Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2018
Review Meta AnalysisPerioperative hyperoxia and post-operative cardiac complications in adults undergoing non-cardiac surgery: Systematic review protocol.
Oxygen therapy is used liberally for all patients undergoing anaesthesia. Recent studies have raised concerns that it may not be without complications when arterial oxygen concentrations reach supranormal concentrations (hyperoxia). Studies of oxygen therapy have raised concerns that the risk of myocardial injury and infarction is elevated in patients with hyperoxia due to vasoconstriction and formation of reactive oxygen species. Due to lack of symptoms or silent ischaemia, post-operative myocardial injury may be missed clinically. In some studies, perioperative hyperoxia has been linked to increased long-term mortality, but cardiac complications are sparsely evaluated. The aim of this review is to summarize current evidence to assess the risk and benefits of perioperative hyperoxia on post-operative cardiac complications. ⋯ This systematic review will provide data on a severe, albeit rare, potential risk of oxygen therapy. We will do a trial sequential analysis to assess the robustness of results as well as help estimate the required patient size for future clinical trials.
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Acta Anaesthesiol Scand · Aug 2018
Randomized Controlled TrialEffect of goal-directed haemodynamic therapy in free flap reconstruction for head and neck cancer.
In free flap reconstruction for head and neck cancer, achieving a haemodynamic target using excessive fluid infusion is associated with decreased flap survival rates and extended hospital stays. We hypothesized that goal-directed haemodynamic therapy would improve flap survival rates and shorten hospitalization periods. ⋯ Compared to conventional haemodynamic therapy, goal-directed haemodynamic therapy does not reduce hospitalization periods; it may, however, reduce the length of intensive care unit stays and increase flap survival rates. Further studies including multi-centre trials with larger sample sizes are warranted.
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Acta Anaesthesiol Scand · Aug 2018
Editorial CommentValidation of the Swedish version of Quality of Recovery score -15: a multicentre, cohort study.
Quality of recovery (QoR) after surgery is often focused on morbidity, mortality and physiological changes, while well-being and emotional state are other important aspects that are often ignored. QoR is poorly investigated in clinical settings and a psychometrically tested questionnaire, QoR-15, has recently been developed. QoR-15 has not been validated for Swedish conditions. The aim of this study was to translate, adapt and validate QoR-15 to Swedish conditions (QoR-15swe). ⋯ We have translated and culturally adapted the QoR-15 into Swedish. The score demonstrated acceptable validity, reliability and responsiveness. The QoR-15swe is a clinically acceptable and feasible outcome measure after surgery in a Swedish population.
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Acta Anaesthesiol Scand · Aug 2018
Randomized Controlled TrialForced fluid removal in intensive care patients with acute kidney injury: The randomised FFAKI feasibility trial.
Accumulation of fluids is frequent in intensive care unit (ICU) patients with acute kidney injury and may be associated with increased mortality and decreased renal recovery. We present the results of a pilot trial assessing the feasibility of forced fluid removal in ICU patients with acute kidney injury and fluid accumulation of more than 10% ideal bodyweight. ⋯ Forced fluid removal aiming at 1 mL/kg ideal body weight/hour may be an effective treatment of fluid accumulation in ICU patients with acute kidney injury. A definitive trial using our inclusion criteria seems less feasible based on our inclusion rate of only 2%.
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Acta Anaesthesiol Scand · Aug 2018
Multicenter StudyShould impaired mobility on presentation be a vital sign?
Vital signs are routinely used to assess acutely ill patients, but they do not detect all patients at risk of death. This retrospective multicenter cohort study compares the prediction of death by impaired mobility with age, co-morbidities, and vital sign changes. ⋯ Immobility on presentation is a vital sign and predicts mortality for acutely ill patients independently of the traditional vital signs, age, and co-morbidities.