Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2022
Multicenter StudyImproving neuromuscular monitoring and reducing residual neuromuscular blockade via e-learning - a multicentre interrupted time-series study (INVERT study).
Neuromuscular monitoring should be applied routinely to avoid residual neuromuscular block. However, anaesthetists often refrain from applying it, even when the equipment is available. We aimed to increase neuromuscular monitoring in six Danish anaesthesia departments via e-learning. ⋯ We found no overall effect of the e-learning module on application of neuromuscular monitoring, although the post-course test indicated an effect on anaesthetists' knowledge in this field.
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Acta Anaesthesiol Scand · May 2022
Improved 60-day survival but impaired general health in Swedish ICU-COVID patients: an ambidirectional population-based study.
Survival among critically ill COVID-19 patients varies between countries and time periods. Mortality rates up to 60% have been reported in intensive care units (ICUs). Standard-of-care has evolved throughout the pandemic. The purpose of the study was to explore management and mortality of COVID-19 ICU-patients during the first pandemic wave and assess their post-ICU health status. ⋯ In this cohort, the initial 60-day mortality quickly declined, despite continuous admittance of critically ill patients. This was parallel to adaptation to increased workload and more intense thromboembolic prophylaxis. A majority of survivors reported declined general health four months after discharge. Further studies on long-term health status of ICU-survivors are indicated.
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Acta Anaesthesiol Scand · May 2022
Flouroscopic Versus Conventional Epidural Blood Patch in Obstetrics - A Retrospective Cohort Study.
Epidural blood patch is a common effective treatment for postdural puncture headache after accidental dural puncture during labor and may be done in conventional or fluoroscopy-guided methods. The aim of this study was to compare intensity of headache at the time of discharge from the hospital and to compare blood volumes injected in conventional epidural blood patches versus fluoroscopic-guided blood patches and evaluate the side effects of both method of treatment. ⋯ Women who received fluoroscopic epidural blood patch required a much lower volume of blood injected while there was no difference between groups in headache pain intensity at discharge.
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Acta Anaesthesiol Scand · May 2022
Observational StudyContinuous Monitoring of Vital Sign Abnormalities; Association to Clinical Complications in 500 Postoperative Patients.
Patients undergoing major surgery are at risk of complications, so-called serious adverse events (SAE). Continuous monitoring may detect deteriorating patients by recording abnormal vital signs. We aimed to assess the association between abnormal vital signs inspired by Early Warning Score thresholds and subsequent SAEs in patients undergoing major abdominal surgery. ⋯ Overall duration of vital sign abnormalities at current thresholds were not significantly associated with subsequent serious adverse events, but more patients with tachycardia and hypotension had subsequent serious adverse events.
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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.