Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2019
Randomized Controlled TrialAssociation between perioperative hyperoxia and cerebrovascular complications after laparotomy-A post-hoc follow-up study.
Perioperative hyperoxia has been linked to increased long-term mortality. Vasoconstrictive and cellular side effects to hyperoxia have been suggested to increase the risk of coronary and cerebral ischemia. The aim of this post-hoc analysis of a large randomized trial was to compare the effects of 80% vs 30% perioperative oxygen on the long-term risk of stroke or transient cerebral ischemia (TCI) in patients undergoing abdominal surgery. ⋯ Stroke or TCI did not seem related to perioperative inspiratory oxygen fraction. Due to few events, this study cannot exclude that perioperative hyperoxia increases risk of mortality, stroke, or TCI after abdominal surgery.
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Acta Anaesthesiol Scand · Feb 2019
Review Meta AnalysisThe effects of general anaesthesia on oxygen consumption: A meta-analysis guiding future studies on perioperative oxygen transport.
Increased oxygen extraction, the ratio of consumption to delivery, has been associated with poor outcome after surgery. Oxygen consumption (VO2) can change in several ways in the perioperative period, but is seldom monitored directly in routine care. This study investigates the effects of general anaesthesia on VO2. ⋯ General anaesthesia probably reduces oxygen consumption but the effect estimate is uncertain. Given the limited generalizability and low quality of the available evidence, new studies in modern perioperative settings and in today's older high-risk surgical patient populations are needed.
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Acta Anaesthesiol Scand · Feb 2019
Comparative Study Observational StudyNational Early Warning Score vs Rapid Response Team criteria-Prevalence, misclassification, and outcome.
The purpose of this study was to examine the prevalence of deviating vital parameters in general ward patients using rapid response team (RRT) criteria and National Early Warning Score (NEWS), assess exam duration, correct calculation and classification of risk score as well as mortality and adverse events. ⋯ Even with a mature RRT in place, we captured patients with failing physiology in general wards reflecting afferent limb failure. Manual calculation of NEWS is frequently incorrect, possibly leading to misclassification of patients at risk.
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Acta Anaesthesiol Scand · Feb 2019
ReviewBleeding and thrombosis in intensive care patients with thrombocytopenia-Protocol for a topical systematic review.
Thrombocytopenia is a common condition in critically ill patients in the intensive care unit (ICU). It is associated with prolonged stay in the ICU, increased transfusion requirements, risk of bleeding and mortality. The evidence regarding the use of prophylactic platelet transfusion and thrombosis prophylaxis in patients with thrombocytopenia in the ICU is unknown. To direct future research, we aim to assess the current evidence regarding prophylactic platelet transfusion and thrombosis prophylaxis on patient-important benefits and harms in the ICU population. ⋯ The outlined topical systematic review will provide important data on the benefits and harms of prophylactic platelet transfusion and thrombosis prophylaxis in ICU patients with thrombocytopenia and provide estimates on the rate of thrombocytopenia in this vulnerable population.