Acta anaesthesiologica Scandinavica
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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
Different measures of ventilatory efficiency in preoperative cardiopulmonary exercise testing are useful for predicting postoperative complications in abdominal cancer surgery.
Ventilation as a function of elimination of CO2 during incremental exercise (VE/VCO2 slope) has been shown to be a valuable predictor of complications and death after major non-cardiac surgery. VE/VCO2 slope and partial pressure of end-tidal carbon dioxide (PetCO2) are both affected by ventilation/perfusion mismatch, but research on the utility of PetCO2 for risk stratification in major abdominal surgery is limited. ⋯ Both preoperative VE/VCO2 slope and PetCO2 could identify subjects with a very high risk of complications following oesophageal resection, with similar prognostic utility. PetCO2 can be measured with simpler equipment and could therefore be useful when CPET is not available.
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Acta Anaesthesiol Scand · Jan 2025
Observational StudyRe-arrest immediately after return of spontaneous circulation: A retrospective observational study of in-hospital cardiac arrest.
Patients who achieve return of spontaneous circulation (ROSC) after in-hospital cardiac arrest (IHCA) may re-arrest. This phenomenon has not been sufficiently investigated. The aim of this study was to examine the immediate (1-min) and short-term (20-min) risks of re-arrest in IHCA. ⋯ The immediate risk of re-arrest was approximately 2% per minute, with the highest risk occurring as a reversion to VF/VT if ROSC was obtained from VF/VT. The risk of re-arrest within 20 min of the initial arrest was 27%, and the overall risk of at least one re-arrest per episode was 33%.