Acta anaesthesiologica Scandinavica
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Increased bleeding and blood product transfusions during cardiac surgery are associated with poor outcomes. The patient's ABO blood group is related to hemostatic balance, although it is unclear whether this influences bleeding during cardiac surgery. This study aimed to evaluate whether ABO blood group is related to bleeding during cardiac surgery. ⋯ The patient's ABO group appears to be related to volumes of chest tube drainage and transfused blood products during cardiac surgery.
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Acta Anaesthesiol Scand · Apr 2021
Outcomes of catheter-directed interventions in high-risk pulmonary embolism-a retrospective analysis.
First-line treatment of high-risk pulmonary embolism with persistent hypotension and/or signs of shock is intravenous thrombolysis. However, if thrombolysis is contraindicated due to risk of serious bleeding, or if it yields insufficient effect, surgical thrombectomy or catheter-directed intervention (CDI) plus anticoagulation is recommended. The aim of this study was to assess the outcomes of the CDI modality introduced in a tertiary referral centre in 2013. ⋯ In patients with high-risk pulmonary embolism, 90-day survival was similar after treatment with CDI plus anticoagulation compared to anticoagulation only. The mean reduction in RV/LV ratio was larger in the CDI group. Our results support the use of CDI in selected patients, respecting the limitations and potential side effects of each technical device used.
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Acta Anaesthesiol Scand · Apr 2021
Arterial and end-tidal carbon dioxide partial pressure difference during prehospital anaesthesia in critically ill patients.
Normoventilation is crucial for many critically ill patients. Ventilation is routinely guided by end-tidal capnography during prehospital anaesthesia, based on the assumption of the gap between arterial partial pressure of carbon dioxide (PaCO2 ) and end-tidal carbon dioxide partial pressure (PetCO2 ) of approximately 0.5 kPa (3.8 mmHg). ⋯ Our results suggest that end-tidal capnography alone might not be an adequate method to achieve normoventilation for critically ill patients intubated and mechanically ventilated in prehospital setting. Thus, an arterial blood gas analysis might be useful to recognize patients with an increased gap between PaCO2 and PetCO2 .
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Acta Anaesthesiol Scand · Apr 2021
Prehospital Antibiotic Therapy preceded by Blood Cultures in a Physician-manned Mobile Emergency Care Unit.
Rapid recognition and antibiotic treatment, preferably preceded by blood cultures (BCs), is a mainstay in sepsis therapy. The objective of this investigation was to determine if pre-hospital BCs were feasible and drawn with an acceptably low level of contamination and to investigate whether pre-hospital antibiotics were administered on correct indications. ⋯ Pre-hospital administration of antibiotics preceded by BCs is feasible, although with somewhat high blood culture contamination rates. Antibiotics are administered on reasonable indications.
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Acta Anaesthesiol Scand · Apr 2021
The swedish covid-19 intensive care cohort: risk factors of icu admission and icu mortality.
Several studies have recently addressed factors associated with severe Coronavirus disease 2019 (COVID-19); however, some medications and comorbidities have yet to be evaluated in a large matched cohort. We therefore explored the role of relevant comorbidities and medications in relation to the risk of intensive care unit (ICU) admission and mortality. ⋯ In our cohort oral anticoagulants were protective of ICU admission and statins was protective of ICU death. Several comorbidities and ongoing RAASi treatment were independent risk factors of ICU admission and ICU mortality.