Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Feb 2021
Development of a comprehensive Percutaneous Dilatational Tracheostomy process model for procedural training: a Delphi-based experts consensus.
Deconstructing a complex procedure improves skills learning, but no model has covered all relevant Percutaneous Dilatational Tracheostomy (PDT) procedural aspects. Moreover, the heterogeneity of techniques described may hinder trainees' competency acquisition. Our objective was to develop a PDT model for procedural training that includes a comprehensive step-by-step design. ⋯ We have presented a PDT model that includes necessary competence dimensions to be considered complete. The model was validated by an experts' consensus, allowing to improve procedural training to promote safer patient care.
-
Acta Anaesthesiol Scand · Feb 2021
Observational StudyContinuous peripheral perfusion index in patients admitted to hospital wards - an observational study.
Risk patients admitted to hospital wards may quickly develop haemodynamic deterioration and early recognition has high priority to allow preventive intervention. The peripheral perfusion index (PPI) may be an indicator of circulatory distress by assessing peripheral perfusion non-invasively from photoplethysmography. We aimed to describe the characteristics of PPI in hospitalized patients since this is not well-studied. ⋯ Lower PPI during daytime vs evening and night-time were seen for both populations. The highest frequency of serious adverse events and mortality was seen among patients with low median PPI. The clinical impact of PPI monitoring needs further confirmation.
-
Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled TrialEffects of thermal softening of endotracheal tubes on postoperative sore throat: A randomized double-blinded trial.
Postoperative throat complications after intubation are undesirable but frequent outcomes. A randomized, double-blinded study was performed to determine whether thermal softening of endotracheal tubes reduced throat complications after intubation. ⋯ Intubation using endotracheal tubes with thermal softening significantly decreased the incidence of sore throat 1 hour after extubation when compared with endotracheal tubes without thermal softening.
-
Acta Anaesthesiol Scand · Feb 2021
Clinical TrialThe 90% effective dose of intranasal dexmedetomidine for procedural sedation in children with congenital heart disease before and after surgery: a biased-coin design up-and-down sequential allocation trial.
Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, there are few reports investigating the effective dose of intranasal dexmedetomidine for sedation in children with congenital heart disease (CHD) before and after surgery. ⋯ The 90% effective dose of intranasal dexmedetomidine for sedation in children with CHD was 2.13 μg/kg before cardiac surgery and 3.51 μg/kg after cardiac surgery.
-
Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled TrialEffects of different mean arterial pressure targets on plasma volume, ANP and glycocalyx - A randomised trial.
Arterial haematocrit (Hct) has been shown to decrease after anaesthesia induction, most probably because of an increased plasma volume (PV). The primary objective was to quantify change in PV if mean arterial pressure (MAP) was kept at baseline level or allowed to decrease to 60 mm Hg. Our secondary objective was to evaluate underlying mechanisms of this response. ⋯ Allowing mean arterial pressure to fall to 60 mm Hg during anaesthesia induction, increases the plasma volume due to reabsorption of interstitial water, with no ANP-induced degradation of the endothelial glycocalyx.