Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2020
Long-term patient-important outcomes after septic shock: a protocol for 1-year follow-up of the CLASSIC-trial.
In patients with septic shock, mortality is high, and survivors experience long-term physical, mental and social impairments. The ongoing Conservative vs Liberal Approach to fluid therapy of Septic Shock in Intensive Care (CLASSIC) trial assesses the benefits and harms of a restrictive vs standard-care intravenous (IV) fluid therapy. The hypothesis is that IV fluid restriction improves patient-important long-term outcomes. ⋯ With this pre-planned follow-up study of the CLASSIC trial, we will provide patient-important data on long-term survival, HRQoL and cognitive function of restrictive vs standard-care IV fluid therapy in patients with septic shock.
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Acta Anaesthesiol Scand · Mar 2020
Review Meta AnalysisEffects of postoperative furosemide in adult surgical patients: a systematic review and meta-analysis of randomised clinical trials.
Acute kidney injury (AKI) is associated with increased morbidity and mortality and may present as oliguria in the post-operative phase. Diuretics, including furosemide, are commonly used in post-operative patients. Accordingly, we aimed to assess the balance between benefits and harms of furosemide post-operatively in adult surgical patients. ⋯ In this systematic review, we found that the quantity and quality of evidence for using furosemide post-operatively in adult surgical patients were very low with no firm evidence for benefit or harm.
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Acta Anaesthesiol Scand · Mar 2020
Randomized Controlled TrialAn Iliopsoas Plane Block does not Cause Motor Blockade - a Blinded Randomized Volunteer Trial.
A femoral nerve block relieves pain after total hip arthroplasty, but its use is controversial due to motor paralysis accompanied by an increased risk of fall. Assumedly, the iliopsoas plane block (IPB) targets the hip articular branches of the femoral nerve without motor blockade. However, this has only been indicated in a cadaver study. Therefore, we designed this volunteer study. ⋯ We observed no significant reduction of maximal force of knee extension after an IPB. The injectate was contained in a fascial compartment previously shown to contain all sensory branches from the femoral nerve to the hip joint. The clinical consequence of selective anesthesia of all sensory femoral nerve branches from the hip could be a reduced risk of fall compared to a traditional femoral nerve block. Registration of Trial: The trial was prospectively registered in EudraCT (Reference: 2018-000089-12, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-000089-12).
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Acta Anaesthesiol Scand · Mar 2020
Association of global DNA hypomethylation with postoperative cognitive dysfunction in elderly patients undergoing hip surgery.
Post-operative cognitive dysfunction (POCD) is a decline of cognitive status that commonly occurs after surgery in elderly patients. Whether DNA methylation is associated with the development of POCD remains unclear. ⋯ Post-operative global hypomethylation of leukocyte DNA was associated with the development of early POCD.