Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2020
Major incident management by helicopter emergency medical services in South-East Norway from 2000 - 2016: Retrospective cohort study.
Helicopter emergency medical services (HEMS) and search and rescue helicopters (SAR) aim to bring specialized personnel to major incidents and transport patients to definite care, but their operational pattern remains poorly described. We aim to describe the use of HEMS and SAR in major incidents in Norway and investigate the feasibility of retrospectively collecting uniform data from incident reports. ⋯ Major incidents are rare in Norway. HEMS and SAR play an important role in incident logistics, cooperation with other agencies, treatment and transport of patients and should be included in major incident plans. Retrospective data collection is challenging as data variables are not systematically integrated into the database. Future research should focus on systematic data gathering and a system for sharing lessons learned.
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Acta Anaesthesiol Scand · Aug 2020
Observational StudyMortality and complications after emergency laparotomy in patients above 80 years.
Emergency laparotomy (EL) is a high-risk procedure. However, available evidence regarding outcome after emergency surgery in very old patients is limited. The aim of this observational study was to investigate outcome following EL in patients ≥80 years of age.
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Acta Anaesthesiol Scand · Aug 2020
The Association Between Arterial Pulse Waveform Analysis Device and In-Hospital Mortalityin High-Risk Non-Cardiac Surgeries.
Perioperative goal-directed fluid therapy is used for haemodynamic optimization in high-risk surgeries. Cardiac output monitoring can be performed by a specialized pressure transducer for arterial pulse waveform analysis (S-APWA). No study has assessed whether real-world use of S-APWA is associated with post-operative outcomes; therefore, using a Japanese administrative claims database, we retrospectively investigated whether S-APWA use is associated with in-hospital mortality among patients undergoing high-risk surgery under general anaesthesia. ⋯ S-APWA use was not associated with in-hospital mortality in the entire study population. However, S-APWA was associated with decreased in-hospital mortality among vascular surgery and increased in-hospital mortality among lower limb amputation.
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Acta Anaesthesiol Scand · Aug 2020
Commercial albumin solution enhances endotoxin-induced vasoplegia and inflammation.
The Gram-negative bacterium Escherichia coli, commonly involved in severe sepsis and septic shock, shed endotoxin that upon detection by the host triggers an inflammatory cascade. Efficiency of albumin solutions to restore hypovolemia during sepsis has been debated. To aid identification of subgroups of sepsis patients that may respond positively or negatively to treatment with albumin we investigated if preparations of albumin for medical use could affect endotoxin-induced inflammatory response. ⋯ We have shown that albumin solution in combination with endotoxin cause vasoplegia in human omental arteries, paralleled by an inflammatory response. This finding could explain the variable efficiency of albumin solutions for sepsis treatment.