Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2019
The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation.
We evaluated whether the administration of sildenafil in children undergoing the TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains. ⋯ Sildenafil administration, pre-operatively or within 24 hours after the TCPC operation, did not reduce the required time for pleural and peritoneal drains but was associated with a significantly higher positive fluid balance.
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Acta Anaesthesiol Scand · Nov 2019
Use of red blood cells in Danish intensive care units: a population-based register study.
Red blood cell (RBC) transfusion is common in the intensive care unit (ICU). Recent trials have shown that a restrictive transfusion strategy is safe in most patients, and recent guidelines recommend such a strategy in most ICU patients. It is unknown if this has translated into a change in clinical practice. ⋯ In this population-based register study, we did not with certainty observe changes over time in the use of RBC transfusions in all patients in all ICUs in the Danish Capital Region. A reduction in RBC use may have occurred in some general ICUs and in medical ICU patients.
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Acta Anaesthesiol Scand · Nov 2019
Comparative StudyPercutaneous versus surgical emergency cricothyroidotomy: An experimental randomised crossover study on an animal-larynx model.
Airway management is a paramount clinical skill for the anaesthesiologist. The Emergency Cricothyroidotomy (EC) constitutes the final step in difficult airway algorithms securing a patent airway via a front-of-neck access. The main distinction among available techniques is whether the procedure is surgical and scalpel-based or percutaneous and needle-based. ⋯ Our study demonstrated that anaesthesiologists achieved successful airway access on an animal experimental model with both EC methods within a reasonable time frame, but the scalpel-based EC is performed more promptly. Recent EC training affected the time expenditure positively, while seniority and clinical EC experience did not. EC procedures should be regularly trained for.
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Acta Anaesthesiol Scand · Nov 2019
Neutrophil activation in septic acute kidney injury: A post-hoc analysis of the FINNAKI study.
Inflammation, reflected by high plasma interleukin-6 concentration, is associated with acute kidney injury (AKI) in septic patients. Neutrophil activation has pathophysiological significance in experimental septic AKI. We hypothesized that neutrophil activation is associated with AKI in critically ill sepsis patients. ⋯ Interleukin-8 in plasma and urine was associated with septic AKI. Elevated plasma activin A indicates intravascular neutrophil activation in septic AKI. Concomitant plasma and urine myeloperoxidase measurements suggest neutrophil accumulation into injured kidneys.
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Acta Anaesthesiol Scand · Nov 2019
Analysis of central venous access injuries from claims to the Swedish Patient Insurance Company 2009-2017.
Insertion and use of central venous access devices (CVADs) can be associated with serious adverse events. The incidence is generally low but considering the vast use of CVADs the consequences can, from a patient safety and health economics perspective, be severe. No exact knowledge exists of number of catheters or complications in Sweden, as there is currently no comprehensive registry. The aim was to analyse injuries reported to the Swedish National Patient Insurance Company (Löf) within 7 days after insertion or removal of a CVAD. ⋯ In Sweden, few injuries related to CVAD use are reported to Löf. About 40% of filed claims were categorized as having an avoidable injury and therefore eligible for compensation. About half of the compensated patients suffered a permanent disability. The results indicate underreporting of CVC-related injuries in Sweden during the studied time-period.