Acta anaesthesiologica Scandinavica
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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
Multicenter Study Observational StudyVolume status and volume responsiveness in postoperative cardiac surgical patients: an observational, multicentre cohort study.
The best strategy to identify patients in whom fluid loading increases cardiac output (CO) following cardiac surgery remains debated. This study examined the utility of a calculated mean systemic filling pressure analogue (Pmsa ) and derived variables to explain the response to a fluid bolus. ⋯ The mean systemic filling Pmsa enabled a comprehensive interpretation of fluid responsiveness with volume efficiency useful to explain the change in CO as a continuous phenomenon.
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Acta Anaesthesiol Scand · Mar 2021
Randomized Controlled TrialEffect of low vs. high haemoglobin transfusion trigger on cardiac output in patients undergoing elective vascular surgery: post-hoc analysis of a randomised trial.
During vascular surgery, restricted red-cell transfusion reduces frontal lobe oxygen (ScO2 ) saturation as determined by near-infrared spectroscopy. We evaluated whether inadequate increase in cardiac output (CO) following haemodilution explains reduction in ScO2 . ⋯ Vascular surgical patients exposed to restrictive RBC transfusion elicit the expected increase in CO making it unlikely that their potentially limited cardiac capacity explains the associated ScO2 decrease.
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Acta Anaesthesiol Scand · Mar 2021
Randomized Controlled TrialHead elevation and laryngeal mask airway Supreme insertion: A randomised controlled trial.
A laryngeal mask airway (LMA) is usually inserted by conventional 7 cm head elevation. However, little is known about the association of head elevation degree and LMA insertion. We hypothesized that 14 cm head elevation would increase the first attempt success rate of LMA Supreme insertion compared with conventional 7 cm head elevation in patients undergoing transurethral resection of bladder tumour. ⋯ Head elevation of 14 cm height increased the first attempt success rate of LMA Supreme insertion and fibreoptic bronchoscopic grade in patients undergoing transurethral resection of bladder tumour. High head elevation can be an effective option for successful LMA Supreme insertion. Trial Registry Number: Clinicaltrials.gov (NCT04229862).
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Acta Anaesthesiol Scand · Mar 2021
Observational StudyAssociations between mean systemic filling pressure and acute kidney injury: an observational cohort study following cardiac surgery.
Venous congestion has been implied in cardiac surgery-associated acute kidney injury (CSA-AKI). The mean systemic filling pressure may provide a physiologically more accurate estimate of renal venous pressure and renal perfusion pressure but its association with CSA-AKI has not been reported. ⋯ The Pmsa in post-operative cardiac surgery patients was associated with the development of CSA-AKI also when incorporated into estimates of renal perfusion pressure.