Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2014
Review Meta AnalysisThe effects of safety checklists in medicine: a systematic review.
Safety checklists have become an established safety tool in medicine. Despite studies showing decreased mortality and complications, the effects and feasibility of checklists have been questioned. This systematic review summarises the medical literature aiming to show the effects of safety checklists with a number of outcomes. ⋯ Safety checklists appear to be effective tools for improving patient safety in various clinical settings by strengthening compliance with guidelines, improving human factors, reducing the incidence of adverse events, and decreasing mortality and morbidity. None of the included studies reported negative effects on safety.
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Acta Anaesthesiol Scand · Jan 2014
Infusion rate and plasma volume expansion of dextran and albumin in the septic guinea pig.
Intravenous fluid treatment of hypovolaemia in states of increased capillary permeability, e.g. sepsis, is often accompanied by adverse oedema formation. A challenge is therefore to achieve and maintain normovolaemia using as little plasma volume substitution as possible to minimise interstitial oedema. In the present study, we evaluated the importance of infusion rate for the plasma volume expanding effects of 6% dextran 70 and 5% human albumin in a guinea pig sepsis model. ⋯ The study performed on a guinea pig sepsis model showed that the plasma volume expanding effects of fixed volumes of 6% dextran 70 and 5% albumin were greater when given at a slow than at a fast infusion rate.
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Acta Anaesthesiol Scand · Jan 2014
Clinical TrialDonepezil provides positive effects to patients treated with gabapentin for neuropathic pain: an exploratory study.
The first-line medication gabapentin and the acetylcholinesterase inhibitor donepezil represent a new promising combination to improve treatment outcomes for patients with severe neuropathic pain. The drugs have previously shown synergism following co-administration in nerve-injured rats. ⋯ Donepezil may provide additional analgesia to neuropathic pain patients with insufficient pain relief from gabapentin as monotherapy. The promising results support controlled clinical trials of the drug combination. The usefulness of mixed-effects analysis in small-scale trials and/or for data with high intersubject variability was also demonstrated.
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Acta Anaesthesiol Scand · Jan 2014
Comparative StudyMeasurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable.
Echocardiography is increasingly becoming an integrated tool for circulatory evaluation in the intensive care unit and the operating room. Therefore, it is imperative to know the reproducibility of measurements obtained by echocardiography. In this study, a comparison of cardiac output (CO) measurements obtained with transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) thermodilution (TD) was carried out to test the precision, accuracy and trending ability of CO measurements obtained with TEE. ⋯ In comparison, CO measurements obtained with TEE and PAC TD had wide limits of agreement, a larger percentage error than would be expected from the precision of the two methods, and a poor trending ability. Thus, TEE is not interchangeable with PAC TD for measuring CO.
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Acta Anaesthesiol Scand · Jan 2014
Observational StudyIs paediatric trauma severity overestimated at triage? An observational follow-up study.
Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). ⋯ There was no difference in the proportion of paediatric and adult trauma patients transported to the TC, neither overall nor among severely injured patients. Paediatric trauma patients admitted to the TC were, however, significantly less injured than adults.