Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2024
Events preceding death after high-risk surgery analyzed by Global Trigger Tool and reflective-thematic approach.
Postoperative mortality might be influenced by postoperative care, vigilance, and competence to rescue. This study aims to describe the course of events preceding death in a high-risk surgical cohort. ⋯ A high predicted risk of death and a peak of adverse events on the day of index surgery were detected. Identified themes reflect lack of documented multi-professional consensus on how to handle prevalent perioperative risk, vigilance, and postoperative level of care.
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Acta Anaesthesiol Scand · Nov 2024
Multidisciplinary nutritional support team and mortality in critically ill patients with acute respiratory distress syndrome.
A careful approach is required when providing nutritional support to patients with acute respiratory distress syndrome (ARDS). This study investigated whether implementing a multidisciplinary nutritional support team (NST) is associated with improved survival outcomes in patients with ARDS. ⋯ NST implementation was associated with enhanced 30-day and 1-year survival rates in patients with ARDS. These findings indicate that nutritional support provided by the NST may influence the survival outcomes of patients with ARDS in the ICU.
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Acta Anaesthesiol Scand · Nov 2024
ReviewPrimary outcomes and anticipated effect sizes in randomised clinical trials assessing adjuncts to peripheral nerve blocks: A scoping review.
Prolonging effects of adjuncts to local anaesthetics in peripheral nerve blocks have been demonstrated in randomised clinical trials. The chosen primary outcome and anticipated effect size have major impact on the clinical relevance of results in these trials. This scoping review aims to provide an overview of frequently used outcomes and anticipated effect sizes in randomised trials on peripheral nerve block adjuncts. ⋯ The reported outcomes and associated anticipated effect sizes can be used in future trials on adjuncts for peripheral nerve blocks to increase methodological homogeneity.
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Acta Anaesthesiol Scand · Nov 2024
Observational StudyPrevalence and etiology of ventilator-associated pneumonia during the COVID-19 pandemic in Denmark: Wave-dependent lessons learned from a mixed-ICU.
Ventilator-associated pneumonia (VAP) may be a particular concern in patients with severe coronavirus disease 2019 (COVID-19). We aimed to determine the prevalence and etiology of VAP in critically ill COVID-19 patients in a Danish intensive care unit (ICU) during the first three waves of the COVID-19 pandemic and to study associations between dexamethasone (DXM) use and development of VAP. ⋯ The prevalence of VAP was high across all three COVID-19 waves and showed a different distribution of pathogens between the first and second wave. Use of DXM was not associated with VAP development. Further and larger studies are needed to understand the risk factors associated with VAP in patients with COVID-19.
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Acta Anaesthesiol Scand · Nov 2024
Review Meta AnalysisSelective decontamination of the digestive tract in burn patients: Protocol for a systematic review.
Nosocomial infections contribute significantly to mortality and morbidity in burn patients. Selective decontamination of the digestive tract is an infection prevention measure that has been shown to improve survival in mechanically ventilated intensive care unit (ICU) patients. It has been hypothesized that burn patients may benefit from selective decontamination of the digestive tract. ⋯ There is clinical equipoise about the use of selective decontamination of the digestive tract in burn patients. In the outlined systematic review and meta-analysis, we will assess the desirable and undesirable effects of selective decontamination of the digestive tract in burn patients.