Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialEffect of pre-operative fluid therapy on hemodynamic stability during anesthesia induction, a randomized study.
Preserving perfusion pressure during anesthesia induction is crucial. Standardized anesthesia methods, alert fluid therapy and vasoactive drugs may help maintain adequate hemodynamic conditions throughout the induction procedure. In this randomized study, we hypothesized that a pre-operative volume bolus based on lean body weight would decrease the incidence of significant blood pressure drops (BPD) after induction with target-controlled infusion (TCI) or rapid sequence induction (RSI). ⋯ Pre-operative fluid bolus decreased the incidence of significant blood pressure drops during TCI and RSI induction of general anesthesia.
-
Acta Anaesthesiol Scand · Oct 2019
Checking mask ventilation before neuromuscular block: A nation-wide survey of anaesthetists' attitudes and thinking.
The value of checking mask ventilation before administering neuromuscular blocking drugs is still debated. ⋯ We found several interesting comments about airway management at both practical and theoretical levels. The survey highlights that routinely performing a MVT is a common practice in Sweden in spite of the lack of evidence for increased patient safety. Future airway guidelines may need to address this practice.
-
Acta Anaesthesiol Scand · Oct 2019
Early termination of resuscitation in in-hospital cardiac arrest and impact to the outcome calculations.
Some in-hospital resuscitation attempts are assessed futile and terminated early on. We hypothesized that if these cases are reported separately, the true outcome of in-hospital cardiac arrest is better reflected. ⋯ One-seventh of resuscitation attempts were terminated early on due to presumed futility of the attempt. Short- and long-term outcomes were 5% and 4% better when early terminated attempts were excluded from the outcome analyses. We believe that in-hospital cardiac arrest outcome is not as poor as repeatedly presented in the literature.
-
Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialConservative versus Liberal fluid therapy in Septic Shock (CLASSIC) trial - protocol and statistical analysis plan.
Intravenous (IV) fluid is a key intervention in the management of septic shock. The benefits and harms of lower versus higher fluid volumes are unknown and thus clinical equipoise exists. We describe the protocol and detailed statistical analysis plan for the conservative versus liberal approach to fluid therapy of septic shock in the Intensive Care (CLASSIC) trial. The aim of the CLASSIC trial is to assess benefits and harms of IV fluid restriction versus standard care in adult intensive care unit (ICU) patients with septic shock. ⋯ The CLASSIC trial results will provide important evidence to guide clinicians' choice regarding the IV fluid therapy in adults with septic shock.
-
Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled Trial Multicenter StudyPantoprazole in ICU patients at risk for gastrointestinal bleeding - one-year mortality in the SUP-ICU trial.
The long-term effects of stress ulcer prophylaxis with pantoprazole are unknown in ICU patients. We report 1-year mortality outcome in the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. ⋯ We did not observe a difference in 1-year mortality among acutely admitted adult ICU patients with risk factors for gastrointestinal bleeding allocated to stress ulcer prophylaxis with pantoprazole or placebo during the ICU stay. (The SUP-ICU trial was funded by Innovation Fund Denmark and others; ClinicalTrials.gov number, NCT02467621).