Simon Tholander, Helle Birgitte Scharling Pedersen, Charlotte Georgi-Jensen, Ole Mathiesen, Nina C. Andersen-Ranberg
Delirium is a clinical condition characterized by an acute change in brain function and is frequently observed in critically ill patients. The condition has been associated with negative outcomes, making it crucial to identify patients who are at risk. Two recent prediction models have been developed to estimate the risk of delirium in intensive care unit (ICU) patients; the prediction model for delirium
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The association between frailty and ageing: Results from an observational study including 9497 elderly patients Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-21 Liva Thoft Jensen, Lars Lundstrøm, Ana Kowark, Mark Coburn, Jacob Steinmetz
Elderly surgical patients have a high risk of postoperative complications. However, patients exhibit considerable diversity in health and functional status; thus, identifying the fragile may be necessary when selecting surgical candidates. We aimed to compare the prevalence of frailty in patients ≥90 years with patients aged 80–89. Second, we assessed the association between frailty and all-cause 30-day
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Albumin use in patients with septic shock—Post-hoc analyses of an international randomised fluid trial Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-17 Tine Sylvest Meyhoff, Anders Granholm, Peter Buhl Hjortrup, Praleene Sivapalan, Theis Lange, Jon Henrik Laake, Maria Cronhjort, Stephan M. Jakob, Maurizio Cecconi, Marek Nalos, Marlies Ostermann, Manu L. N. G. Malbrain, Morten Hylander Møller, Anders Perner
Albumin administration is suggested in patients with sepsis and septic shock who have received large volumes of crystalloids. Given lack of firm evidence, clinical practice variation may exist. To address this, we investigated if patient characteristics or trial site were associated with albumin use in septic shock.
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Frequency and risk factors of atrial fibrillation after acute abdominal surgery: A prospective cohort study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-17 Christoffer L. Madsen, Bonna Leerhøy, Lars N. Jørgensen, Christian S. Meyhoff, Ahmad Sajadieh, Helena Domínguez
Scarce data exist on the true incidence of postoperative atrial fibrillation (POAF) after acute abdominal surgery and associated outcomes. The current study aimed to identify the frequencies of clinically recognized POAF and associated complications, along with their risk factors.
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Perioperative hypersensitivity in children: A prospective multidisciplinary study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-14 Sezin Aydemir, Hatice Betul Gemici Karaaslan, Ulviye Mustu, Oguzhan Tin, Ali Ekber Hakalmaz, Rahsan Ozcan, Senol Emre, Pinar Kendigelen, Ayse Cigdem Tutuncu, Ayca Kiykim, Haluk Cokugras
There are few studies of perioperative hypersensitivity reactions in children. The diagnosis of perioperative hypersensitivity reactions may be under estimated because it is difficult to recognize the reactions. Anaphylaxis may go unnoticed because of patient unconsciousness. Urticaria may be missed due to sterile drapes. The aim of this study was to prospectively evaluate perioperative hypersensitivity
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Anaesthesia practice, quality indices including all-cause 30-day mortality associate to wrist fracture repositioning and surgery in Sweden: A perioperative register-based study 2018–2021 Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-12 Iren Sellbrant, Bengt Nellgård, Jon Karlsson, Johanna Albert, Jan G. Jakobsson
Wrist fracture is one of most common fractures frequently requiring surgical anaesthesia. There is limited information related to the anaesthetic practice and quality including 30-day mortality associated with wrist fracture in Sweden in recent years.
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Mixing short- and long-acting local anaesthetics in peripheral nerve blocks: Protocol for a systematic review and meta-analysis Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-10 Jens L. Temberg, Sanja Pisljagic, Mathias T. Steensbæk, Sina Yousef, Lana Chafranska, Kai H. W. Lange, Christian Rothe, Anders K. Nørskov, Mathias Maagaard, Lars H. Lundstrøm
This protocol describes a systematic review and meta-analysis to evaluate the clinical effects of mixing short- and long-acting local anaesthetics in peripheral nerve blocks. Clinicians often combine short- and long-acting local anaesthetics to achieve a briefer onset time. However, this may come with a prize, namely a shorter total duration of the block, which is of clinical importance.
