Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2021
ReviewHuman glycocalyx shedding: systematic review and critical appraisal.
The number of studies measuring breakdown products of the glycocalyx in plasma has increased rapidly during the past decade. The purpose of the present systematic review was to assess the current knowledge concerning the association between plasma concentrations of glycocalyx components and structural assessment of the endothelium. ⋯ Shedding of glycocalyx components is a ubiquitous process that occurs during both acute and chronic inflammation with no sensitivity or specificity for a specific disease or condition.
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Acta Anaesthesiol Scand · May 2021
Observational StudySupraclavicular ultrasonographic real-time guidance of peripherally inserted central catheters - a feasibility study.
Mispositioning is common during insertion of peripherally inserted central catheters. Ultrasonographic visualization of anatomical structures may enable continuous guidance during insertion. The aim was to investigate the feasibility of ultrasonographic real-time guidance of peripherally inserted central catheter placement using the supraclavicular fossa view. ⋯ Supraclavicular ultrasonographic real-time guidance for peripherally inserted central catheter placement was feasible and enabled successful placement together with detection and redirection of mispositioned catheters without delay.
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Acta Anaesthesiol Scand · May 2021
Multicenter StudyRapid Response Team Nurses' Attitudes and Barriers to the Rapid Response System: A Multicentre Survey.
Despite wide implementation of rapid response teams (RRTs), no published data exist on RRT nurses' attitudes and barriers to the rapid response system (RRS). ⋯ RRT nurses consider their work important and believe it fosters improved critical care skills; these beliefs are emphasized among those with more frequent RRT participation. Infrequent RRT participation, feeling overworked and/or undercompensated and conflicts between RRT and ward doctors may present barriers for successful RRS among RRT nurses.
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Acta Anaesthesiol Scand · May 2021
Discharge Prediction for Patients Undergoing Inpatient Surgery: Development and Validation of the DEPENDENSE Score.
A substantial proportion of patients undergoing inpatient surgery each year is at risk for postoperative institutionalization and loss of independence. Reliable individualized preoperative prediction of adverse discharge can facilitate advanced care planning and shared decision making. ⋯ Using preoperatively available data, we developed and validated a prediction instrument for adverse discharge following inpatient surgery. Reliable prediction of this patient centered outcome can facilitate individualized operative planning to maximize value of care.
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Acta Anaesthesiol Scand · May 2021
Comparative StudyHigher vs. Lower Doses of Dexamethasone in Patients with COVID-19 and Severe Hypoxia (COVID STEROID 2) trial: protocol for a secondary Bayesian analysis.
Coronavirus disease 2019 (COVID-19) can lead to severe hypoxic respiratory failure and death. Corticosteroids decrease mortality in severely or critically ill patients with COVID-19. However, the optimal dose remains unresolved. The ongoing randomised COVID STEROID 2 trial investigates the effects of higher vs lower doses of dexamethasone (12 vs 6 mg intravenously daily for up to 10 days) in 1,000 adult patients with COVID-19 and severe hypoxia. ⋯ This secondary, pre-planned Bayesian analysis will supplement the primary, conventional analysis and may help clinicians, researchers and policymakers interpret the results of the COVID STEROID 2 trial while avoiding arbitrarily dichotomised interpretations of the results.