Acta anaesthesiologica Scandinavica
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The influence of working conditions on the development of burnout syndrome was assessed in anesthetists working at a university hospital. ⋯ Job conditions providing little opportunity to influence work pace and participation contribute to the development of burnout syndrome. Communication and contact with colleagues appear to be an important preventive regulative.
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Acta Anaesthesiol Scand · Jan 2006
Case ReportsA case of suspected non-neurosurgical adult fatal propofol infusion syndrome.
A previously healthy woman (20 years old) was admitted to our hospital with several fractures after a car accident. She was sedated with propofol, etc. in doses ranging from 1.4 to 5.1 mg/kg/h for 88 h. She developed multiple organ failure with rhabdomyolysis and died. This case fulfils (except acidosis) the criteria of propofol-infusion syndrome (PRIS) in a young adult.
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Acta Anaesthesiol Scand · Jan 2006
Changes in respiratory mechanics and gas exchange during the acute respiratory distress syndrome.
The time course of impairment of respiratory mechanics and gas exchange in the acute respiratory distress syndrome (ARDS) remains poorly defined. We assessed the changes in respiratory mechanics and gas exchange during ARDS. We hypothesized that due to the changes in respiratory mechanics over time, ventilatory strategies based on rigid volume or pressure limits might fail to prevent overdistension throughout the disease process. ⋯ We found a decrease in UIP from acute to established ARDS. If applied to our data, the inspiratory pressure limit advocated by the ARDSnet (30 cmH2O) would produce ventilation over the UIP, with a consequent increased risk of overdistension in 12%, 43% and 65% of our patients during the acute, intermediate and late phases of ARDS, respectively. Lung protective strategies based on fixed tidal volume or pressure limits may thus not fully avoid the risk of lung overdistension throughout ARDS.
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Acta Anaesthesiol Scand · Jan 2006
The effect of tracheostomy on outcome in intensive care unit patients.
Percutaneous dilatation tracheostomy (PDT) is increasingly being used in the intensive care unit (ICU), and has probably increased the number of procedures performed. The primary aim of this study was to document the short- and long-term outcome of patients with a tracheostomy performed during an ICU stay. ⋯ In our ICU, having a tracheostomy performed was associated with a favourable long-term outcome with regard to survival, and early tracheostomy improved survival in addition to consuming less ICU resources.
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Acta Anaesthesiol Scand · Jan 2006
Transarterial block as an addition to a conventional catheter technique improves the axillary block.
We have had favourable experience with a triple injection technique, combining an axillary catheter technique with a transarterial axillary block. This method has been used successfully for routine surgery and re-implantation of fingers, hand or forearm. We hypothesized that with this technique, block onset time and effectiveness are better than with a conventional catheter technique, and designed a study comparing this new technique with a conventional single injection through a catheter. ⋯ The combined triple injection is faster and more effective than the catheter method alone.