Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2020
Observational StudyAssessment of platelet function after discontinuation of ticagrelor.
Patients presenting with acute coronary syndromes (ACS) are often treated by percutaneous coronary intervention (PCI) with insertion of coronary artery stents and a majority receive dual antiplatelet therapy (DAPT), usually a combination of a COX-1 inhibitor (aspirin) and a P2Y12 inhibitor (eg ticagrelor). Not seldom the question arises as to when DAPT should be discontinued prior to interventional surgery. This study was done with the primary aim of investigating thrombocyte function immediately prior to and after discontinuation of ticagrelor. ⋯ Discontinuation of ticagrelor for 3 days resulted in return of adequate platelet function in all patients on Multiplate® and in a majority of patients on VerifyNow® , indicating a lower bleeding risk. A bedside test for platelet function may be considered if time to anticipated surgery is less than 5 days after ticagrelor discontinuation.
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Acta Anaesthesiol Scand · Apr 2020
Randomized Controlled TrialFlow-controlled ventilation improves gas exchange in lung-healthy patients - a randomised interventional cross-over study.
Flow-controlled ventilation (FCV) is a new ventilation mode that provides constant inspiratory and expiratory flow. FCV was shown to improve gas exchange and lung recruitment in porcine models of healthy and injured ventilated lungs. The primary aim of our study was to verify the influences of FCV on gas exchange, respiratory mechanics and haemodynamic variables in mechanically ventilated lung-healthy patients. ⋯ Flow-controlled ventilation improves oxygenation and carbon dioxide elimination within a short time, compared to VCV with identical tidal volume, inspiratory plateau pressure and end-expiratory pressure.
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Acta Anaesthesiol Scand · Apr 2020
Observational StudyRedistribution of pulmonary ventilation after lung surgery detected with electrical impedance tomography.
Regional ventilation of the lung can be visualized by pulmonary electrical impedance tomography (EIT). The aim of this study was to examine the post-operative redistribution of regional ventilation after lung surgery dependent on the side of surgery and its association with forced vital capacity. ⋯ Only after right-sided lung surgery, EIT showed reduced ventilation on the side of surgery while vital capacity was markedly reduced in both groups.
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Acta Anaesthesiol Scand · Apr 2020
Health care providers' knowledge and handling of impairments after intensive unit treatment: A questionnaire survey.
Numerous patients experience long-term impairments after discharge from the intensive care unit (ICU), including physical, psychological and cognitive deficiencies. This study aims to investigate the knowledge and handling of post-intensive care impairments among Danish doctors and nurses in the medical and surgical wards. ⋯ Doctors and nurses generally reported having average or higher knowledge of ICU patients' in-hospital needs, but few screened systematically for ICU-related impairments. Most respondents believed that detecting these problems is a shared responsibility between professionals in the primary and, especially, the secondary healthcare sector.
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Acta Anaesthesiol Scand · Apr 2020
Short interruptions between prewarming and intraoperative warming are associated with low intraoperative hypothermia rates.
Prevention of inadvertent hypothermia is recommended for procedures >30 minutes because hypothermia increases the risk of myocardial ischemia, intraoperative blood loss, transfusion and wound complications. Therefore, short warming interruptions between pre-warming and intraoperative warming might result in lower hypothermia rates. The aim of this retrospective investigation was to determine whether the incidence of inadvertent intraoperative hypothermia was affected by the warming interruption. ⋯ Intraoperative hypothermia rates increased significantly with longer forced-air warming interruptions between pre-warming and intraoperative warming. Short warming interruptions can preserve the effect of pre-warming and are associated with low intraoperative hypothermia rates.