Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2019
Physical function and actigraphy in intensive care survivors-A prospective 3-month follow-up cohort study.
Impaired physical function after intensive care unit (ICU) stay is common. We aimed to study the association between activity levels in the ward after discharge from ICU and physical function at 3-month follow-up. ⋯ We found improved physical function for most patients 3 months after ICU treatment. Activity levels for 1 week after ICU discharge at the ward were not associated with better physical function at 3-month follow-up.
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Acta Anaesthesiol Scand · May 2019
Short- and long-term mortality in major non-cardiac surgical patients admitted to the intensive care unit.
The aim of this register-based cohort study was to characterize patients admitted to the intensive care unit (ICU) following non-cardiac surgery and identify risk factors associated with 30-days, 90-days and 1-year mortality after ICU admission. ⋯ Short- and long-term mortality in non-cardiac surgical patients admitted to the ICU is very high, especially among the elderly comorbid patients undergoing acute surgery. Future research should focus on targeting clinically modifiable risk factors and performing tailored treatment for these high-risk patients.
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Acta Anaesthesiol Scand · May 2019
Randomized Controlled TrialPost-extubation continuous positive airway pressure improves oxygenation after pediatric laparoscopic surgery: A randomized controlled trial.
Effects of intraoperative recruitment maneuvers (RMs) on oxygenation and pulmonary compliance are lost during recovery if high inspired oxygen and airway suctioning are used. We investigated the effect of post-extubation noninvasive CPAP mask application on the alveolar arterial oxygen difference [(A-a) DO2 ] after pediatric laparoscopic surgery. ⋯ An RM done after pneumoperitoneum inflation followed by decremental PEEP titration improved oxygenation at 1 hour postoperatively. The addition of an early post-extubation noninvasive CPAP mask ventilation improved oxygenation at 12 hours postoperatively.
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Acta Anaesthesiol Scand · May 2019
Comparative StudyUnannounced vs announced in situ simulation of emergency teams: Feasibility and staff perception of stress and learning.
Simulation-based medical education, often used for teaching teamwork, can be conducted in different settings: off-site (simulation centers or other settings away from clinical units) or in situ (real clinical environment), where the latter can be either announced or unannounced. Simulation in general, but especially unannounced in situ simulation, has been described as stressful and stress can affect learning. The aim of this study was to evaluate feasibility and the perception of learning and stress. ⋯ No significant difference was found between unannounced and announced in situ simulation among emergency department staff according to self-perceived learning and self-perceived stress. This is relevant for the future planning of simulation when considering what is to be achieved from implementing different designs for simulation-based medical education.
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Acta Anaesthesiol Scand · May 2019
Randomized Controlled Trial Comparative StudyDiaphragm-sparing effect of the infraclavicular subomohyoid block vs low volume interscalene block. A randomized blinded study.
Both low volume interscalene and infraclavicular-subomohyoid blocks were suggested to provide shoulder analgesia with low risk of phrenic nerve block. The aim of this study was to compare the frequency of the phrenic nerve block between these two techniques. ⋯ Compared with the low volume interscalene block, the infraclavicular subomohyoid block resulted in a significantly less frequent phrenic nerve block and with no difference in postoperative analgesia. Therefore, it may be relevant to consider for patients who cannot tolerate a phrenic nerve block.