Acta anaesthesiologica Scandinavica
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Life saving measures is the main focus in the initial treatment of major trauma. In surviving patients, chronic pain may be a serious problem, but the long term incidence and potential risk factors are not very well studied. ⋯ Two thirds of the trauma patients had chronic pain 6 y after injury and one out of four had severe pain. The initial pain treatment was focused on opioids.
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Acta Anaesthesiol Scand · Sep 2019
Electrical impedance tomography monitoring during spontaneous breathing trial: Physiological description and potential clinical utility.
Readiness for mechanical ventilation (MecV) weaning and extubation is usually assessed clinically with the use of a spontaneous breathing trial (SBT), but its accuracy is limited, and the pathophysiology of weaning failure not completely elucidated. The purpose of the present study was to describe the physiological behavior of electrical impedance tomography parameters during SBT and to propose additional variables that could be helpful in defining weaning/extubation outcome. ⋯ dEELI was a potentially useful parameter in the evaluation of MecV weaning outcome when abrupt lung depressurization was induced during SBT in our study. The degree of dEELI decrease was probably related to the magnitude of lung derecruitment, which seems to play a key role in the MecV weaning outcome.
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Acta Anaesthesiol Scand · Sep 2019
Multicenter Study Observational StudyAge-associated outcomes after survived out-of-hospital cardiac arrest and subsequent target temperature management.
The registry of the German Society of Intensive Care and Emergency Medicine was founded to analyze outcome of modern post-resuscitation care. ⋯ Increasing age was associated with a higher mortality, but not with an unfavorable neurological outcome. The majority of survivors had a favorable neurologic outcome 6 months after cardiac arrest.
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Acta Anaesthesiol Scand · Sep 2019
Fluid balance after continuous renal replacement therapy initiation and outcome in paediatric multiple organ failure.
Patients with multiple organ failure (MOF) often receive large amounts of resuscitation fluid, making them at high risk of fluid overload (FO). Our main objective was to investigate if the ability to achieve a negative fluid balance during the first 3 continuous renal replacement therapy (CRRT) days was associated with mortality in children with MOF. ⋯ Our results suggest that early fluid removal is associated with improved patient outcome in critically ill children receiving CRRT, and that prompt measures should be taken to prevent fluid overload in critical illness. These results need to be verified in further, prospective studies.
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Acta Anaesthesiol Scand · Sep 2019
Effects of simulated sample sizes on mortality estimates-Protocol for a study in 3 randomised ICU trials.
An increasing number of trials are stopped earlier than originally planned. It has been suggested that trials stopped pre-maturely overestimate the treatment effect. With the outlined observational study, we aim to simulate the results of stopping trials before they reach their planned sample size to assess the effects on mortality estimates. ⋯ We will use data from consenting patients enrolled in RCTs approved by the relevant ethical committees; this study requires no further permissions. We will report the results in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement and submit the final approved manuscript to a peer-reviewed journal.