Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2021
ReviewHuman glycocalyx shedding: systematic review and critical appraisal.
The number of studies measuring breakdown products of the glycocalyx in plasma has increased rapidly during the past decade. The purpose of the present systematic review was to assess the current knowledge concerning the association between plasma concentrations of glycocalyx components and structural assessment of the endothelium. ⋯ Shedding of glycocalyx components is a ubiquitous process that occurs during both acute and chronic inflammation with no sensitivity or specificity for a specific disease or condition.
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Acta Anaesthesiol Scand · May 2021
Comparative StudyHigher vs. Lower Doses of Dexamethasone in Patients with COVID-19 and Severe Hypoxia (COVID STEROID 2) trial: protocol for a secondary Bayesian analysis.
Coronavirus disease 2019 (COVID-19) can lead to severe hypoxic respiratory failure and death. Corticosteroids decrease mortality in severely or critically ill patients with COVID-19. However, the optimal dose remains unresolved. The ongoing randomised COVID STEROID 2 trial investigates the effects of higher vs lower doses of dexamethasone (12 vs 6 mg intravenously daily for up to 10 days) in 1,000 adult patients with COVID-19 and severe hypoxia. ⋯ This secondary, pre-planned Bayesian analysis will supplement the primary, conventional analysis and may help clinicians, researchers and policymakers interpret the results of the COVID STEROID 2 trial while avoiding arbitrarily dichotomised interpretations of the results.
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Acta Anaesthesiol Scand · May 2021
Observational StudySupraclavicular ultrasonographic real-time guidance of peripherally inserted central catheters - a feasibility study.
Mispositioning is common during insertion of peripherally inserted central catheters. Ultrasonographic visualization of anatomical structures may enable continuous guidance during insertion. The aim was to investigate the feasibility of ultrasonographic real-time guidance of peripherally inserted central catheter placement using the supraclavicular fossa view. ⋯ Supraclavicular ultrasonographic real-time guidance for peripherally inserted central catheter placement was feasible and enabled successful placement together with detection and redirection of mispositioned catheters without delay.
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Acta Anaesthesiol Scand · May 2021
Randomized Controlled TrialTime to ventilation and success rate of airway devices in microgravity: A randomized crossover manikin-trial using an underwater setting.
Medical support for space exploration missions must prepare for severe medical events in conditions of microgravity. A key component to managing these events is techniques of airway management. The aim of the present trial is to compare airway management devices in simulated microgravity. ⋯ In simulated microgravity conditions, use of the laryngeal tube or laryngeal mask provided the quickest time to initial ventilation, without deliberate tethering of the mannequin and rescuer to a fixed surface. Endotracheal intubation required significantly longer procedure times and, thus, was considered insufficient for clinical use in microgravity.
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Acta Anaesthesiol Scand · May 2021
Observational StudyCharacteristics, management and survival of ICU patients with coronavirus disease-19 in Norway, March - June 2020. A prospective observational study.
Norwegian hospitals have operated within capacity during the COVID-19 pandemic. We present patient and management characteristics, and outcomes for the entire cohort of adult (>18 years) COVID-19 patients admitted to Norwegian intensive care units (ICU) from 10 March to 19 June 2020. ⋯ In this national cohort of COVID-19 patients, mortality was low and attributable to known risk factors. Importantly, prolonged length-of-stay must be taken into account when planning for resource allocation for any next surge.