Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2015
Review Practice GuidelineScandinavian clinical practice guideline on mechanical ventilation in adults with the acute respiratory distress syndrome.
The objective of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) task force on mechanical ventilation in adults with the acute respiratory distress syndrome (ARDS) is to formulate treatment recommendations based on available evidence from systematic reviews and randomised trials. ⋯ We strongly recommend pressure- and volume limitation and suggest using higher PEEP and prone ventilation in patients with severe respiratory failure.
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Acta Anaesthesiol Scand · Mar 2015
Injectate spread following ultrasound-guided lateral to medial approach for dual transversus abdominis plane blocks.
Bilateral dual transversus abdominis plane (BD-TAP) injections were devised to cover the T7-8 and L1 dermatomes, which are usually spared with classical and mid-axillary TAP injections. The purpose of this study was to delineate the vertical and lateral extent of injectate spread following a lateral to medial approach for TAP injections in embalmed cadavers. ⋯ A lateral to medial approach for TAP injection resulted in spread of the injectate ranging from T7/8-L1 dermatomes in the majority of the hemi-abdomens. Subcostal and lateral TAP injections do not cover the lateral cutaneous branches of the segmental nerves.
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Acta Anaesthesiol Scand · Mar 2015
Safety of pediatric continuous interscalene block catheters placed under general anesthesia: a single center's experience.
The use of interscalene catheters is an effective treatment strategy for children and adolescents undergoing shoulder surgery. Although placement of interscalene catheters in the awake child is challenging, some have cautioned against performing regional anesthesia in the patient under general anesthesia. We present a case series of 154 interscalene catheters placed in pediatric patients under general anesthesia and managed in the outpatient setting. ⋯ Interscalene catheter placement under general anesthesia and management on an outpatient basis is feasible in the pediatric population and is associated with a low rate of catheter-related complications.
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Acta Anaesthesiol Scand · Mar 2015
Side of pupillary mydriasis predicts the cognitive prognosis in patients with severe traumatic brain injury.
Pupils' abnormalities are associated to bad prognosis in traumatic brain injury. We investigated the association between the side of pupil mydriasis and the long-term cognitive performance of patients with severe traumatic brain injury (TBI). ⋯ Side of admission pupil abnormalities may be a useful variable to improve prognostic models for long-term cognitive performance in severe TBI patients.
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Acta Anaesthesiol Scand · Mar 2015
Intraosseous and intravenous administration of antibiotics yields comparable plasma concentrations during experimental septic shock.
We aimed to investigate whether comparable antibiotic concentrations could be reached with intraosseous and intravenous administration during septic shock. ⋯ In this porcine septic shock model, intraosseous and intravenous administration of gentamicin and cefotaxime yielded comparable concentrations. In an emergency, intraosseous administration of these antibiotics may be considered in severe infections when venous access is difficult.