Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2024
ReviewDelirium diagnostic tools in the postoperative setting: A scoping review protocol.
Delirium is an acute and fluctuating disturbance in attention, awareness, and cognition, commonly observed in hospital settings, particularly among older adults, critically ill and surgical patients. Delirium poses significant challenges in patient care, leading to increased morbidity, mortality, prolonged hospital stays, and functional decline. ⋯ This scoping review will provide an overview of existing delirium diagnostic tools used in the postoperative setting and highlight knowledge-gaps to support future research. Due to the large number of patients affected by postoperative delirium, evidence mapping is much needed to facilitate evidence-based practice.
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Acta Anaesthesiol Scand · Nov 2024
ReviewExploring heterogeneity of treatment effect in patients with sepsis: Protocol for a scoping review.
The average treatment effect (ATE) reported by most randomised clinical trials provides estimates of treatment effects for the theoretical, non-existent average patient. However, ATE may not accurately reflect the outcomes for all subsets of the trial population; some individuals may benefit from the intervention, while others experience worse outcomes or no effect at all. Heterogeneity of treatment effect (HTE) is the non-random and explainable variation in the magnitude or direction of a treatment effect among individuals within a population. Predictive approaches to HTE seek to provide estimates of which treatment of choice is better suited for the individual patient, using regression and/or machine learning techniques. This scoping review aims to investigate the extent to which such predictive approaches to HTE are applied to data from trials on sepsis or septic shock as well as the results of these analyses. ⋯ The planned scoping review will systematically investigate, summarise and delineate the existing evidence of analysis of HTE in trials on sepsis or septic shock patients as well as their findings, when performed using predictive approaches.
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Acta Anaesthesiol Scand · Nov 2024
Observational StudyHealth status and quality of life before critical illness: Northern Finland Birth Cohort 1966 study.
Previous findings support the claim intensive care unit (ICU) patients have a higher rate of comorbidities and reduction of health- and functional status compared with the normal population. ⋯ In this study examining previously un-hospitalized patients, the main factors associated with future critical illness were neurological comorbidities, malignancy, alcohol misuse, smoking, low maximum muscle strength, and less frequent physical exercise compared with those with hospitalization not requiring ICU admission.
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Acta Anaesthesiol Scand · Nov 2024
Observational StudyIntraoperative QTc interval interpretation: Effects of anaesthesia, ECG, correction formulae, sex, and current limits: A Prospective Observational Study.
Severe QT interval prolongation requires monitoring QTc intervals during anaesthesia with recommended therapeutic interventions at a threshold of 500 ms. The need for 12-lead ECG and lack of standardisation limit such monitoring. We determined whether automated continuous intraoperative QTc monitoring with 5-lead ECG measures QTc intervals comparable to 12-lead ECG and whether the interpretation of QTc intervals depends on the correction formulae and the patient's sex. We compared intraoperative QTc times to QTc times from resting ECGs of a population from the same region, to substantiate the hypothesis that patients under general anaesthesia may need specific treatment thresholds. ⋯ Intraoperative QTc interval measurement using a 5-lead ECG is valid. Correction formulae and gender influence the intraoperative QTc interval duration and the incidence of pathologically prolonged values according to current limits. The consideration and definition of sex-specific normal limits for QTc times under general anaesthesia, therefore, warrant further investigation.
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Acta Anaesthesiol Scand · Nov 2024
ReviewHypernatremia in hospitalised adult patients: A protocol for a scoping review.
Hypernatremia is a common electrolyte disturbance in hospitalised patients associated with adverse outcomes. The aetiology is diverse but often related to fluid therapy and sodium-containing medicaments. We aim to outline the evidence base on hypernatremia in adult hospitalised patients. ⋯ This scoping review will provide an overview of the current evidence regarding the incidence of hypernatremia, treatment modalities, and outcomes reported for hospitalised adult patients with hypernatremia.