Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2013
Review Meta AnalysisPeripherally inserted central catheters in infants and children - indications, techniques, complications and clinical recommendations.
Venous access required both for blood sampling and for the delivery of medicines and nutrition is an integral element in the care of sick infants and children. Peripherally inserted central catheters (PICCs) have been shown to be a valuable alternative to traditional central venous devices in adults and neonates. However, the evidence may not extrapolate directly to older paediatric patients. ⋯ Assisted visualisation, preferably with ultrasound, yields high rates of insertion success. With good catheter care, rates of mechanical, infectious and thrombotic complications are low and compare favourably with those of traditional central venous catheters. Even in the case of occlusion or infection, fibrinolytics and antibiotic locks often allow the catheter to be retained.
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Acta Anaesthesiol Scand · Mar 2013
Randomized Controlled TrialCan electromyographic arousal be detected visually on the Datex-Ohmeda S/5™ anesthesia monitor?
Electroencephalogram (EEG)-based depth of anaesthesia monitoring is susceptible to contaminating electromyographic (EMG) activity. Many authorities have suggested that anaesthesiologists using these monitors should interpret the raw EEG waveform seen on the anaesthesia monitor. ⋯ In contrast to many EEG phenomena, EMG activity cannot be accurately detected visually from the raw EEG on the anaesthesia monitor. Further development in the quality of the anaesthesia monitors is warranted.
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Acta Anaesthesiol Scand · Mar 2013
Randomized Controlled TrialThe duration of fibre-optic intubation is increased by cricoid pressure. A randomised double-blind study.
In some categories of patients, a rapid sequence induction using a fibre-optic method may be indicated. The aim of the present study was to examine the effect of cricoid pressure (CP) on the duration of fibre-optic intubation. The hypothesis was that CP would prolong the intubation time. ⋯ The study showed that CP prolongs the duration of fibre-optic intubation in patients with Mallampati grades 1-2.
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Acta Anaesthesiol Scand · Mar 2013
Extracorporeal membrane oxygenation in adult patients with severe acute respiratory failure.
A group of patients with severe acute respiratory distress syndrome (ARDS) is resistant to advanced respiratory therapy. In these patients, extracorporeal membrane oxygenation (ECMO) can be used as a rescue therapy. This study presents 14 years of experience from a Scandinavian ECMO centre. The aim of the study is to present outcome results and to investigate whether or not simplified acute physiology score II (SAPS-II), sequential organ failure assessment (SOFA) and/or Murray scores can be used to predict patients' outcome. ⋯ Patients with severe ARDS have a favourable outcome when treated with ECMO and when an ECMO retrieval team establishes the ECMO treatment at the referring hospital. SAPS-II, SOFA and Murray scores predicted the outcome.