Acta anaesthesiologica Scandinavica
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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
EditorialTime to consider supraglottic airway device oropharyngeal leak pressure measurement more objectively.
Oropharyngeal leak pressure (OLP) is considered a measure of successful placement, adequate performance and is a useful comparator between supraglottic airway devices (SADs). OLP measurement is based on the premise that the SAD is sited properly in the hypopharynx after blind placements, but the evidence suggests otherwise. Several limitations and controversies surround OLP. This editorial addresses the uses and pitfalls of OLP, the rationale for and methods of ascertaining OLP, the pros and cons of OLP measurement and newer modalities to improve its accuracy.
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Acta Anaesthesiol Scand · Feb 2021
Prior statin therapy and 30-day mortality in South Korean patients with acute respiratory distress syndrome.
The effect of prior statin therapy on mortality in patients with acute respiratory distress syndrome (ARDS) remains controversial. This study aimed to investigate whether prior statin therapy was associated with lower 30-day mortality compared to non-statin use. ⋯ This population-based cohort study in South Korea showed that prior statin therapy was not significantly associated with 30-day mortality in patients with ARDS. Our findings should be confirmed in future prospective studies.
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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.