Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2014
A follow-up meeting post death is appreciated by family members of deceased patients.
A practice with a follow-up meeting post death (FUMPD) with physician and staff for family members of patients who died in the intensive care unit (ICU) was started as a quality project to improve the support of families in post-ICU bereavement. A quality improvement control was conducted after 4 years. ⋯ A routine with a Follow-Up Meeting Post Death with the ICU team for the families of the patients who die in the ICU is appreciated. The presence of the physician is important.
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Acta Anaesthesiol Scand · Aug 2014
Observational StudyDynamic variables and fluid responsiveness in patients for aortic stenosis surgery.
Aortic stenosis is the most common valvular disease in developed countries, but it carries an increased mortality during non-cardiac surgery underscoring the importance of adequate hemodynamic management. Further, haemodynamic management of patients immediately after surgery for aortic stenosis can be challenging. Prediction of fluid responsiveness using dynamic variables has not been sufficiently studied in patients for aortic stenosis surgery. ⋯ The arterial pressure-based variables had moderate predictive values before valve replacement, but it predicted fluid responsiveness well postoperatively. Pleth variability index did not predict fluid responsiveness preoperatively, and it had a moderate predictive value postoperatively. These results indicate that arterial pressure-based dynamic variables have limited potential to guide fluid therapy in patients with aortic stenosis. Their ability to guide fluid therapy after aortic valve replacement seems better.
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Acta Anaesthesiol Scand · Aug 2014
Case ReportsPriapism following continuous thoracic epidural anaesthesia: emergency or a benign condition?
Priapism is a rare complication of epidural anaesthesia, and the pathophysiology is poorly understood. In general, 95% of all priapism episodes are ischemic because of decreased penile blood flow, and therefore requires immediate treatment. ⋯ However, confirmation by serial cavernous blood gas analysis or colour duplex ultrasonography is mandatory. Until this hypothesis is confirmed, termination of epidural infusion is advised as a primary treatment.
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Acta Anaesthesiol Scand · Aug 2014
Umbilical cord blood acid-base status in pregnancy with congenital heart disease.
The risk of fetal and neonatal complications is higher in pregnant women with congenital heart disease (CHD). It remains unknown whether umbilical cord blood gas values are different between pregnant women with CHD and healthy women undergoing elective cesarean section during combined spinal-epidural anesthesia. The purpose of the present study was to compare umbilical cord blood acid-base status and gas values in pregnant women with CHD vs. healthy pregnant women undergoing elective cesarean section during combined spinal-epidural (CSE) anesthesia. ⋯ The lower values of umbilical arterial blood pH, BE and HCO3 (-) were observed in pregnant women with CHD than in healthy women undergoing elective cesarean section during CSE anesthesia.