Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2019
Review Meta AnalysisDexmedetomidine for the prevention of delirium in critically ill patients - A protocol for a systematic review.
Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially prevent delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in preventing delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the prevention of delirium. ⋯ This systematic review can potentially aid clinicians in decision-making and benefit the many critically ill patients at risk of delirium.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialSupervised exercise training with multimodal pre-habilitation leads to earlier functional recovery following colorectal cancer resection.
Exercise training is a component of the pre-habilitation program. While in one previous study the training was home-based, in a subsequent investigation it was supervised in hospital. The hypothesis of this secondary analysis of the two studies was to determine whether supervised exercise further accelerates the return to baseline walking ability. ⋯ Supervised exercise training leads to meaningful changes in functional capacity thus accelerating the postoperative return to baseline activities.
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Acta Anaesthesiol Scand · Apr 2019
Review Practice GuidelineClinical practice guideline on atraumatic (pencil-point) vs conventional needles for lumbar puncture: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.
The Scandinavian Society of Anaesthesiology and Intensive Care Medicine Clinical Practice Committee endorses the BMJ Rapid Recommendation clinical practice guideline on atraumatic (pencil-point) vs conventional needles for lumbar puncture. This includes the strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age or indication.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialEffects of thoracic epidural analgesia on exercise-induced myocardial ischaemia in refractory angina pectoris.
Thoracic epidural analgesia (TEDA) was offered to patients with refractory angina pectoris. Our primary objectives were to evaluate TEDAs´ influence on quality of life (QoL, base for power analysis), and hypothesising that TEDA with bupivacaine during 1 month counteracts exercise-induced myocardial hypoperfusion and increase physical performance. ⋯ In refractory angina, TEDA with bupivacaine inhibits myocardial ischaemia in contrast to TEDA with saline. Regardless of whether bupivacaine or saline is applied intermittently every day, TEDA during 1 month improves the quality of life and reduces angina, even when physical performance remains low. A significant placebo effect has to be considered.
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Acta Anaesthesiol Scand · Apr 2019
Lower short-term mortality in ICU patients on chronic dialysis than in those requiring acute dialysis.
In ICU patients, we aimed to describe the outcomes of those with end-stage renal disease (ESRD) as compared to those requiring acute renal replacement therapy (RRT). ⋯ The crude mortality for patients with pre-existing ESRD was high. Short-term mortality was within range of those not receiving RRT when adjusted for confounders. The severity of acute illness and the burden of comorbidities may be more important than the lack of kidney function per se for the short-term prognosis of RRT patients in the ICU.