Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2015
Randomized Controlled TrialAcute kidney injury with hydroxyethyl starch 130/0.42 in severe sepsis.
We aimed to detail the effects of hydroxyethyl starch (HES) vs. Ringer's on kidney function including the interaction with mortality in post-hoc analyses as resuscitation with HES 130/0.42 increased mortality in the Scandinavian Starch for Severe Sepsis/Septic Shock (6S) trial. ⋯ In patients with severe sepsis, HES appeared to increase the rate of severe AKI and use of RRT within the first 5 days. The increased mortality observed with HES may have been partly mediated through acute kidney impairment.
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Acta Anaesthesiol Scand · Mar 2015
Review Practice GuidelineScandinavian clinical practice guideline on choice of fluid in resuscitation of critically ill patients with acute circulatory failure.
The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure. ⋯ We recommend using crystalloid solutions rather than colloid solutions for resuscitation in the majority of critically ill patients with acute circulatory failure.
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Acta Anaesthesiol Scand · Mar 2015
Multicenter StudyPaediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries.
Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies. ⋯ Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres.
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Acta Anaesthesiol Scand · Mar 2015
Randomized Controlled TrialIntravenous lidocaine increases the depth of anaesthesia of propofol for skin incision - a randomised controlled trial.
The anaesthetic potency of intravenous propofol is quantified by its Cp50 value, which is defined as the plasma concentration required to prevent movement response in 50% of patients to surgical stimuli. We hypothesised that, in addition to propofol anaesthesia, an intravenous bolus of lidocaine 1.5 mg/kg will decrease the Cp50 value of propofol during anaesthesia. ⋯ An intravenous bolus injection of 1.5 mg/kg lidocaine 2% caused a significant reduction of the propofol Cp50 value.
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Acta Anaesthesiol Scand · Mar 2015
Injectate spread following ultrasound-guided lateral to medial approach for dual transversus abdominis plane blocks.
Bilateral dual transversus abdominis plane (BD-TAP) injections were devised to cover the T7-8 and L1 dermatomes, which are usually spared with classical and mid-axillary TAP injections. The purpose of this study was to delineate the vertical and lateral extent of injectate spread following a lateral to medial approach for TAP injections in embalmed cadavers. ⋯ A lateral to medial approach for TAP injection resulted in spread of the injectate ranging from T7/8-L1 dermatomes in the majority of the hemi-abdomens. Subcostal and lateral TAP injections do not cover the lateral cutaneous branches of the segmental nerves.