Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2019
Randomized Controlled TrialCutaneous anaesthesia of hip surgery incisions with iliohypogastric and subcostal nerve blockade: A randomised trial.
Cutaneous nerve blockade may improve analgesia after hip surgery. Anaesthesia after the lateral femoral cutaneous (LFC) nerve block is too distal for complete coverage of most hip surgery incisions, which requires additional anaesthesia of the adjacent, proximal area. The transversalis fascia plane (TFP) block potentially anaesthetises the iliohypogastric and subcostal nerves. The primary aim of the present study was to investigate, if the TFP block provides cutaneous anaesthesia adjacent to the LFC nerve block. ⋯ The TFP block anaesthetises the skin proximal to the LFC nerve block by anaesthetising the iliohypogastric and subcostal nerves. TFP block as a supplement to LFC nerve block improves the coverage of the proximal surgical incisions used for hip surgery.
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Acta Anaesthesiol Scand · Jan 2019
Comparative StudyComparison of two prehospital predictive models for mortality and impaired consciousness after severe traumatic brain injury.
The primary aim was to investigate the performance of a National Advisory Committee for Aeronautics based predictive model (NACA-BM) for mortality at 14 days and a reference model using motor GCS (GCS-RM). The secondary aim was to compare the models for impaired consciousness of survivors at 14 days (IC-14; GCS ≤ 13). ⋯ Prehospital prediction of mortality after TBI was good with both models, and the NACA-BM was not inferior to the GCS-RM. Prediction of IC-14 was moderate in both models.
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Acta Anaesthesiol Scand · Jan 2019
Prolonged vasopressor support during hip-fracture surgery is a risk factor for enhanced mortality.
Hip fracture is a common injury in the elderly population and is associated with high morbidity and mortality. Intraoperative hypotension is commonly noted, and is often treated with vasopressors (VP), however, to what extent is unknown. We set out to examine retrospectively how many hip fracture-patients received VP perioperatively and further to investigate if VP treatment is connected to increased mortality. ⋯ Vasopressor treatment is common during hip fracture surgery. Patients treated with VP infusion ≥3 hours have increased mortality, while patients treated with injections or infusion <3 hours have not. We suggest that the prolonged use of VP treatment is linked to increased mortality.
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Acta Anaesthesiol Scand · Jan 2019
Observational StudyElevated serum S-100β in patients with septic shock is associated with delirium.
A high prevalence of delirium is observed in sepsis, yet specific markers for this brain dysfunction in sedated patients are still lacking. Cytoplasmic low molecular weight calcium-binding protein, S-100β, is a commonly used nonspecific marker for brain injury. Here, we evaluated whether delirium is associated with increases in S-100β levels. ⋯ Delirium in septic shock was associated with an elevated protein S-100β when using a laboratory cutoff value of 0.15 μg/L and with more severe organ dysfunction during the ICU stay.
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Acta Anaesthesiol Scand · Jan 2019
Observational StudyPerformance of SAPS II according to ICU length of stay: Protocol for an observational study.
Severity scores, including the Simplified Acute Physiology Score (SAPS) II, are widely used in the intensive care unit (ICU) to predict mortality outcomes using data from ICU admission or shortly hereafter. For patients with longer ICU length of stay (LOS), the predictive performance of admission-based severity scores may deteriorate compared to patients with shorter ICU LOS. This protocol and statistical analysis plan outlines a study that will assess the influence of ICU LOS on the performance of SAPS II for predicting 90-day post-ICU mortality. ⋯ The outlined large, nationwide cohort study will provide important, contemporary information about the influence of ICU LOS on severity score performance relevant for ICU clinicians, researchers, and administrators. Publication of the protocol and statistical analysis plan prior to study conduct ensures transparency, and limits the risk of publication bias, post hoc changes in analyses, and challenges with multiple comparisons.