Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2021
The Use of Minimal Invasive Extracorporeal Circulation for Rewarming After Accidental Hypothermia and Circulatory Arrest.
Extracorporeal cardiopulmonary resuscitation has become a recommended treatment option for patients with severe hypothermia with cardiac arrest. Minimal invasive extracorporeal circulation (MiECC) may offer advantages over the current standard extracorporeal membrane oxygenation (ECMO). ⋯ MiECC for extracorporeal rewarming from severe accidental hypothermia is a feasible alternative to ECMO, with comparable survival rates.
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Acta Anaesthesiol Scand · May 2021
Bronchially instilled IgY-antibodies did not decrease pulmonary P. aeruginosa concentration in experimental porcine pneumonia.
P. aeruginosa possesses antibiotic resistance, making treatment difficult. Polyclonal anti-P. aeruginosa IgY-antibodies (Pa-IgY) have antibacterial effects, but have not been studied in large animal pneumonia. ⋯ The chosen dose of Pa-IgY did not decrease concentrations of P. aeruginosa in BAL over 27 hours. We conclude that it is unlikely that there is a large effect of this specific dose and route of administration of Pa-IgY in this type of model.
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Acta Anaesthesiol Scand · May 2021
Review Meta AnalysisPre-operative epidural analgesia in hip fracture patients - A systematic review and meta-analysis.
Hip fracture is a common, painful injury with increasing global incidence. Patients require optimal acute pain management. Systematic reviews have investigated the postoperative use of epidural analgesia and found that it may have advantages over systemic analgesia. It is of interest to determine whether pre-operative use of epidural analgesia is also advantageous. We conducted a systematic review and meta-analyses on the effect of epidural analgesia on pre-operative pain management in hip fracture patients. ⋯ We did not find a difference in pre-operative pain at rest between epidural analgesia and any other method of pre-operatively initiated analgesia. The studies were few, of low quality and the difference between the two interventions remains unknown.
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Acta Anaesthesiol Scand · May 2021
Observational StudyCharacteristics, management and survival of ICU patients with coronavirus disease-19 in Norway, March - June 2020. A prospective observational study.
Norwegian hospitals have operated within capacity during the COVID-19 pandemic. We present patient and management characteristics, and outcomes for the entire cohort of adult (>18 years) COVID-19 patients admitted to Norwegian intensive care units (ICU) from 10 March to 19 June 2020. ⋯ In this national cohort of COVID-19 patients, mortality was low and attributable to known risk factors. Importantly, prolonged length-of-stay must be taken into account when planning for resource allocation for any next surge.
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Acta Anaesthesiol Scand · May 2021
Training non-intensivist doctors to work with COVID-19 patients in intensive care units.
Due to an expected surge of COVID-19 patients in need of mechanical ventilation, the intensive care capacity was doubled at Rigshospitalet, Copenhagen, in March 2020. This resulted in an urgent need for doctors with competence in working with critically ill COVID-19 patients. A training course and a theoretical test for non-intensivist doctors were developed. The aims of this study were to gather validity evidence for the theoretical test and explore the effects of the course. ⋯ Non-intensivist doctors, irrespective of experience level, can acquire relevant knowledge for working in the ICU through a focused 1-day evidence-based course. This knowledge was largely retained as shown by a multiple-choice test supported by validity evidence. The test is available in appendix and online.