Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2021
ReviewPre-procedural platelet transfusion thresholds in hospitalised children - protocol for a scoping review.
Thrombocytopenia is a common condition in hospitalised critically ill children and most platelet transfusions are given as prophylaxis to non-bleeding children prior to invasive procedures such as central venous catheterisation and lumbar puncture. Platelet transfusion may reduce bleeding complications but have also been associated with potential adverse effects and variation in clinical practice exist. To direct future research, we aim to assess the current evidence regarding prophylactic platelet transfusion prior to procedures in hospitalised thrombocytopenic children. ⋯ The outlined scoping review will provide an overview on the benefits and harms of prophylactic platelet transfusion prior to invasive procedures in thrombocytopenic hospitalised children.
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Acta Anaesthesiol Scand · Apr 2021
Outcomes of catheter-directed interventions in high-risk pulmonary embolism-a retrospective analysis.
First-line treatment of high-risk pulmonary embolism with persistent hypotension and/or signs of shock is intravenous thrombolysis. However, if thrombolysis is contraindicated due to risk of serious bleeding, or if it yields insufficient effect, surgical thrombectomy or catheter-directed intervention (CDI) plus anticoagulation is recommended. The aim of this study was to assess the outcomes of the CDI modality introduced in a tertiary referral centre in 2013. ⋯ In patients with high-risk pulmonary embolism, 90-day survival was similar after treatment with CDI plus anticoagulation compared to anticoagulation only. The mean reduction in RV/LV ratio was larger in the CDI group. Our results support the use of CDI in selected patients, respecting the limitations and potential side effects of each technical device used.
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Increased bleeding and blood product transfusions during cardiac surgery are associated with poor outcomes. The patient's ABO blood group is related to hemostatic balance, although it is unclear whether this influences bleeding during cardiac surgery. This study aimed to evaluate whether ABO blood group is related to bleeding during cardiac surgery. ⋯ The patient's ABO group appears to be related to volumes of chest tube drainage and transfused blood products during cardiac surgery.
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Acta Anaesthesiol Scand · Apr 2021
Arterial and end-tidal carbon dioxide partial pressure difference during prehospital anaesthesia in critically ill patients.
Normoventilation is crucial for many critically ill patients. Ventilation is routinely guided by end-tidal capnography during prehospital anaesthesia, based on the assumption of the gap between arterial partial pressure of carbon dioxide (PaCO2 ) and end-tidal carbon dioxide partial pressure (PetCO2 ) of approximately 0.5 kPa (3.8 mmHg). ⋯ Our results suggest that end-tidal capnography alone might not be an adequate method to achieve normoventilation for critically ill patients intubated and mechanically ventilated in prehospital setting. Thus, an arterial blood gas analysis might be useful to recognize patients with an increased gap between PaCO2 and PetCO2 .
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Acta Anaesthesiol Scand · Apr 2021
Non sedation - does it improve health-related quality of life after critical illness? A 3-month follow-up sub-study of the NONSEDA trial.
Critical illness is associated with severely impaired health-related quality of life (HRQoL) for years following discharge. The NONSEDA trial was a multicenter randomized trial on non-sedation versus sedation with a daily wake-up trial in critically ill, mechanically ventilated patients in Scandinavia. The aim of this sub-study was to assess the effect of non-sedation on HRQoL and degree of independence in activities in daily living (ADL) 3 months post-ICU. ⋯ Randomization to non-sedation neither improved nor impaired health-related quality of life or degree of independence in activities in daily living 3 months post-ICU discharge.