Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2017
Adductor canal blocks: changing practice patterns and associated quality profile.
Femoral nerve blocks have been the gold standard approach for post-operative analgesia following total knee arthroplasty; however, the adductor canal block has recently gained popularity due to less block-induced motor weakness. The primary aim of this time-series analysis was to identify whether regional anesthesia practice changes have occurred for total knee arthroplasty. Our secondary aim was to assess for possible associated changes in safety and quality. ⋯ There was a large increase in the utilization of adductor canal blockade for TKAs among participating registry members. This change in practice was not associated with significant changes in safety or quality.
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Acta Anaesthesiol Scand · Feb 2017
Cumulative changes in weight but not fluid volume balances reflect fluid accumulation in ICU patients.
The cumulative fluid balance of critically ill patients seems to be an outcome-relevant variable. However, there are no validated data for their reliability calculated for longer (> 5 days) periods of time. ⋯ Assuming that changes in body weight reflect changes in whole body water content cumulative daily fluid volume balances without or with correction for insensible water loss are not useful for estimating cumulative fluid balance of ICU patients. Survivors but not nonsurvivors had a significant loss of weight over time.
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Acta Anaesthesiol Scand · Feb 2017
Occult upper gastrointestinal mucosal abnormalities in critically ill patients.
The objectives of this study were to estimate the frequency of occult upper gastrointestinal abnormalities, presence of gastric acid as a contributing factor, and associations with clinical outcomes. ⋯ Occult mucosal abnormalities were observed in one-third of subjects. The presence of mucosal abnormalities appeared to be independent of prior acid-suppressive therapy and was not associated with reduced haemoglobin concentrations, increased transfusion requirements, or mortality.
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Acta Anaesthesiol Scand · Feb 2017
Extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest in a Danish health region.
Extracorporeal Cardiopulmonary Resuscitation (ECPR) has emerged as a feasible rescue therapy for refractory, normothermic out-of-hospital cardiac arrest (OHCA). Reported survival rates vary and comparison between studies is hampered by heterogeneous study populations, differences in bystander intervention and in pre-hospital emergency service organisation. We aimed to describe the first experiences, treatment details, complications and outcome with ECPR for OHCA in a Danish health region. ⋯ Extracorporeal cardiopulmonary resuscitation is feasible as a rescue therapy in normothermic refractory OHCA in highly selected patients. Low-flow time was longer than previously reported. Survival with favourable neurological outcome is possible despite prolonged low-flow duration.