Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2015
The effects of surgical checklists on morbidity and mortality: a pre- and post-intervention study.
Surgical checklists (SCs) have been developed to enhance teamwork and facilitate handovers, thereby improving the safety of surgical patients in health care organisations. The aim of this study was to determine whether the implementation of a 39-item SC reduced mortality and surgical adverse events (AEs) in patients undergoing inpatient surgery. ⋯ The overall AE rate did not decrease significantly between the two periods. However, the rate of infectious AEs and overall AEs in patients with non-elective admissions had statistically significant reductions. Further research is needed to determine how and in which patients SC introduction can work successfully.
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Acta Anaesthesiol Scand · Feb 2015
Systemic matrix metalloproteinase-8 and tissue inhibitor of metalloproteinases-1 levels in severe sepsis-associated coagulopathy.
Matrix metalloproteinase-8 (MMP-8) and tissue inhibitor of metalloproteinases-1 (TIMP-1) have recently been suggested to be involved in coagulation process. Our objectives were to observe systemic MMP-8 and TIMP-1 levels in patients with severe sepsis with or without disseminated intravascular coagulation (DIC) and to study their relationship with coagulation markers over time. ⋯ In this first human study, we could show that TIMP-1 is elevated in the early phase of sepsis-induced overt DIC, and it correlates both with degree of coagulopathy and disease severity. These findings suggest that TIMP-1 may play a role in the pathogenesis of DIC in septic patients.
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Acta Anaesthesiol Scand · Feb 2015
Association of mortality with out-of-hours admission in patients with perforated peptic ulcer.
Perforated peptic ulcer is a serious emergency surgical condition. The aim of the present nationwide cohort study was to evaluate the association between mortality and out-of-hours admission in patients surgically treated for perforated peptic ulcer. ⋯ No statistically significant adjusted association between 90-day mortality and out-of-hours admission was found in patients surgically treated for perforated peptic ulcer.
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Acta Anaesthesiol Scand · Feb 2015
Randomized Controlled Trial Comparative StudyEmergence agitation after orthognathic surgery: a randomised controlled comparison between sevoflurane and desflurane.
This study aimed to compare emergence agitation following sevoflurane and desflurane anaesthesia in adults undergoing orthognathic surgery. The hypothesis was that there might be a difference in the incidence of emergence agitation following sevoflurane and desflurane anaesthesia considering the difference in blood solubility and speed of recovery between the two. ⋯ In adults undergoing orthognathic surgery, desflurane anaesthesia was associated with less emergence agitation than was sevoflurane anaesthesia.