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Magnitude and time to peak oxygenation effect of prone positioning in ventilated adults with COVID-19 related acute hypoxemic respiratory failure Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-09 Thomas C. Rollinson, Luke A. McDonald, Joleen Rose, Glenn Eastwood, Rahul Costa-Pinto, Lucy Modra, Akinori Maeda, Zoe Bacolas, James Anstey, Samantha Bates, Scott Bradley, Jodi Dumbrell, Craig French, Angaj Ghosh, Kimberley Haines, Tim Haydon, Carol Hodgson, Jennifer Holmes, Nina Leggett, Forbes McGain, Cara Moore, Kathleen Nelson, Jeffrey Presneill, Hannah Rotherham, Simone Said, Meredith Young, Peinan
Prone positioning may improve oxygenation in acute hypoxemic respiratory failure and was widely adopted in COVID-19 patients. However, the magnitude and timing of its peak oxygenation effect remain uncertain with the optimum dosage unknown. Therefore, we aimed to investigate the magnitude of the peak effect of prone positioning on the PaO2:FiO2 ratio during prone and secondly, the time to peak oxygenation
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An ultrasound-guided serratus anterior plane block with continuous local anaesthetic infusion and epidural analgesia for rib fracture pain Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-07 Anna R. Lundén, Pekka Tarkkila
We compared analgesia with an ultrasound (US)-guided serratus anterior plane block (SAPB) to thoracic epidural analgesia (EA) with continuous local anaesthetic infusion in patients with unilateral multiple traumatic rib fractures. EA often carries contraindications in patients with multiple rib fractures (MRFs), whereby having alternative effective methods to treat rib fracture pain remains important
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Peripheral nerve blocks for closed reduction of distal radius fractures—A protocol for a systematic review Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-06 Sanja Pisljagic, Jens L. Temberg, Mathias T. Steensbæk, Sina Yousef, Mathias Maagaard, Lana Chafranska, Kai H. W. Lange, Christian Rothe, Lars H. Lundstrøm, Anders K. Nørskov
Current methods of anaesthesia used for closed reduction of distal radial fractures may be insufficient for pain relief and muscle relaxation, potentially compromising reduction quality and patient satisfaction. Peripheral nerve blocks have already been implemented for surgery of wrist fractures and may provide optimal conditions for closed reduction due to complete motor and sensory blockade of the
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Respiratory effects of pressure support ventilation in spontaneously breathing patients under anaesthesia: Randomised controlled trial Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-11-03 Roberta Sudy, Domitille Dereu, Na Lin, Isabelle Pichon, Ferenc Petak, Walid Habre, Gergely Albu
Lung volume loss is a major risk factor for postoperative respiratory complications after general anaesthesia and mechanical ventilation. We hypothesise that spontaneous breathing without pressure support may enhance the risk for atelectasis development. Therefore, we aimed at characterising whether pressure support prevents changes in lung function in patients breathing spontaneously through laryngeal
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Intravenous MELAtonin for prevention of Postoperative Agitation and Emergence Delirium in children (MELA-PAED): A protocol and statistical analysis plan for a randomized clinical trial Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-30 Anne Louise de Barros Garioud, Lars Peter Kloster Andersen, Aksel Karl Georg Jensen, Hien Quoc Do, Janus Christian Jakobsen, Lars Broksø Holst, Lars Simon Rasmussen, Arash Afshari
Emergence agitation and delirium in children remain a common clinical challenge in the post-anesthetic care unit. Preoperative oral melatonin has been suggested as an effective preventive drug with a favorable safety profile. The oral bioavailability of melatonin, however, is low. Therefore, the MELA-PAED trial aims to investigate the efficacy and safety of intraoperative intravenous melatonin for
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Frailty in the prediction of delirium in the intensive care unit: A secondary analysis of the Deli study Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-30 Steven A. Frost, Kathleen Brennan, David Sanchez, Joan Lynch, Sonja Hedges, Yu Chin Hou, Masar El Sayfe, Sharon-Ann Shunker, Tony Bogdanovski, Leanne Hunt, Evan Alexandrou, Kaye Rolls, Danielle Ni Chroinin, Anders Aneman
Delirium is an acute disorder of attention and cognition with an incidence of up to 70% in the adult intensive care setting. Due to the association with significantly increased morbidity and mortality, it is important to identify who is at the greatest risk of an acute episode of delirium while being cared for in the intensive care. The objective of this study was to determine the ability of the cumulative
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Dexamethasone doses in patients with COVID-19 and hypoxia: A systematic review and meta-analysis Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-26 Marie Warrer Munch, Anders Granholm, Jan Maláska, Jan Stašek, Pablo O. Rodriguez, Tyler Pitre, Rebecca Wilson, Jelena Savović, Bram Rochwerg, Adam Svobodnik, Milan Kratochvíl, Manuel Taboada, Vivekanand Jha, Bharath Kumar Tirupakuzhi Vijayaraghavan, Sheila Nainan Myatra, Balasubramanian Venkatesh, Anders Perner, Morten Hylander Møller
The optimal dose of dexamethasone for severe/critical COVID-19 is uncertain. We compared higher versus standard doses of dexamethasone in adults with COVID-19 and hypoxia.
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Preventing hypothermia in pediatric neurosurgery in Africa—A randomized controlled non-inferiority trial of insulation versus active warming Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-26 Anders C. Feyling, Patrick D. Kamalo, Terje Hanche-Olsen, Singatiya S. Chikumbanje, Aina S. Zsidek, Erica Ponzi, Johan Ræder
The objective of this study was to compare the efficacy of a low-cost heat-preserving method in preventing intraoperative hypothermia with that of forced-air warming in a resource-limited setting.
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Flexible bronchoscopic intubation through a supraglottic airway device: An evaluation of consultant anaesthetist performance Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-25 Christine N. Svendsen, Gine L. Glargaard, Lars H. Lundstrøm, Charlotte V. Rosenstock, Anne C. Haug, Arash Afshari, Rasmus Hesselfeldt, Camilla Strøm
Few clinical studies investigate technical skill performance in experienced clinicians.
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As-needed opioid dosing for emergency patients with a daily use of opioids Acta Anaesth. Scand. (IF 2.1) Pub Date : 2023-10-25 Stine Fjendbo Galili, Lone Nikolajsen, Bodil Hammer Bech, Hans Kirkegaard, Jette Ahrensberg
Patients with a daily use of opioids have a higher risk of insufficient pain treatment during hospitalization than other patients. This study aimed to examine whether as-needed opioid doses (PRN) were adequately adjusted when patients were admitted to the emergency department (ED) with pain.