Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2022
Continuing professional development (CPD) for anesthesiologists: a systematic review protocol.
Regulators increasingly use formalized programs that are based on continuing professional development (CPD) activities to ensure that physicians are fit to practice. There is convincing evidence regarding the positive effects of CPD activities on performance and patient outcomes. However, there is limited available studies, investigating its effect in anesthesia, specifically. Moreover, although there exists considerable evidence linking specific CPD activities to improved performance, only few studies have investigated the effect of combinations of activities, or formalized systems, as a whole. Consequently, to address this uncertainty regarding the impact of CPD activities, within anesthesiology, this systematic review aims to establish which activities anesthesiologists are engaged in and their impact on clinical competence and subsequent patient outcomes. ⋯ The aim of the study was to give an overview of the breadth and nature of CPD activities, and their effects on fully qualified anesthesiologists' clinical competences and patient outcomes.
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Acta Anaesthesiol Scand · Jan 2022
ReviewThe long-term effects of lower versus higher oxygenation levels in adult ICU patients - protocol for a systematic review.
Many organs can remain impaired after discharge from the intensive care unit (ICU) leading to temporal or permanent dysfunctions. Long-term impairments may be affected by supplemental oxygen, a common treatment in ICU, having both potential beneficial and harmful long-lasting effects. This systematic review aims to assess the long-term outcomes of lower versus higher oxygen supplementation and/or oxygenation levels in adults admitted to ICU. ⋯ No systematic reviews on the impact of oxygen treatment in the ICU on long-term outcomes, other than mortality and quality of life, have been reported yet. This systematic review will provide an overview of the current evidence and will help future research in the field.
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Acta Anaesthesiol Scand · Jan 2022
Randomized Controlled TrialDextran-based priming solution during cardiopulmonary bypass attenuates renal tubular injury - a secondary analysis of randomized controlled trial in adult cardiac surgery patients.
Acute kidney injury (AKI) is a well-known complication after cardiac surgery and cardiopulmonary bypass (CPB). In the present secondary analysis of a blinded randomized controlled trial, we evaluated the effects of a colloid-based versus a conventional crystalloid-based prime on tubular injury and postoperative renal function in patients undergoing cardiac surgery with CPB. ⋯ In patients undergoing cardiac surgery with CPB, colloid-based priming solution (dextran 40) induced less renal tubular injury compared to a crystalloid-based priming solution. Whether a colloid-based priming solution will improve renal outcome in high-risk cardiac surgery, or not, needs to be evaluated in future studies on higher risk cardiac surgery patients.
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Acta Anaesthesiol Scand · Jan 2022
Randomized Controlled TrialInteractions in clinical trials: Protocol and statistical analysis plan for an explorative study of four randomised ICU trials on use of pantoprazole, oxygenation targets, haloperidol and intravenous fluids.
Intensive care unit (ICU) patients receive numerous interventions, but knowledge about potential interactions between these interventions is limited. Co-enrolment in randomized clinical trials represents a unique opportunity to investigate any such interactions. We aim to assess interactions in four randomized clinical trials with overlap in inclusion periods and patient populations. ⋯ This exploratory analysis will investigate the presence of any interactions between pantoprazole, oxygenation targets, haloperidol and amount of intravenous fluids in four international ICU trials using co-enrolment. Assessment of possible interactions represents valuable information to guide the design, statistical powering and conduct of future trials.
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Acta Anaesthesiol Scand · Jan 2022
Randomized Controlled TrialGeneral or regional anaesthesia for postpartum haemorrhage - a national population-based cohort study.
Anaesthesia is required to assist the treatment of postpartum haemorrhage (PPH) when manual removal of the placenta or emptying of the uterine cavity is required. The choice between general or regional anaesthesia may depend upon factors such as existing epidural, airway, hypovolaemia, and tradition. ⋯ Practice varies immensely between delivery centres with large centres preferring regional anaesthesia. Difference in practice might be explained by level of experience, here large centres might be more confident using regional anaesthesia. Knowledge is being extrapolated from literature on caesarean sections. Future studies should address the optimal choice of anaesthesia for PPH procedures.