Ugeskrift for laeger
-
In this article we discuss the current level of evidence for using a high inspiratory oxygen fraction (0.60-0.90) during surgery. More than 7,000 patients have been included in randomized trials, but no significant beneficial effect was found in a recent meta-analysis as compared with 0.30-0.40 oxygen. A high oxygen fraction should be used to correct or prevent hypoxaemia in special situations, but the available studies do not allow a recommendation to use a high inspiratory oxygen fraction as a routine practice in surgical patients.
-
It is estimated that 15% of patients above 65 years of age are frail. Frail patients have significantly higher risk of post-operative complications when undergoing both elective and emergency surgery than patients who are not frail. Therefore, it is recommended that all patients above 65 years are frailty scored prior to a surgical procedure. It seems advisable to include the following items in a multimodal frailty score: evaluation of the patient's cognitive ability, functional status, nutritional status and pulmonary and cardiac function.
-
Ugeskrift for laeger · Nov 2016
Case Reports[Life-threatening ketoacidosis in a 25-year-old woman treated with sodium-glucose cotransporter 2 inhibitor].
We report a case of atypical ketoacidosis in a patient treated with a sodium-glucose cotransporter- (SGLT) 2 inhibitor. The 25-year-old woman, who one year earlier had been prescribed dapagliflozin for presumed Type 2 diabetes, came to the emergency department in a state of severe ketoacidosis, pH 6.85, and a plasma glucose level of 14.3 mmol/l. She received standard treatment and recovered. We discuss the increasing evidence for atypical ketoacidosis being a serious side effect of the SGLT2 inhibitors.
-
Ugeskrift for laeger · Oct 2016
Review[Reversal strategies for non-vitamin K antagonist oral anticoagulants].
Non-vitamin K oral anticoagulants (NOACs) are alternatives to vitamin K antagonists and provide consistent anticoagulation with equal or better clinical outcome and no need for routine monitoring. Bleeding is a feared complication of anticoagulants. ⋯ Andexanet alpha (expected release in 2016) and PER977 are antidotes under clinical development. This article summarizes current and potential future options to antagonize NOACs.