Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2020
Observational StudyThe risk of postoperativemyocardial injury after major emergency abdominal surgery: aretrospective cohort study.
The aim was to examine the risk of post-operative myocardial injury after major emergency abdominal surgery and identify pre- and intra-operative risk factors of post-operative myocardial injury. Moreover, the study aimed to examine the association between post-operative myocardial injury and clinical outcomes. ⋯ One in four patients suffered a post-operative myocardial injury within the third post-operative day. Post-operative myocardial injury was a risk factor of adverse cardiac and non-cardiac clinical outcomes. Troponin monitoring could potentially improve the post-operative risk stratification in this cohort of high-risk surgical patients.
-
Acta Anaesthesiol Scand · Sep 2020
Observational StudyIntroducing the "hip call"to facilitate early surgical treatment of hip fractures: A feasibility study.
Surgical treatment of hip fractures within 24-48 hours decreases morbidity and mortality, but goals for early surgery have not been widely achieved so far. The primary aim of this study was to investigate the feasibility of implementation of a hip call, and the secondary aim was to investigate the effect of the hip call on time for pre-operative preparation and surgery compared to a historical control cohort. ⋯ The implementation of a hip call was feasible with 83% of patients being ready for surgery within 4 hours, and 88% being operated within 24 hours. Future large-scale studies should clarify potential benefits on clinical outcome.
-
Acta Anaesthesiol Scand · Sep 2020
Determination of adequate positive end expiratory pressure level required for carbon dioxide homeostasis in an animal model of infant laparoscopy.
Capnoperitoneum provides a ventilatory challenge due to reduction in end-expiratory lung volume and peritoneal carbon dioxide absorption in both children and adults. The primary aim of this controlled interventional trial was to determine the positive end-expiratory pressure (PEEP) level needed to ensure for adequate carbon dioxide clearance and preservation of carbon dioxide homeostasis in an experimental model of infant laparoscopy. The secondary aim was to evaluate potential effects on cardiac output of PEEP and abdominal pressure level variations in the same setting. ⋯ The results promote a PEEP level of 9 cmH2 O in this model of infant capnoperitoneum to allow for adequate carbon dioxide removal with subsequent preservation of carbon dioxide homeostasis. The use of high PEEP was not associated with any decrease in cardiac output.
-
Acta Anaesthesiol Scand · Sep 2020
Kinetics of crystalloid fluid in hyperglycemia; an open-label exploratory clinical trial.
Infusion with 0.9% saline is a mainstay in the treatment of severe hyperglycemia, but the kinetics of the saline volume in this setting has not been studied. ⋯ The excretion of 0.9% saline was increased depending on the degree of hyperglycemia. The kinetics was characterized by glucose-accelerated diuresis, and an intracellular uptake that occurred at two thirds the urine flow rate. These data could help to determine appropriate volumes and rates of infusion of crystalloids in hyperglycemia.
-
Acta Anaesthesiol Scand · Sep 2020
Review Meta AnalysisFemoral nerve blocks for the treatment of acute prehospital pain: a systematic reviewwith meta-analysis.
The analgesic benefit and safety of pre-hospital femoral nerve block compared with other, more common forms of pain-relief remains uncertain.
pearl