Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2021
The relationship between resited epidural catheters after secondary epidural catheter failure and vaginal delivery: A retrospective case-control study.
There are cases where epidural analgesia is initially effective but subsequently fails and needs to be resited. We evaluated the rate of normal vaginal delivery and operative delivery among parturients who had resited epidurals compared to parturients with epidurals that were not resited. ⋯ Need for labor epidural catheter replacement does not appear to be associated with need for operative delivery based on this single-centre cohort analysis.
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Acta Anaesthesiol Scand · Mar 2021
Randomized Controlled TrialCombined short- and long-axis method for internal jugular vein catheterization in premature newborns: A randomized controlled trial.
Rapid central venous catheterization is critical for the rescue and perioperative management of premature infants requiring surgery. Ultrasound-guided dynamic needle tip positioning (DNTP) has been widely used as a very effective technique, especially in paediatric vascular puncture and catheterization. However, for low-weight premature newborns, central vein catheterization still poses greater difficulties for paediatricians and paediatric anaesthesiologists. This prospective randomized control study aimed to evaluate the efficacy of combined short- and long-axis (CSLA) internal jugular vein catheterization for premature newborns in comparison with the DNTP technique. ⋯ Ultrasound-guided internal jugular vein catheterization by the CSLA method is effective and safe. The CSLA method may be superior to the DNTP technique in premature newborns.
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Acta Anaesthesiol Scand · Mar 2021
Prone positioning in mechanically ventilated patients with severe acute respiratory distress syndrome and coronavirus disease 2019.
The management of COVID-19 ARDS is debated. Although current evidence does not suggest an atypical acute respiratory distress syndrome (ARDS), the physiological response to prone positioning is not fully understood and it is unclear which patients benefit. We aimed to determine whether proning increases oxygenation and to evaluate responders. ⋯ Proning increased PaO2 :FiO2 , primarily in patients with PaO2 :FiO2 approximately < 120 mm Hg, with a consistency over three sessions. No characteristic was associated with non-responding, why proning may be considered in most patients. Further study is required to evaluate mortality.
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Acta Anaesthesiol Scand · Mar 2021
Health care use before and after intensive care unit admission - a nationwide register-based study.
The aim of this study was to describe healthcare utilization of patients admitted to ICU before and after ICU admission. ⋯ Patients admitted to an ICU had increased use of both primary and secondary health care both before and for years after ICU treatment, even after adjustment for comorbidities and socio-economic factors.
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Acta Anaesthesiol Scand · Mar 2021
Review Meta AnalysisProphylactic acid suppressants in children in the intensive care unit: a systematic review with meta-analysis and trial sequential analysis.
Critically ill children are at risk of stress-induced gastrointestinal ulceration. Acid suppressants are frequently used in intensive care units even though there is uncertainty about the benefits and harms. With this systematic review, we aimed to assess patient-important benefits and harms of stress ulcer prophylaxis (SUP) in children in intensive care. ⋯ We found no difference in all-cause mortality, overt gastrointestinal bleeding or hospital-acquired pneumonia in children in intensive care receiving acid suppressants compared with placebo/no prophylaxis. However, the quantity and quality of evidence was very low with no firm evidence for benefit or harm.