Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2019
Chronic post-surgical pain after colon surgery in patients included in an enhanced recovery program.
Enhanced recovery after surgery (ERAS) program improves immediate recovery. Beyond immediate benefits, long-term impact of ERAS implementation is not yet evident. This retrospective single-center cohort study investigates prevalence and characteristics of chronic post-surgical pain (CPSP) in patients who underwent colon surgery. ⋯ CPSP prevalence after laparoscopic colon surgery seems not much affected by ERAS context. Pre-operative presence of pain emerged as an important risk factor. These findings should be confirmed in a prospective multicenter study.
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Acta Anaesthesiol Scand · Aug 2019
Chronic kidney disease and acute kidney injury in arthroplasty patients over 65 years of age.
The purpose of this study was to evaluate the prevalence of chronic kidney disease (CKD) and the incidence of perioperative acute kidney injury (AKI) in primary arthroplasty patients over 65 years of age. Risk factors, perioperative events and the outcome of surgery were evaluated. ⋯ Impairment of kidney function was common and was related to mortality in emergency arthroplasties. Measurements of postoperative sCr were allocated to high risk patients. Preoperative kidney function, kidney disease and diabetes mellitus were important determinants for perioperative AKI.
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Acta Anaesthesiol Scand · Aug 2019
The Cornell Assessment of Pediatric Delirium: Translation and inter-rater reliability in a Danish pediatric intensive care unit.
Delirium is a serious medical problem and recognized as a common syndrome in critically ill children. Without routine screening, delirium diagnosis is often missed by the medical providers. Internationally, there are tools to assess pediatric delirium (PD), but none currently available in Danish. The aim of this project was to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Danish and determine its feasibility and reliability in a Danish clinical setting. ⋯ Standardized assessment tools are a pre-requisite to identify PD. A Danish version of the CAPD now exists, and preliminary testing has demonstrated it as feasible and reliable for use in a Danish clinical setting. A multi-institutional study is needed to determine the prevalence of PD in Denmark.
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Acta Anaesthesiol Scand · Aug 2019
Review Meta Analysis Comparative StudyPiperacillin/tazobactam vs carbapenems for patients with bacterial infection: Protocol for a systematic review.
Early empirical broad-spectrum antimicrobial therapy is recommended for patients with severe infections, including sepsis. β-lactam/β-lactamase inhibitor combinations or carbapenems are often used to ensure coverage of likely pathogens. Piperacillin/tazobactam is proposed as a carbapenem-sparing agent to reduce the incidence of multidrug-resistant bacteria and superinfections. In the recently published MERINO trial, increased mortality from piperacillin/tazobactam was suggested in patients with bacteraemia with resistant Escherichia coli or Klebsiella species. Whether these findings also apply to empirical piperacillin/tazobactam in patients with other severe infections, including sepsis, is unknown. We aim to assess the benefits and harms of empirical and definitive piperacillin/tazobactam vs carbapenems for patients with severe bacterial infections. ⋯ This protocol has been prepared according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols statement, the Cochrane Handbook and the Grading of Recommendations, Assessment, Development, and Evaluation approach. We will include randomised clinical trials assessing piperacillin/tazobactam vs carbapenems in patients with severe bacterial infections of any origin. The primary outcome will be all-cause short-term mortality ≤ 90 days. Secondary outcomes will include all-cause long-term mortality > 90 days, adverse events, quality of life, use of life support, secondary infections, antibiotic resistance, and length of stay. We will conduct meta-analyses, including pre-planned subgroup and sensitivity analyses for all assessed outcomes. The risk of random errors in the meta-analyses will be assessed by trial sequential analysis.
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Acta Anaesthesiol Scand · Aug 2019
Randomized Controlled Trial Comparative StudyRestrictive vs liberal oxygen for trauma patients-the TRAUMOX1 pilot randomised clinical trial.
Hyperoxaemia is commonly observed in trauma patients but has been associated with pulmonary complications and mortality in some patient populations. The objectives of this study were to evaluate whether maintenance of normoxia is feasible using a restrictive oxygen strategy in the initial phase after trauma and to evaluate the incidence of 30-day mortality and/or major pulmonary complications. ⋯ Maintenance of normoxia using a restrictive oxygen strategy following trauma is feasible. This pilot study serves as the basis for a larger clinical trial.