Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2020
Review Meta AnalysisEffects of postoperative furosemide in adult surgical patients: a systematic review and meta-analysis of randomised clinical trials.
Acute kidney injury (AKI) is associated with increased morbidity and mortality and may present as oliguria in the post-operative phase. Diuretics, including furosemide, are commonly used in post-operative patients. Accordingly, we aimed to assess the balance between benefits and harms of furosemide post-operatively in adult surgical patients. ⋯ In this systematic review, we found that the quantity and quality of evidence for using furosemide post-operatively in adult surgical patients were very low with no firm evidence for benefit or harm.
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Acta Anaesthesiol Scand · Mar 2020
Randomized Controlled TrialIntra- and inter-Individual variability in nerve block duration: A randomised cross-over trial in the common peroneal nerve of healthy volunteers.
The reported variation in nerve block duration is considerable. To individualize nerve block therapy, knowledge of the intra- vs inter-individual variability is essential. We investigated the relative contribution of these 2 parameters to the overall nerve block duration variability. ⋯ The intra-individual variability is a substantially minor contributor to the overall variability in sensory nerve block duration compared with the inter-individual variability.
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Acta Anaesthesiol Scand · Mar 2020
Randomized Controlled Trial Comparative StudyCost analysis comparison between peripherally inserted central catheters and implanted chest ports in patients with cancer - a health economicevaluation of the PICCPORT trial.
A reliable central venous access device is a cornerstone in the treatment of cancer. Both peripherally inserted central catheters (PICC) and totally implanted chest ports (PORT) are commonly used for the delivery of chemotherapy. Both types of catheter can cause adverse events such as catheter-related deep venous thrombosis (CR-DVT), infection and mechanical complications. ⋯ We have demonstrated that the cost from a healthcare perspective is higher in cancer patients receiving a PICC than to those with a PORT. The difference is driven mainly by the cost related to the management of adverse events. Our findings are relevant to anaesthetists, oncologists and vascular access clinicians and should be considered when choosing vascular access device prior to chemotherapy.
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Acta Anaesthesiol Scand · Mar 2020
Respiratory Complications after Adenotonsillectomy in High-Risk Children with Obstructive Sleep Apnea: A retrospective cohort study.
Obstructive sleep apnea (OSA) occurs in 1%-4% of children; adenotonsillectomy is an effective treatment. Mortality/severe brain injury occurs among 0.6/10 000 adenotonsillectomies; in children, 60% are secondary to airway/respiratory events. Earlier studies identified that children aged <2 years, extremes of weight, with co-morbidities of craniofacial, neuromuscular, cardiac/respiratory disease, or severe OSA are at high risk for adverse post-operative respiratory events (AE). We aimed to: Firstly, investigate which risk factors were associated with AEs either in the post-anesthesia care unit (PACU), pediatric intensive care unit (PICU), or both in this population. Secondly, we investigated factors associated with post-operative PICU AE despite no event in the PACU in order to predict need of post-operative PICU after their PACU stay. ⋯ Among high-risk children undergoing TA, absence of adverse events in PACU during a 2-hour observation period does not predict absence of subsequent AEs in the PICU.
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Acta Anaesthesiol Scand · Mar 2020
The effect of cognitive aid design on the perceived usability of critical event cognitive aids.
Critical events require that clinicians process information and make decisions quickly. To reduce mental workload during such events, cognitive aids have been developed. We have previously observed that designing such aids to facilitate discrete information transfer decreased time to information finding. However, whether clinicians perceive aids designed for discrete information transfer as more usable than step-by-step designs remains unclear. We hypothesized that experimental cognitive aids designed for discrete information transfer would be judged more usable than step-by-step Linear aids. ⋯ During simulated critical events, cognitive aids designed for discrete information transfer were considered more usable than step by step Linear aids. Specific themes governing usability were identified during mixed methods analysis. Further work is needed to optimize cognitive aid use among anesthesia clinicians.