Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2019
Randomized Controlled Trial Multicenter StudyIndications for fluid resuscitation in patients with septic shock: Post-hoc analyses of the CLASSIC trial.
Fluid resuscitation is recommended in septic shock, but the specific indications for fluids have not been established. Our aim was to investigate the indications currently used for fluid resuscitation and the effect of fluid on these indications in patients with septic shock admitted to the intensive care unit (ICU). ⋯ In ICU patients with septic shock, low blood pressure, high lactate, and low urinary output were the most frequent indications for fluid. The effects of fluids when given on these indications were less clear, but may dependent on the time course of sepsis resuscitation.
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Acta Anaesthesiol Scand · Mar 2019
Randomized Controlled Trial Comparative StudyHaemodynamic stability after paracervical block: A randomized, controlled, double-blind study comparing bupivacaine-adrenaline with bupivacaine.
Paracervical block is widely used in gynaecological interventions on cervix and uterus. Many surgeons add adrenaline 100 μg or pitressin 3-5 IU in a total volume of 10-20 mL to reduce total blood loss. We wanted to examine haemodynamic stability in healthy patients given bupivacaine with and without adrenaline. ⋯ Paracervical block with bupivacaine 50 mg and adrenaline 100 μg may give haemodynamic instability in healthy females and is not recommended if haemodynamic side effects are to be avoided.
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Acta Anaesthesiol Scand · Mar 2019
Energy expenditure of patients on ECMO: A prospective pilot study.
An optimal nutritional approach sustained by convenient monitoring of metabolic status and reliable assessment of energy expenditure (EE) may improve the outcome of critically ill patients on extracorporeal membrane oxygenation (ECMO). We previously demonstrated the feasibility of indirect calorimetry (IC)-the standard of care technique to determine caloric targets-in patients undergoing ECMO. This study aims to compare measured with calculated EE during ECMO treatment. We additionally provide median EE values for use in settings where IC is not available. ⋯ Compared with measured EE, calculation of EE both over- and underestimated caloric needs during ECMO treatment. Despite a median EE of 21 kcal/kg/day, large variability in metabolic rate was found and demands further investigation.
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Acta Anaesthesiol Scand · Mar 2019
Review Meta AnalysisAerosolized corticosteroids to prevent postoperative sore throat in adults: A systematic review and meta-analysis.
Postoperative sore throat negatively affects patient recovery and satisfaction levels. We conducted a systematic review and meta-analysis to assess the efficacy and safety of aerosolized corticosteroids in the prevention of postoperative sore throat in adults undergoing tracheal intubation for surgery. ⋯ Aerosolized corticosteroids may be superior to non-analgesic methods in preventing postoperative sore throat, but the evidence for efficacy and safety is still limited and not definitive.
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Acta Anaesthesiol Scand · Mar 2019
Comparative Study Observational StudySpeckle tracking-vs conventional echocardiography for the detection of myocardial injury-A study on patients with subarachnoid haemorrhage.
Myocardial injury with regional wall motion abnormalities (RWMA) is common in subarachnoid haemorrhage (SAH). We hypothesized that the diagnostic performance of left ventricular (LV) global and regional longitudinal strain (GLS and RLS, respectively), assessed with speckle tracking echocardiography is superior to standard echocardiography for the detection of myocardial injury in SAH. ⋯ The diagnostic performance of GLS by strain imaging is not superior to standard echocardiography for the detection of myocardial injury in SAH. RLS could not reliably detect regional myocardial injury.