Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2019
Observational StudySubanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis.
Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct. Despite significant data regarding its use in adult patients, there remains a paucity of information related to its quality and side effect profile in pediatrics and how it can be effectively used. We aimed to summarize our practice of utilizing ketamine for pediatric pain management in non-critical care settings. ⋯ Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non-critical care settings. Our five-year experience using low-dose ketamine infusions highlights an acceptable side effect profile, with no attributable escalations in care or serious adverse events.
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Acta Anaesthesiol Scand · Oct 2019
External validation of the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU).
The Simplified Mortality Score for the Intensive Care Unit (SMS-ICU) is a clinical prediction model, which estimates the risk of 90-day mortality in acutely ill adult ICU patients using 7 readily available variables. We aimed to externally validate the SMS-ICU and compare its discrimination with existing prediction models used with 90-day mortality as the outcome. ⋯ Discrimination for 90-day mortality of the SMS-ICU in this cohort was poor, but similar to SAPS II and better than that of the SOFA score with markedly less missing data.
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Acta Anaesthesiol Scand · Oct 2019
Age, SAPS 3 and female sex are associated with decisions to withdraw or withhold intensive care.
Intensive care treat critically ill patients. When intensive care is not considered beneficial for the patient, decisions to withdraw or withhold treatments are made. We aimed to identify independent patient variables that increase the odds for receiving a decision to withdraw or withhold intensive care. ⋯ Older age, higher SAPS 3 at admission and female sex were found to be independent variables that increased the odds to receive a decision to withdraw or withhold intensive care.
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Acta Anaesthesiol Scand · Oct 2019
Pre-medication before dental procedures: A randomized controlled study comparing intranasal dexmedetomidine with oral midazolam.
This study aimed to determine if intranasal dexmedetomidine is a superior pre-medication to oral midazolam in older, difficult children. ⋯ Intranasal dexmedetomidine provides higher success rate in sedation and parental separation compared to oral midazolam, in older, difficult children.