Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2021
Ischemic vascular disease and long-term mortality in emergency abdominal surgical patients: a population-based cohort study.
Emergency abdominal surgery carries a high mortality, as patients are often frail with significant comorbidity. We aimed to evaluate the association between co-existing ischaemic vascular disease (IVD) and long-term mortality in patients undergoing emergency abdominal surgery. ⋯ In adult major emergency abdominal surgical patients, preoperative IVD was prevalent and associated with a 10% relative increase in long-term mortality, but not in short-term mortality.
-
Acta Anaesthesiol Scand · Oct 2021
ReviewBioimpedance as a measure of fluid status in critically ill patients: A systematic review.
Precise measurements of fluid status lack valid methods. Bioimpedance is an attractive diagnostic tool because it is noninvasive, quick, and relatively cheap. This systematic review aims to assess the existing evidence of bioimpedance as an accurate measure of fluid status in critically ill patients. ⋯ The accuracy of bioimpedance as a measure for fluids in critically ill patients in the intensive care unit cannot be determined. Due to the lack of a gold standard, numerous studies compared bioimpedance with surrogate outcomes with great variability in both designs and results. Assessing the internal reproducibility of bioimpedance had the same limitations, but the studies overall reported good internal reproducibility.
-
Acta Anaesthesiol Scand · Oct 2021
ReviewPatient and public involvement in contemporary large intensive care trials: protocol for a meta-epidemiological study.
Patient and public involvement (PPI) in randomized clinical trials (RCTs) has increased in recent years but remains the exception rather than the rule. We aim to assess the frequency and extent of PPI in large, contemporary RCTs conducted in an intensive care setting. ⋯ This meta-epidemiological study will provide an important insight into the use of PPI in large, contemporary intensive care trials. We wish to reveal ways in which patient involvement could be incorporated more broadly and purposefully here and help to empower clinicians, researchers and patients to collaborate further on future research processes and goals.
-
Acta Anaesthesiol Scand · Oct 2021
Randomized Controlled TrialQuality of recovery in patients under low- or standard-pressure pneumoperitoneum. A randomised controlled trial.
The use of low-pressure pneumoperitoneum seems to be capable of reducing complications such as post-operative pain. However, the quality of evidence supporting this conclusion is low. Both the lack of investigator blinding to both intra-abdominal pressure and to method of neuromuscular blockade represent key sources of bias. Hence, this prospective, randomised, and double-blind study aimed to compare the quality of recovery (Questionnaire QoR-40) of patients undergoing laparoscopic cholecystectomy under low-pressure and standard-pressure pneumoperitoneum. We tested the hypothesis that low pneumoperitoneum pressure enhances the quality of recovery following LC. ⋯ We thus conclude that the use of low-pressure pneumoperitoneum during elective laparoscopic cholecystectomy does not improve the quality of recovery.
-
Acta Anaesthesiol Scand · Oct 2021
Randomized Controlled TrialPhrenic nerve block on severe post-hepatectomy shoulder pain: A randomized, double-blind, placebo-controlled, pilot study.
Severe shoulder pain occurs frequently after surgery close to the diaphragm, potentially caused by referred pain via the ipsilateral phrenic nerve. We aimed to assess the analgesic effect of an ultrasound-guided phrenic nerve block on moderate to severe right-sided shoulder pain after open partial hepatectomy. ⋯ Postoperative phrenic nerve block significantly reduced severe post-hepatectomy shoulder pain. Larger studies are warranted to confirm the lack of clinically relevant block-related impairment of respiratory function.