Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2019
Duration of critically low oxygen delivery is associated with acute kidney injury after cardiac surgery.
Acute kidney injury is a serious complication following cardiac surgery associated with mortality. Restricted oxygen delivery is a potential risk factor for acute kidney injury. The aim of this study was to investigate the impact of the duration of low oxygen delivery (<272 mL min-1 m-2 ), during cardiopulmonary bypass on kidney function. ⋯ A low oxygen delivery during cardiopulmonary bypass was in a dose-dependent manner associated with an increased risk of renal injury.
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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
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
Storage time of red blood cells among ICU patients with septic shock.
We aimed to describe the exposure to blood transfusions and mortality among patients with septic shock. ⋯ Patients with septic shock were transfused both before and after ICU. Exposure to blood of less than 7 days or more than 24 days old were limited. We were not able to detect higher mortality among the limited number of patients with septic shock transfused with very fresh or very old blood.
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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.