Acta anaesthesiologica Scandinavica
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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
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
ReviewTranexamic acid for prevention of bleeding in caesarean Delivery: an overview of systematic reviews.
Bleeding is the leading cause of maternal mortality in the world. Tranexamic acid reduces bleeding in trauma and surgery. Several systematic reviews of randomized trials have investigated tranexamic acid in the prevention of bleeding in cesarean delivery. However, the conclusions from systematic reviews are conflicting. This overview aims to summarize the evidence and explore the reasons for conflicting conclusions across the systematic reviews. ⋯ Systematic reviews investigating prophylactic tranexamic acid in cesarean delivery are heterogeneous in terms of methodological and reporting quality. Tranexamic acid may reduce blood transfusion and bleeding outcomes, but rigorous well-designed research is needed due to the limitations of the included studies. Data on safety and adverse effects are insufficient to draw conclusions.
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Acta Anaesthesiol Scand · Jan 2022
Observational StudyFrequency, indications and success of out-of-hospital intubations in Finnish children.
Earlier studies have shown variable results regarding the success of paediatric emergency endotracheal intubation between different settings and operators. We aimed to describe the paediatric population intubated by physician-staffed helicopter emergency medical service (HEMS) and evaluate the factors associated with overall and first-pass success (FPS). ⋯ Emergency endotracheal intubation of children is successfully performed by a physician staffed HEMS unit even though these procedures are rare. To improve the care, emphasis should be on airway management of infants and patients in cardiac arrest.