Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2020
The influence of time to surgery on mortality after a hip fracture.
The effect of time-to-surgery on mortality in acute hip fracture (AHF) patients has been debated and studies are inconsistent regarding from what time limit mortality starts to increase. At Sahlgrenska University Hospital/Mölndal, surgery is recommended within 24 hours leaving little time for pre-operative optimization. However, internationally the definition of early surgery varies between 24 and 48 hours and over. This retrospective study was initiated to investigate the relation between time-to-surgery and 30-day mortality. ⋯ In AHF patients, a time-to-surgery exceeding 39-48 hours was associated with increased mortality. Patients with surgeries performed before 39-48 hours did not have increased mortality and this time may, in some patients, be used for optimization prior surgery even if time-to-surgery exceeds 24 hours.
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Acta Anaesthesiol Scand · Mar 2020
Observational StudyIntubation rate, duration of noninvasive ventilation and mortality after noninvasive neurally adjusted ventilatory assist (NIV-NAVA).
Asynchrony is a common problem in patients treated with noninvasive ventilation (NIV). Neurally adjusted ventilatory assist (NAVA) has shown to improve patient-ventilator interaction. However, it is unknown whether NIV-NAVA improves outcomes compared to noninvasive pressure support (NIV-PS). ⋯ This present study found no improved clinical outcomes in patients treated with NIV-NAVA compared to NIV-PS.
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Acta Anaesthesiol Scand · Mar 2020
The effect of cognitive aid design on the perceived usability of critical event cognitive aids.
Critical events require that clinicians process information and make decisions quickly. To reduce mental workload during such events, cognitive aids have been developed. We have previously observed that designing such aids to facilitate discrete information transfer decreased time to information finding. However, whether clinicians perceive aids designed for discrete information transfer as more usable than step-by-step designs remains unclear. We hypothesized that experimental cognitive aids designed for discrete information transfer would be judged more usable than step-by-step Linear aids. ⋯ During simulated critical events, cognitive aids designed for discrete information transfer were considered more usable than step by step Linear aids. Specific themes governing usability were identified during mixed methods analysis. Further work is needed to optimize cognitive aid use among anesthesia clinicians.