Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2021
ReviewPhysiological and inflammatory consequences of high and low respiratory rate in acute respiratory distress syndrome.
Using protective mechanical ventilation strategies with low tidal volume is usually accompanied by an increment of respiratory rate to maintain adequate alveolar ventilation. However, there is no robust data that support the safety of a high respiratory rate concerning ventilator-induced lung injury. ⋯ Undoubtedly, the respiratory rate can influence respiratory mechanics in various ways as a factor of multiplication of the power of ventilation, and gas exchange, and also on alveolar dynamics. In this narrative review, we present our point of view over the main experimental and clinical evidence available regarding the effect of respiratory rate on ventilator-induced lung injury development.
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Acta Anaesthesiol Scand · Sep 2021
Review Meta AnalysisThe effects of adding quinolones to beta-lactam antibiotics for sepsis.
Sepsis is common, deadly, and a major challenge to treat. Quinolones added to beta-lactam antibiotics are currently recommended as a second-line empiric regimen in sepsis, but the evidence regarding their benefits and harms is unclear. ⋯ The effects of adding quinolones to beta-lactam antibiotics for the treatment of sepsis were unclear for all outcomes. Additional trial data are warranted to support the recommendation of empirical use of quinolones for sepsis.
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Acta Anaesthesiol Scand · Sep 2021
Multicenter Study Observational Study24-hour fluid administration in emergency department patients with suspected infection; a multicenter, prospective, observational study.
To describe 24-hour fluid administration in emergency department (ED) patients with suspected infection. ⋯ Patients with simple infection and sepsis received equal fluid volumes. Fluid volumes varied markedly, a variation that was partly explained by clinical characteristics.
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Acta Anaesthesiol Scand · Sep 2021
Multicenter StudyPrevalence and impact of hazardous alcohol use in intensive care cohort: a multi-center, register-based study.
Reports of the prevalence and impact of hazardous alcohol use among intensive care unit (ICU) patients are contradictory. We aimed to study the prevalence of hazardous alcohol use among ICU patients and its association with ICU length of stay (LOS) and mortality. ⋯ The prevalence of hazardous alcohol use in Finnish ICUs was 21%. Patients with hazardous alcohol use were more often younger and male compared with non-hazardous alcohol users.
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Acta Anaesthesiol Scand · Sep 2021
Fluid balance -adjusted creatinine in diagnosing Acute Kidney Injury in the critically ill.
Acute kidney injury (AKI) is often diagnosed based on plasma creatinine (Cr) only. Adjustment of Cr for cumulative fluid balance due to potential dilution of Cr and subsequently missed Cr-based diagnosis of AKI has been suggested, albeit the physiological rationale for these adjustments is questionable. Furthermore, whether these adjustments lead to a different incidence of AKI when used in conjunction with urine output (UO) criteria is unknown. ⋯ Fluid balance-adjusted Cr resulted in little change in AKI incidence, and only minor differences in mortality between patients who changed category after adjustment and those who did not. Using adjusted Cr values to diagnose AKI does not seem worthwhile in critically ill patients.