Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2016
Early chest computed tomography in adult acute severe community-acquired pneumonia patients treated in the intensive care unit.
The value of early chest computed tomography (CT) was evaluated among severe community-acquired pneumonia (SCAP) patients. ⋯ Compared with chest radiograph, chest CT generated new findings in nearly 60% of SCAP patients, leading to new procedures or changes in medical treatment in nearly 75% of those patients. Chest CT better describes the pulmonary involvement and severity of oxygenation disorder compared to a plain chest radiograph.
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Acta Anaesthesiol Scand · Sep 2016
Impact of acute kidney injury on patient outcome in out-of-hospital cardiac arrest: a prospective observational study.
Kidney disease after out-of-hospital cardiac arrest (OHCA) is incompletely described. We examined the occurrence of acute kidney injury (AKI) in OHCA patients and impact of AKI, with or without renal replacement therapy (RRT), on 6-month mortality and neurological outcome. ⋯ Kidney disease occurred in about half of patients successfully resuscitated from OHCA. Presence of AKI, but not RRT, was associated with unfavourable 6-month outcome.
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Acta Anaesthesiol Scand · Sep 2016
Open lung approach ventilation abolishes the negative effects of respiratory rate in experimental lung injury.
We recently reported that a high respiratory rate was associated with less inflammation than a low respiratory rate, but caused more pulmonary edema in a model of ARDS when an ARDSNet ventilatory strategy was used. We hypothesized that an open lung approach (OLA) strategy would neutralize the independent effects of respiratory rate on lung inflammation and edema. This hypothesis was tested in an ARDS model using two clinically relevant respiratory rates during OLA strategy. ⋯ Contrary to previous findings with the ARDSNet strategy, respiratory rate did not influence lung inflammatory response or pulmonary edema during OLA ventilation in experimental ARDS. This indicates that changing the respiratory rate when OLA ventilation is used will not exacerbate lung injury.
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Acta Anaesthesiol Scand · Sep 2016
Perceived cognitive impairments after critical illness: a longitudinal study in survivors and family member controls.
Many former intensive care unit (ICU) patients report difficulties in cognitive functions especially in their daily life. We aimed to measure perceived cognitive impairments in daily life in survivors of critical illness and their family member controls (FMC). ⋯ A substantial part of former patients were affected by post-ICU cognitive impairment in daily life. Pre-existing cognitive impairments were a risk factor. These patients would probably profit from tailored neurorehabilitative therapy. Therefore, an efficient tool to identify potential patients for neurorehabilitation is needed. The questionnaire revealed good psychometric properties. We recommend a comprehensive validation of the questionnaire in this patient population.
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Acta Anaesthesiol Scand · Sep 2016
Long term end-stage renal disease and death following acute renal replacement therapy in the ICU.
In ICU the need for acute renal replacement therapy (RRT) associates with high mortality and risk of end-stage renal disease (ESRD), but there are limited long-term data. We investigated these outcomes and their risk factors. ⋯ The need of acute RRT was associated with markedly increased long term risk of death and ESRD; in contrast its use was not associated with 30-day mortality. In addition to acute RRT, decreased kidney function and peripheral vascular disease before ICU admission were risk factors for ESRD. It seems warranted offering medical follow-up to patients after acute RRT in ICU.