Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2013
Body image and psychological outcome after severe skin and soft tissue infection requiring intensive care.
Patients with severe skin and soft tissue infection (SSTI) requiring intensive care unit (ICU) stay are commonly treated with antibiotics, surgery and in some centers also with hyperbaric oxygen therapy. Long-term follow-up of body image and psychological outcome has not been described despite extensive surgery, potentially altered body image and subsequent psychological problems. The aim was to describe perceived body image and its relation to anxiety, depression and post-traumatic stress disorder (PTSD)-related symptoms in patients with severe SSTI 1 year after ICU stay. Specifically, we aimed to assess potential differences related to gender and anatomic site of infection. ⋯ One year after severe SSTI requiring intensive care, women and patients with abdominoperineal SSTI reported significantly more body image problems. Negative body image was associated with anxiety, depression and PTSD-related symptoms. Specific follow-up for SSTI patients is warranted.
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Acta Anaesthesiol Scand · Feb 2013
Randomized Controlled TrialHigh thoracic epidural analgesia decreases stress hyperglycemia and insulin need in cardiac surgery patients.
Assuming that high thoracic epidural analgesia (HTEA) with the sympathetic block might decrease postoperative blood glucose (BG) level and reduce the need of insulin, the aim was to evaluate the effect of HTEA on the BG level and insulin requirement in patients undergoing cardiac surgery. ⋯ HTEA preserves glucose metabolism better and leads to a lesser degree of 'stress hyperglycaemia' in cardiac surgery patients.
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Acta Anaesthesiol Scand · Feb 2013
Comparative StudyParker Flex-Tip or standard tracheal tube for percutaneous emergency airway access?
Percutaneous emergency airway access (PEAA) can be established utilising a scalpel, bougie and cuffed tracheal tube. The study compared the Parker Flex-Tip tracheal tube with a standard tracheal tube for PEAA in cadavers. We hypothesised that a standard tracheal tube would be more likely to advance over a bougie into the trachea during a PEAA procedure than a Parker Flex-Tip tracheal tube. ⋯ The Parker Flex-Tip tube and a standard tracheal tube perform equally well during PEAA procedures on adult cadavers.
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Acta Anaesthesiol Scand · Feb 2013
Long-term effects of a perioperative safety checklist from the viewpoint of personnel.
While positive short-term effects of the use of safety checklists have previously been reported by personnel, it is unclear to which extent these effects are maintained for a long-term period. The aim of the present study was to evaluate perioperative safety standards and the quality of interprofessional cooperation from the viewpoint of the involved personnel for up to 2 years following the introduction of a safety checklist. ⋯ Some positive effects concerning the perioperative organisation and management were rated more positively even 2 years after checklist implementation. However, interprofessional communication and cooperation did not show long-term improvement from staff members' point of view. Probably longer lasting effects for the latter aspects could be achieved by repeated instruction and communication training.
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Acta Anaesthesiol Scand · Feb 2013
Diabetes mellitus abrogates the cardioprotection of sufentanil against ischaemia/reperfusion injury by altering glycogen synthase kinase-3β.
Sufentanil is widely used in clinical anaesthesia because of its protective effects against ischaemia/reperfusion injury. Diabetes mellitus elevates the activity of glycogen synthase kinase-3β (GSK-3β), thereby increasing the permeability of mitochondrial transition pore. This study investigated the role of GSK-3β in ameliorating the cardioprotective effect of sufentanil post-conditioning in diabetic rats. ⋯ Sufentanil treatment was ineffective in preventing against ischaemia/reperfusion in diabetic rats, which is associated with the activation of GSK-3β. Our results also suggest that direct inhibition of GSK-3β may provide a strategy to protect diabetic hearts against ischaemia/reperfusion injury.