Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled Trial Multicenter StudyThe effect of remote ischaemic preconditioning on endothelial function after hip fracture surgery.
Endothelial dysfunction seems to play a role in the pathophysiology of myocardial injury after surgery. The aim of this randomised clinical trial was to examine whether remote ischaemic preconditioning in relation to hip fracture surgery ameliorates post-operative systemic endothelial dysfunction. ⋯ No beneficial effect of remote ischaemic preconditioning on the systemic endothelial dysfunction, assessed at a single time point on post-operative day one, was detected after hip fracture surgery.
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Acta Anaesthesiol Scand · Feb 2021
ReviewInterpreting the results of clinical trials, embracing uncertainty: A Bayesian approach.
Most clinical trials use null hypothesis significance testing with frequentist statistical inference to report P values and confidence intervals for effect estimates. This method leads to a dichotomisation of results as 'significant' or 'non-significant'. ⋯ The use of Bayesian statistics is introduced in this paper for a hypothetical sepsis trial with worked examples in the R language for Statistical Computing environment and the open-source statistical software JASP. It is hoped that this general introduction to Bayesian inference stimulates some interest and confidence among clinicians to consider applying these methods to the interpretation of new evidence for interventions relevant to anaesthesia and intensive care medicine.
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Acta Anaesthesiol Scand · Feb 2021
Estimation of changes in cyclic lung strain by electrical impedance tomography: Proof of concept study.
Cyclic strain may be a determinant of ventilator-induced lung injury. The standard for strain assessment is the computed tomography (CT), which does not allow continuous monitoring and exposes to radiation. Electrical impedance tomography (EIT) is able to monitor changes in regional lung ventilation. In addition, there is a correlation between mechanical deformation of materials and detectable changes in its electrical impedance, making EIT a potential surrogate for cyclic lung strain measured by CT (StrainCT ). ⋯ The change in electrical impedance may provide a noninvasive assessment of global cyclic strain, without radiation at bedside.
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Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled TrialThe effect of mannitol on oxidation-reduction potential in patients undergoing deceased donor renal transplantation - A randomized controlled trial.
Mannitol, an osmotic diuretic, is proposed to be an oxygen radical scavenger. Mannitol is often used in renal transplantation to attenuate oxidative stress and thus to protect renal graft function. We tested the hypothesis that mannitol reduces overall oxidative stress during deceased donor renal transplantation. ⋯ Mannitol showed no systemic redox scavenging effects during deceased donor renal transplantation. To evaluate the direct effect of mannitol on the renal graft further studies are needed.
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Acta Anaesthesiol Scand · Feb 2021
Development of a comprehensive Percutaneous Dilatational Tracheostomy process model for procedural training: a Delphi-based experts consensus.
Deconstructing a complex procedure improves skills learning, but no model has covered all relevant Percutaneous Dilatational Tracheostomy (PDT) procedural aspects. Moreover, the heterogeneity of techniques described may hinder trainees' competency acquisition. Our objective was to develop a PDT model for procedural training that includes a comprehensive step-by-step design. ⋯ We have presented a PDT model that includes necessary competence dimensions to be considered complete. The model was validated by an experts' consensus, allowing to improve procedural training to promote safer patient care.