Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2018
Risk factors of acute kidney injury in children after cardiac surgery.
The objective of this retrospective study was to determine the risk factors for acute kidney injury (AKI), including albumin, in children who underwent cardiac surgery. In addition, we evaluated the association between preoperative serum albumin level and postoperative AKI in these patients. ⋯ Preoperative serum albumin level, age <12 months, preoperative pulmonary hypertension, and CPB duration were associated with risk for postoperative AKI in children who underwent congenital cardiac surgery.
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Acta Anaesthesiol Scand · Nov 2018
Changes in nasotracheal tube depth in response to head and neck movement in children.
A tracheal tube is often inserted via the nasal cavity for dental surgery. The position of the tube tip is important, given that the head position sometimes changes during surgery. Head movement induces changes in the length of the trachea (t-length) and/or the distance between the nare and the vocal cords (n-v-distance). In this study, we investigated the changes in t-length and n-v-distance in children undergoing nasotracheal intubation. ⋯ A change in the position of the tracheal tube tip in the trachea depends mainly on changes in t-length during paediatric dental surgery.
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Acta Anaesthesiol Scand · Nov 2018
Pneumococcal sepsis requiring mechanical ventilation: Cohort study in 38 patients with rapid progression to septic shock.
The aim was to study the course of severe pneumococcal sepsis in patients who rapidly developed septic shock with multiorgan failure. ⋯ In this patient cohort with pneumococcal sepsis and respiratory failure rapid development of septic shock was seen in all cases, even in young healthy individuals. Initial clinical features were variable; none were treated with antibiotics before admission. Mortality was high (40%), as was morbidity with limb amputations and neurological complications.
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Acta Anaesthesiol Scand · Nov 2018
CYP3A4 gene polymorphism is correlated with individual consumption of sufentanil.
Pain is one of the major adverse clinical outcomes of cesarean section (CS). In the past few years, researchers and physicians have been optimizing post-operative analgesic modalities, but the results are still undesirable for the parturient. The cytochrome P-450 3A4 (CYP3A4) gene has been reported to contribute significantly to human liver microsomal oxidation of sufentanil and alfentanil. ⋯ In summary, we found a correlation between CYP3A4 genetic polymorphism and sufentanil consumption. This might be helpful for optimizing the anesthesia strategies and reducing their side effects.
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Acta Anaesthesiol Scand · Nov 2018
Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018.
Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterwards. ⋯ For clinical purposes, it is recommended to use the DSM-5 nomenclature. The working group recommends that 'perioperative neurocognitive disorders' be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of acute event (postoperative delirium) and cognitive decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery) and up to 12 months (postoperative neurocognitive disorder).