Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2021
Multicenter Study Observational Study24-hour fluid administration in emergency department patients with suspected infection; a multicenter, prospective, observational study.
To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection. ⋯ Patients with simple infection and sepsis received equal fluid volumes. Fluid volumes varied markedly, a variation that was partly explained by clinical characteristics.
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Acta Anaesthesiol Scand · Sep 2021
ReviewPhysiological and inflammatory consequences of high and low respiratory rate in acute respiratory distress syndrome.
Using protective mechanical ventilation strategies with low tidal volume is usually accompanied by an increment of respiratory rate to maintain adequate alveolar ventilation. However, there is no robust data that support the safety of a high respiratory rate concerning ventilator-induced lung injury. ⋯ Undoubtedly, the respiratory rate can influence respiratory mechanics in various ways as a factor of multiplication of the power of ventilation, and gas exchange, and also on alveolar dynamics. In this narrative review, we present our point of view over the main experimental and clinical evidence available regarding the effect of respiratory rate on ventilator-induced lung injury development.
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Acta Anaesthesiol Scand · Sep 2021
Frailty and survival in elderly intensive care patients in Norway.
Today, 10%-15% of Norwegian intensive care patients are ≥80 years. This proportion will increase significantly over the next 20 years, but it is unlikely that resources for intensive care increase correspondingly. Thus, it is important to establish which patients among elderly people will benefit from intensive care. The main objective of the study was to investigate the relationships between geriatric scoring tools and 30-day mortality. ⋯ Elderly intensive care patients had a 30-day survival rate of 59.9%. Factors strongly associated with 30-day mortality were increasing SOFA score and increasing frailty (CFS). Other geriatric scores had no significant association with survival in multivariate analyses.
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Acta Anaesthesiol Scand · Sep 2021
Fluid balance -adjusted creatinine in diagnosing Acute Kidney Injury in the critically ill.
Acute kidney injury (AKI) is often diagnosed based on plasma creatinine (Cr) only. Adjustment of Cr for cumulative fluid balance due to potential dilution of Cr and subsequently missed Cr-based diagnosis of AKI has been suggested, albeit the physiological rationale for these adjustments is questionable. Furthermore, whether these adjustments lead to a different incidence of AKI when used in conjunction with urine output (UO) criteria is unknown. ⋯ Fluid balance-adjusted Cr resulted in little change in AKI incidence, and only minor differences in mortality between patients who changed category after adjustment and those who did not. Using adjusted Cr values to diagnose AKI does not seem worthwhile in critically ill patients.
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Acta Anaesthesiol Scand · Sep 2021
Difference in postoperative opioid consumption after spinal vs. general anaesthesia for ankle fracture surgery - a retrospective cohort study.
Surgical treatment of ankle fracture is associated with significant pain and high postoperative opioid consumption. The anaesthesia method may affect early postoperative pain. The main objective of the study was to compare postoperative opioid consumption after ankle-fracture surgery between patients treated with spinal anaesthesia and general anaesthesia. ⋯ Patients with surgically treated ankle fracture whose operation was performed under general anaesthesia used significantly more opioids in the first 48 h postoperatively, predominantly in the post-anaesthesia care unit, compared with patients given spinal anaesthesia.