Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2020
Kinetics of crystalloid fluid in hyperglycemia; an open-label exploratory clinical trial.
Infusion with 0.9% saline is a mainstay in the treatment of severe hyperglycemia, but the kinetics of the saline volume in this setting has not been studied. ⋯ The excretion of 0.9% saline was increased depending on the degree of hyperglycemia. The kinetics was characterized by glucose-accelerated diuresis, and an intracellular uptake that occurred at two thirds the urine flow rate. These data could help to determine appropriate volumes and rates of infusion of crystalloids in hyperglycemia.
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Acta Anaesthesiol Scand · Sep 2020
Observational StudyIntensive care patient survival afterlimiting life-sustaining treatment-the FINNEOL*national cohort study.
Few studies have examined survival in intensive care unit (ICU) patients after the restriction of life-sustaining treatment (LST). We aimed to analyse independent factors associated with hospital and 12-month survival rates in ICU patients after treatment restrictions. ⋯ Survival among ICU patients with limited treatment was higher than expected. Advanced age was not associated with higher mortality, potentially because treatment restrictions may be set more easily for older patients.
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Acta Anaesthesiol Scand · Sep 2020
Multicenter StudyBarriers and aidsto routine neuromuscular monitoring and consistent reversal practice -a qualitative study.
Neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered, but surveys have demonstrated inconsistent monitoring practices. Using qualitative methods, we aimed to explore barriers and aids to routine neuromuscular monitoring and consistent reversal practice. ⋯ Using qualitative methods, we found that though Danish anaesthetists generally apply objective neuromuscular monitoring routinely and residents at the US institution often apply subjective neuromuscular monitoring, barriers to consistent and correct use still exist.
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Acta Anaesthesiol Scand · Sep 2020
Comparative StudyHypothermia during CRRT, a comparative analysis.
One of the most common adverse events during continuous renal replacement therapy (CRRT) is hypothermia, reported to occur in over 4/10 cases. In turn, hypothermia is known to be associated with higher mortality rates among patients treated in intensive care units (ICU). The present study examined if a novel warming device in the current generation of CRRT systems could lower incidence of hypothermia compared to previous generation technology. ⋯ The current generation CRRT system and blood warmer significantly decreases the risk of hypothermia among critically ill patients treated with continuous renal replacement therapy as compared to historic controls. Achieving target temperature is easier with the new system.
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Acta Anaesthesiol Scand · Sep 2020
Observational StudyIntroducing the "hip call"to facilitate early surgical treatment of hip fractures: A feasibility study.
Surgical treatment of hip fractures within 24-48 hours decreases morbidity and mortality, but goals for early surgery have not been widely achieved so far. The primary aim of this study was to investigate the feasibility of implementation of a hip call, and the secondary aim was to investigate the effect of the hip call on time for pre-operative preparation and surgery compared to a historical control cohort. ⋯ The implementation of a hip call was feasible with 83% of patients being ready for surgery within 4 hours, and 88% being operated within 24 hours. Future large-scale studies should clarify potential benefits on clinical outcome.