Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2019
Lipo-prostaglandin E1 increases immediate arterial maximal flow velocity of free flap in patients undergoing reconstructive surgery.
In free flap surgery, the maintenance of proper blood flow after anastomosis of flap pedicle vessels is important. Lipo-prostaglandin E1 (lipo-PGE1) has been empirically administered to prevent blood flow insufficiency in a free flap reconstruction. We tested our hypothesis that lipo-PGE1 administration increases the arterial inflow of free flap. We also evaluated lipo-PGE1-related haemodynamic changes and complications. ⋯ Lipo-PGE1 significantly increases the maximal blood flow velocity without complications in patients undergoing free flap reconstruction and may be an effective and safe method of maintaining adequate blood flow in these cases.
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Acta Anaesthesiol Scand · Jan 2019
Prolonged vasopressor support during hip-fracture surgery is a risk factor for enhanced mortality.
Hip fracture is a common injury in the elderly population and is associated with high morbidity and mortality. Intraoperative hypotension is commonly noted, and is often treated with vasopressors (VP), however, to what extent is unknown. We set out to examine retrospectively how many hip fracture-patients received VP perioperatively and further to investigate if VP treatment is connected to increased mortality. ⋯ Vasopressor treatment is common during hip fracture surgery. Patients treated with VP infusion ≥3 hours have increased mortality, while patients treated with injections or infusion <3 hours have not. We suggest that the prolonged use of VP treatment is linked to increased mortality.
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Acta Anaesthesiol Scand · Jan 2019
Comparative StudyComparison of two prehospital predictive models for mortality and impaired consciousness after severe traumatic brain injury.
The primary aim was to investigate the performance of a National Advisory Committee for Aeronautics based predictive model (NACA-BM) for mortality at 14 days and a reference model using motor GCS (GCS-RM). The secondary aim was to compare the models for impaired consciousness of survivors at 14 days (IC-14; GCS ≤ 13). ⋯ Prehospital prediction of mortality after TBI was good with both models, and the NACA-BM was not inferior to the GCS-RM. Prediction of IC-14 was moderate in both models.
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Acta Anaesthesiol Scand · Jan 2019
Endotracheal tube cuff pressure changes during manual cuff pressure control manoeuvres: An in-vitro assessment.
Endotracheal tube (ETT) cuffs are designed to seal the lower airway for precise ventilation and to protect against ingress of pathogens from the pharyngeal space. Therefore, a minimal continuous cuff pressure must be maintained. Aim of this study was to analyse the course of cuff pressure in an in-vitro model during manual cuff pressure control manoeuvres. ⋯ Routine manual cuff pressure control manoeuvres in ETT cuffs result in considerable cuff pressure drops. This may have an impact on silent aspiration of pharyngeal contents passing along the cuff into the lower airway.