Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2022
Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.
The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline Transfusion strategies in bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. This trustworthy clinical practice guideline serves as a useful decision aid for Nordic anaesthesiologists caring for critically ill patients with bleeding.
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Acta Anaesthesiol Scand · May 2022
Ambulance crew initiated non-conveyance in the Helsinki EMS system - A retrospective cohort study.
Ambulance patients are usually transported to the hospital in the emergency medical service (EMS) system. The aim of this study was to describe the non-conveyance practice in the Helsinki EMS system and to report mortality following non-conveyance decisions. ⋯ One-third of EMS missions did not result in patient transport to the hospital. Thirty-day mortality was 1.3%. Abnormalities in multiple respiratory-related vital signs were associated with an increased likelihood of death within 30 days.
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Acta Anaesthesiol Scand · May 2022
AHA STEROID TRIAL, Dexamethasone in Acute High-risk Abdominal surgery, protocol for a randomized controlled trial.
Existing multimodal pathways for patients undergoing acute high-risk abdominal surgery for intestinal obstruction (IO) and perforated viscus (PV) have focused on rescue in the immediate perioperative period. However, there is little focus on the peri-operative pathophysiology of recovery in this patient group, as done to develop enhanced recovery pathways in elective care. Acute inflammation is the main driver of the perioperative pathophysiology leading to adverse outcomes. Pre-operative high-dose of glucocorticoids provides a reduction in the inflammatory response after surgery, effective pain relief in several major surgical procedures, as well as reduce fatigue and improving endothelial dysfunction. ⋯ The AHA STEROID trial will provide important evidence to guide the potential use of high-dose glucocorticoids in emergency high-risk abdominal surgery, with respect to different pathophysiologies.
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Acta Anaesthesiol Scand · May 2022
Randomized Controlled TrialAuraGain™ versus i-gel™ for Bronchoscopic Intubation under Continuous Oxygenation: a Randomised Controlled Trial.
After failed mask ventilation and tracheal intubation, guidelines issued by the Difficult Airway Society recommend placing a second generation supraglottic airway device to secure oxygenation. Ultimately, a secure airway can be obtained by tracheal intubation through the supraglottic airway device using a bronchoscope. In this randomised trial, we compared the AuraGain™ with the i-gel™ as conduit for bronchoscopic intubation under continuous oxygenation performed by a group of anaesthesiologists with variable experience in a general population of patients. ⋯ We found no difference in total time for airway management between using the i-gel™ and using the AuraGain™.