Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2021
Preferences for measurement and supplementation of magnesium, phosphate and zinc in ICUs: The international WhyTrace survey.
Patients admitted to the Intensive Care Unit (ICU) often have low magnesium, phosphate and zinc levels. Monitoring of serum concentrations and supplementation may be important, but there is no consensus on optimal practice. The objective of the WhyTrace survey was to describe current practice regarding the measurement and supplementation of magnesium, phosphate and zinc in ICUs. ⋯ The practice of measuring and supplementing magnesium, phosphate and zinc differed substantially between ICUs. Our findings indicate that there is a need for high-quality prospective data on frequencies of measurements, treatment goals and effects of supplementation on patient-important outcomes.
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Acta Anaesthesiol Scand · Mar 2021
ReviewLong term IV access in paediatrics - why, what, where, who and how.
Establishment of long-term central venous access imposes the risk of procedural adverse events (air embolism, pneumothorax, accidental arterial cannulation of the great vessels, tricuspid valve damage and cardiac tamponade) as well as the risk of increased morbidity and mortality due to catheter related blood stream infections, vessel stenosis, deep vein thrombosis and the often high risk anaesthetic management of syndromic children. This narrative review aims to provide a historical and clinical background for the development and use of CVADs (central venous access devices), origin and management of the most common complications (catheter related thrombosis, infections and persistent withdrawal occlusion) and present the reader with an update on the "why, what, where, who and how" in paediatric long-term central venous access. Finally, we will present the reader with a clinical method for applying a retrograde inserted tunnelled and cuffed catheter using the left brachiocephalic vein access.
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Acta Anaesthesiol Scand · Mar 2021
Effect of penicillin allergy on prophylactic antibiotic administration in the parturient undergoing cesarean delivery.
Administering antibiotics is often difficult in patients with specific medication allergies. This investigation aimed to determine if a penicillin or cephalosporin allergy increased the risk for not receiving correct timing of prophylactic antibiotics at cesarean delivery. We hypothesized that patients with a penicillin or cephalosporin allergy would be less likely to receive antibiotics prior to incision for cesarean delivery. ⋯ Patients with a penicillin or cephalosporin allergy were less likely to receive prophylactic antibiotics within the recommended 60 minutes prior to surgical incision. Clear plans and communication are important for ensuring proper antibiotic administration at cesarean delivery to prevent surgical site infection.
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Acta Anaesthesiol Scand · Mar 2021
Health care use before and after intensive care unit admission - a nationwide register-based study.
The aim of this study was to describe healthcare utilization of patients admitted to ICU before and after ICU admission. ⋯ Patients admitted to an ICU had increased use of both primary and secondary health care both before and for years after ICU treatment, even after adjustment for comorbidities and socio-economic factors.
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Acta Anaesthesiol Scand · Mar 2021
A survey of anaesthesia practices at all hospitals performing caesarean sections in Sierra Leone.
Providing safe anaesthesia is essential when performing caesarean sections, one of the most commonly performed types of surgery. Anaesthesia-related causes of maternal mortality are generally considered preventable. The primary aim of our study was to assess the type of anaesthesia used for caesarean sections in Sierra Leone. Secondary aims were to identify the type and training of anaesthesia providers, availability of equipment and drugs and use of perioperative routines. ⋯ Anaesthesia for caesarean sections in Sierra Leone showed a predominance for spinal anaesthesia. The workforce consisted mainly of non-physicians, of which a third was not trained to provide anaesthesia independently. Both the type of anaesthesia and the presence of qualified anaesthetic providers was widely variable between hospitals. Significant gaps were identified in the availability of equipment, essential drugs and perioperative routines.