Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2025
A descriptive, retrospective single-centre study of air-leak syndrome in intensive care unit patients with COVID-19.
Acute respiratory failure is the predominant presentation of intensive care unit (ICU) patients with COVID-19, and lung protective strategies are recommended to mitigate additional respiratory complications such as air-leak syndrome. The aim of this study is to investigate the prevalence, type, and timing of air-leak syndrome with regards to associated factors and patient outcome in patients with COVID-19 in ICUs at a large Swedish emergency hospital. ⋯ This single-centre cohort study of air leakage into soft tissue in ventilated COVID cases presents findings for associated factors and clinical manifestations, including with different COVID-19 periods and treatments.
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Acta Anaesthesiol Scand · Mar 2025
Impact of nitroglycerin-induced vasodilation on stroke volume and diuretic response in acute heart failure: A protocol for a mechanistic trial.
Acute heart failure is a clinical syndrome characterized by cardiac dysfunction and neurohumoral activation, encompassing complex underlying pathophysiology which may vary across phenotypes. Nitroglycerine is a nitrate donor with vasodilatory effects on both venous capacitance vessels and arterial resistance vessels in higher doses, typically used with the aim of reducing congestion, preload, and afterload. A limited number of studies have proposed that nitroglycerin could promote diuresis and natriuresis. However, the exact hemodynamic effects of nitroglycerin remain uncertain in the clinical setting of acute decompensated heart failure. We hypothesize that intravenous nitroglycerin induces a significant increase in stroke volume and urinary output while lowering cardiac filling pressures. ⋯ This study will assess the acute effects of vasodilation on stroke volume and urinary output in hospitalized patients with AHF. Furthermore, characterizing the hemodynamic profile of the patient prior to vasodilation may help explore which patients will benefit from vasodilation.
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Acta Anaesthesiol Scand · Mar 2025
Exploring management reasoning when discharging high-risk postoperative patients from the post-anaesthesia care unit.
Decision-support tools for detecting physiological deterioration are widely used in clinical medicine but have been criticised for fostering a task-oriented culture and reducing the emphasis on clinical reasoning. Little is understood about what influences clinical decisions aided by decision-support tools, including professional standards, policies, and contextual factors. Therefore, we explored management reasoning employed by anaesthesiologists and PACU nurses in the post-anaesthesia care unit during the discharge of high-risk postoperative patients. ⋯ While decision-support tools offer cognitive aid and help standardise patient trajectories, they also limit professional discretion in management reasoning and can potentially compromise care and treatment. This highlights the need for a balanced approach that considers both the benefits and limitations of these tools in clinical decision-making.
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Acta Anaesthesiol Scand · Mar 2025
Clinical practice and outcomes in European pediatric cardiac anesthesia: A secondary analysis of the APRICOT and NECTARINE studies.
Despite advancements in surgical techniques and perioperative care, pediatric cardiac patients remain at an increased risk of adverse events. The APRICOT (2017) study aimed to establish the incidence of severe critical events in children undergoing anesthesia in Europe, while the NECTARINE (2021) study aimed to assess anesthesia practices and outcomes in neonates and infants under 60 weeks postconceptual age. Our goal was to conduct a secondary analysis of the cardiac cohorts from these two studies to determine mortality rates and other outcomes after cardiac procedures at 30 and 90 days, identify factors influencing mortality, illustrate clinical practices, and assess the methodology of the two studies. ⋯ This secondary analysis of the APRICOT and NECTARINE studies focused on pediatric cardiac surgical cases. Outcomes differed according to weight and age of the children, where mortality risk was higher for very young and low-weight children.
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Acta Anaesthesiol Scand · Mar 2025
Perceptions of eHealth and digitalization among professional anaesthesia personnel: A Swedish national study.
The objective of this study was to evaluate anaesthesia care professionals' perceptions and attitudes regarding the implementation and advancement of digital solutions in perioperative care. ⋯ Swedish anaesthesia personnel are confident that digital solutions may enhance the efficiency of care within the anaesthesia setting. However, varying perceptions on the benefits and necessity of digital solutions are indicated.