Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2021
Randomized Controlled TrialEffect of dexmedetomidine on evoked-potential monitoring in patients undergoing brain stem and supratentorial cranial surgery.
Dexmedetomidine is used as adjuvant in total intravenous anaesthesia (TIVA), but there have been few studies concerning its effect on intraoperative neurophysiological monitoring (IONM) during cranial surgery. Our aim was to study the effect of dexmedetomidine on IONM in patients undergoing brain stem and supratentorial cranial surgery. ⋯ The administration of dexmedetomidine at a dosage of 0.5 mg/kg/h may reduce propofol requirements and adversely affect some neuromonitoring variables. However, it can be an alternative on IONM during cranial surgeries. REDEX EudraCT: 2014-000962-23.
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Acta Anaesthesiol Scand · Sep 2021
Multicenter StudyPrevalence and impact of hazardous alcohol use in intensive care cohort: a multi-center, register-based study.
Reports of the prevalence and impact of hazardous alcohol use among intensive care unit (ICU) patients are contradictory. We aimed to study the prevalence of hazardous alcohol use among ICU patients and its association with ICU length of stay (LOS) and mortality. ⋯ The prevalence of hazardous alcohol use in Finnish ICUs was 21%. Patients with hazardous alcohol use were more often younger and male compared with non-hazardous alcohol users.
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Acta Anaesthesiol Scand · Sep 2021
EditorialThe Lure of the Lüer Connector Non-Lüer Connectors in Regional Anaesthesia.
Health service professionals do not have perfect vigilance. There will always be the possibility that a serious untoward incident can occur due to crossover injections of medication being administered via the wrong route. The universality of the Lüer connector made it very easy to connect several medical devices for different therapeutic uses. ⋯ The International Organisation for Standardisation introduced specific ISO 80 369 connectors for use in different medical systems, with the ISO 80369-6 series of standards specifically designed to improve safety in regional anaesthesia. Human error can never be completely eliminated, but the risk of a patient inadvertently suffering from an inadvertent wrong-route injection can be reduced through the use of new 'fit and no-fit' technology. This article focuses on the universality of the Lüer connector and the introduction of the newly engineered non-Lüer connectors, for specific use in medical systems.
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Acta Anaesthesiol Scand · Sep 2021
Perioperative acute kidney injury and urine output in lower limb arthroplasties.
This study aimed to evaluate the occurrence and perioperative risk factors of acute kidney injury (AKI) in primary elective hip and knee and emergency hip arthroplasty patients. We also aimed to assess the effect of urine output (UOP) as a diagnostic criterion in addition to serum creatinine (sCr) levels. We hypothesized that emergency arthroplasties are prone to AKI and that UOP is an underrated marker of AKI. ⋯ Emergency hip arthroplasty is associated with an increased risk of AKI. Since AKI increases mortality in both elective and emergency arthroplasty, perioperative oliguria should also be considered as a diagnostic criterion for AKI. Focusing solely on sCr may overlook many cases of AKI.
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Acta Anaesthesiol Scand · Sep 2021
Review Meta AnalysisThe effects of adding quinolones to beta-lactam antibiotics for sepsis.
Sepsis is common, deadly, and a major challenge to treat. Quinolones added to beta-lactam antibiotics are currently recommended as a second-line empiric regimen in sepsis, but the evidence regarding their benefits and harms is unclear. ⋯ The effects of adding quinolones to beta-lactam antibiotics for the treatment of sepsis were unclear for all outcomes. Additional trial data are warranted to support the recommendation of empirical use of quinolones for sepsis.