Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2023
Observational StudyRegional ventilation in spontaneously breathing COVID-19 patients during postural maneuvers assessed by Electrical Impedance Tomography.
Gravity-dependent positioning therapy is an established concept in the treatment of severe acute respiratory distress syndrome and improves oxygenation in spontaneously breathing patients with hypoxemic acute respiratory failure. In patients with coronavirus disease 2019, this therapy seems to be less effective. Electrical impedance tomography as a point-of-care functional imaging modality for visualizing regional ventilation can possibly help identify patients who might benefit from positioning therapy and guide those maneuvers in real-time. Therefore, in this prospective observational study, we aimed to discover typical patterns in response to positioning maneuvers. ⋯ Distribution of ventilation and response to lateral positioning is variable and thus unpredictable in spontaneously breathing patients with coronavirus disease 2019. Electrical impedance tomography might add useful information on the immediate reaction to postural maneuvers and should be elucidated further in clinical studies. Therefore, we suggest a customized individualized positioning therapy guided by electrical impedance tomography.
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Acta Anaesthesiol Scand · Feb 2023
Implementation of video laryngoscopes and the development in airway management strategy and prevalence of difficult tracheal intubation - a national cohort study.
We aimed to determine the development in the use of video laryngoscopy over a 9-year period, and its possible impact on airway planning and management. ⋯ From 2008 to 2016, a period of massive implementation of video laryngoscopes, a significant change in airway management behaviour was recorded. Increasingly, video laryngoscopy is becoming a first-choice device for both acute and routine airway management. Most importantly, the data showed a noticeable reduction in failed intubation over the time of observation.
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Acta Anaesthesiol Scand · Feb 2023
Anaesthesia related mortality data at a Tertiary Pediatric Hospital in Western Australia.
Anaesthesia related mortality in paediatrics is rare. There are limited data describing paediatric anaesthesia related mortality. This study determined the anaesthesia related mortality at a Tertiary Paediatric Hospital in Western Australia. ⋯ Paediatric anaesthesia related mortality as reflected in this retrospective cohort study is uncommon. Significant risk factors were determined as predictors of mortality.
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Acta Anaesthesiol Scand · Feb 2023
Frailty Assessment Tools and Associated Postoperative Outcomes in Older Patients Undergoing Elective Surgery: A Prospective Pilot Study.
There is a need for a feasible tool to assess the risk of frailty prior to surgery. We aimed to identify the ratio of abnormal results for three clinically applicable screening tools to assess the risk of frailty, and their association with adverse outcomes in a cohort of elderly surgical patients. ⋯ Approximately 40% of elderly surgical patients have abnormal PRISMA7, TUG, and CDT screening tests for frailty, and they are associated individually or in combination with increased risk of adverse postoperative outcomes. The results will aid in designing studies to further risk-stratify patients at risk of frailty and attempt to modify associated outcomes.