Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2022
ReviewLong-term effects of lower versus higher oxygenation levels in adult ICU patients - a systematic review.
Oxygen therapy is a common treatment in the intensive care unit (ICU) with both potentially desirable and undesirable long-term effects. This systematic review aimed to assess the long-term outcomes of lower versus higher oxygenation strategies in adult ICU survivors. ⋯ The evidence is very uncertain about the effect of a lower versus a higher oxygenation strategy on both the cognitive function and HRQoL. A lower versus a higher oxygenation strategy may have a little to no effect on both outcomes but the certainty of evidence is very low. No evidence was found for the effects on the standardised 6-min walking test and diffusion capacity test.
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Acta Anaesthesiol Scand · Sep 2022
ReviewOutcomes in patients requiring intensive care unit (ICU) admission after emergency laparotomy - a retrospective study.
Outcomes after emergency laparotomy (EL) are poor. These patients are often admitted to an intensive care unit (ICU). This study explored outcomes in patients who were admitted to an ICU within 48 h after EL. ⋯ Age, high APACHE II-score, low CRP and platelet count, and admission from the PACU to the ICU associated with mortality after EL in patients admitted to an ICU within 48 h after EL.
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Acta Anaesthesiol Scand · Sep 2022
Utilization and outcomes of tracheostomies in the intensive care unit in Iceland in 2007-2020: a descriptive study.
Tracheostomies are commonly utilized in ICU patients due to prolonged mechanical ventilation, upper airway obstruction, or surgery in the face/neck region. However, practices regarding the timing of placement and utilization vary. This study provides a nationwide overview of tracheostomy utilization and outcomes in the ICU over a 14-year period. ⋯ We describe a whole-nation practice of tracheostomies. A notable finding is the relatively low rate of extubation attempts prior to tracheostomy insertion. Future work should focus on standardization of assessing the need for tracheostomy and the role of extubation attempts prior to tracheostomy placement.
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Acta Anaesthesiol Scand · Sep 2022
Observational StudyOrthostatic intolerance after fast-track knee arthroplasty: Incidence and hemodynamic pathophysiology.
Early postoperative mobilization can be hindered by orthostatic intolerance (OI) due to failed orthostatic cardiovascular regulation. The underlying mechanisms are not fully understood and specific data after total knee arthroplasty (TKA) are lacking. Therefore, we evaluated the incidence of OI and the cardiovascular response to mobilization in fast-track TKA. ⋯ Early postoperative OI is common following fast-track TKA. Pathophysiologic mechanisms include impaired orthostatic cardiovascular responses. The progression to severe OI symptoms appears to be primarily due to inadequate heart rate response.
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Acta Anaesthesiol Scand · Sep 2022
Establishing a sustainable training programme in anaesthesia in Ethiopia.
Lack of qualified staff is a major hindrance for quality and safety improvements in anaesthesia and critical care in many low-income countries. Support in specialist training may enhance perioperative treatment and have a positive downstream impact on other hospital services, which may improve the overall standard of care. ⋯ Nearly 11 years after establishment of the programme, locally trained highly qualified anaesthetists work in Ethiopia's major hospitals throughout the country.