Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2025
ReviewViscoelastic testing of fibrinolytic capacity in acutely infected critically ill patients: Protocol for a scoping review.
Viscoelastic testing (VET) has been implemented in clinical care to diagnose and manage coagulation in patients with manifest or high risk of major bleeding. However, the breakdown of formed blood clots, that is, fibrinolysis, has been comparatively less studied. There is an increasing recognition that acute infections trigger a dysregulated immunothrombotic response, which has focused attention on viscoelastic testing to identify in particular fibrinolysis resistant states. ⋯ This scoping review aims to map the research describing viscoelastic testing (VET) to assess fibrinolysis in acutely infected critically ill patients, with the goal of identifying diagnostic capabilities, any associations with patient outcomes, and the potential to guide clinical management.
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Acta Anaesthesiol Scand · Jan 2025
ReviewChronic postsurgical pain following gastrointestinal surgery - A scoping review.
Chronic postsurgical pain (CPSP) has a great impact on quality of life and socioeconomic status. The mechanisms behind CPSP remain poorly understood, however type of surgical intervention seems to play a role. Gastrointestinal surgeries are common procedures, yet research in CPSP following gastrointestinal surgery is limited. The objective of this scoping review was to map the current literature on CPSP following gastrointestinal surgery, identifying how CPSP have been investigated, and which evidence gaps exist. ⋯ There was a wide consensus on CPSPs' negative impact on quality of life. CPSP following gastrointestinal surgery is prevalent and significantly impacts quality of life. Standardized definitions and methodologies to improve the comparability and reliability of the findings across studies are needed. Future research should focus on CPSP following specific surgical procedures to develop tailored prevention and treatment strategies.
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Acta Anaesthesiol Scand · Jan 2025
Comparative StudyComparison of venous and calculated blood gas values to arterial values in critically ill patients.
Arterial blood gas (ABG) values are important in the assessment of critically ill patients. However, arterial puncture may be challenging to perform in these patients. The venous-to-arterial conversion method (v-TAC) is used to convert venous blood gas values to calculated values meant to resemble arterial values. Calculated pH and partial pressure of carbon dioxide (PCO2) values have shown good agreement with arterial values in stable patients, but performance of the method in patients with severe acid-base disturbances is unknown. We aim to evaluate venous and calculated blood gas value congruency with arterial values in critically ill patients. ⋯ Venous and calculated pH and PCO2 values showed similar congruency with arterial values in patients with alkalemia and moderate acidaemia, while the method was unreliable in a patient suspected of severe metabolic acidaemia.
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Acta Anaesthesiol Scand · Jan 2025
Randomized Controlled TrialEffect of intraoperative methadone in robot-assisted cystectomy on postoperative opioid requirements: A randomized clinical trial.
Postoperative pain management is a challenge after robot-assisted cystectomy (RAC). Methadone has a long duration of action, and we therefore hypothesized that a single dose of intraoperative methadone would reduce postoperative opioid requirements and pain intensity in bladder cancer patients undergoing RAC. ⋯ A single dose of intraoperative methadone does not reduce postoperative opioid requirements compared with a single dose of morphine in bladder cancer patients undergoing RAC.
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Acta Anaesthesiol Scand · Jan 2025
Randomized Controlled TrialGastric ultrasound assessment of two preoperative fasting regimens in pediatric patients: A randomized clinical trial.
Preoperative fasting aims to reduce the risk of pulmonary aspiration. Our aim was to compare the incidence of increased gastric content after preoperative liberal versus a standard fasting in children. ⋯ Prolonged preoperative fasting may be unnecessary. The 6-4-0 fasting regimen can be applied to pediatric patients before elective surgeries without increasing the incidence of "at risk stomach," but further studies with larger sample size are needed to confirm these results.