Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2022
Goal directed fluid removal with furosemide versus placebo in intensive care patients with fluid overload: a trial protocol for a randomised, blinded trial (GODIF Trial).
Fluid overload is a risk factor for mortality in intensive care unit (ICU) patients. Administration of loop diuretics is the predominant treatment of fluid overload, but evidence for its benefit is very uncertain when assessed in a systematic review of randomised clinical trials. The GODIF trial will assess the benefits and harms of goal directed fluid removal with furosemide versus placebo in ICU patients with fluid overload. ⋯ The GODIF trial will provide important evidence of possible benefits and harms of fluid removal with furosemide in adult ICU patients with fluid overload.
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Acta Anaesthesiol Scand · Oct 2022
Randomized Controlled TrialEffect of dexamethasone on intraoperative remifentanil dose in total knee arthroplasty surgery under general anaesthesia.
The effects of glucocorticoids may include both genomic and rapid nongenomic effects. The potential rapid analgesic effect during surgery has not previously been investigated. We aimed to explore the effect of dexamethasone on intraoperative infusion rate of remifentanil in patients undergoing total knee arthroplasty (TKA) surgery under general anaesthesia. ⋯ ClinicalTrials.gov Identifier: NCT05002361 (12 August 2021).
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Acta Anaesthesiol Scand · Oct 2022
Ten-year trends of adult trauma patients in Central Denmark Region from 2010 to 2019: A retrospective cohort study.
Trauma causes significant economic and societal burdens, and the trauma patient population and their prognosis change over time. This study aims to analyze 10-year trends of trauma patients at a major trauma center in Central Denmark Region. ⋯ Ten-year trends of trauma patients at a major trauma center show an increasing median age, injury severity, and number of fall injuries. The 30-day mortality of trauma patients decreased slightly for both minor injuries and severe injuries when adjusting for age, sex, and injury severity.
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Acta Anaesthesiol Scand · Oct 2022
Targeted temperature management evolving over time-A local process analysis.
Post-resuscitation care of comatose survivors from cardiac arrest includes target temperature management (TTM) to mitigate cerebral reperfusion injury. High-quality TTM requires protocols enhancing good precision. This study explored how the quality of TTM may have evolved with increasing experience from clinical trial protocols and standard operating procedures. We hypothesized that there would be a positive effect over time, detectable between trial periods and between trial periods and later everyday practice. ⋯ The observed increase in TTM quality in this single-center study may be a result of increased competence through learning and training in different strict TTM protocols. If so, the results of this study further support the protocolization of post-cardiac arrest intensive care.
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Acta Anaesthesiol Scand · Oct 2022
Comparison of patient characteristics and long-term mortality between transferred and non-transferred COVID-19 patients in Dutch intensive care units: A national cohort study.
COVID-19 patients were often transferred to other intensive care units (ICUs) to prevent that ICUs would reach their maximum capacity. However, transferring ICU patients is not free of risk. We aim to compare the characteristics and outcomes of transferred versus non-transferred COVID-19 ICU patients in the Netherlands. ⋯ Transferred COVID-19 patients are more often mechanically ventilated and are less severely ill compared to non-transferred patients. Furthermore, transferring critically ill COVID-19 patients in the Netherlands is not associated with mortality during the first 180 days after ICU admission.