Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2022
Online Exhaled Propofol Monitoring in Normal-weight and Obese Surgical Patients.
Ion mobility spectrometry (IMS) allows for online quantification of exhaled propofol concentrations. We aimed to validate a bedside online IMS device, the Edmon® , for predicting plasma concentrations of propofol in normal-weight and obese patients. ⋯ Online monitoring of exhaled propofol concentrations is clinically feasible in normal-weight and obese patients. With a 5-min delay, our model outperforms the Marsh plasma TCI model in a post hoc analysis. Modest correlation with plasma concentrations makes the clinical usefulness questionable.
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Acta Anaesthesiol Scand · May 2022
Multicenter Study Observational StudyCardiac dysfunction and mortality in critically ill patients with COVID-19 - a Swedish multicentre observational study.
The prevalence and importance of cardiac dysfunction in critically ill patients with COVID-19 in Sweden is not yet established. The aim of the study was to assess the prevalence of cardiac dysfunction and elevated pulmonary artery pressure (PAP), and its influence on mortality in patients with COVID-19 in intensive care in Sweden. ⋯ Cardiac dysfunction occurs commonly in critically ill patients with COVID-19 in Sweden. RV dysfunction and elevated PAP are associated with an increased risk of death.
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Acta Anaesthesiol Scand · May 2022
AHA STEROID TRIAL, Dexamethasone in Acute High-risk Abdominal surgery, protocol for a randomized controlled trial.
Existing multimodal pathways for patients undergoing acute high-risk abdominal surgery for intestinal obstruction (IO) and perforated viscus (PV) have focused on rescue in the immediate perioperative period. However, there is little focus on the peri-operative pathophysiology of recovery in this patient group, as done to develop enhanced recovery pathways in elective care. Acute inflammation is the main driver of the perioperative pathophysiology leading to adverse outcomes. Pre-operative high-dose of glucocorticoids provides a reduction in the inflammatory response after surgery, effective pain relief in several major surgical procedures, as well as reduce fatigue and improving endothelial dysfunction. ⋯ The AHA STEROID trial will provide important evidence to guide the potential use of high-dose glucocorticoids in emergency high-risk abdominal surgery, with respect to different pathophysiologies.
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Acta Anaesthesiol Scand · May 2022
Randomized Controlled TrialAuraGain™ versus i-gel™ for Bronchoscopic Intubation under Continuous Oxygenation: a Randomised Controlled Trial.
After failed mask ventilation and tracheal intubation, guidelines issued by the Difficult Airway Society recommend placing a second generation supraglottic airway device to secure oxygenation. Ultimately, a secure airway can be obtained by tracheal intubation through the supraglottic airway device using a bronchoscope. In this randomised trial, we compared the AuraGain™ with the i-gel™ as conduit for bronchoscopic intubation under continuous oxygenation performed by a group of anaesthesiologists with variable experience in a general population of patients. ⋯ We found no difference in total time for airway management between using the i-gel™ and using the AuraGain™.
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Acta Anaesthesiol Scand · May 2022
Multicenter StudyImproving neuromuscular monitoring and reducing residual neuromuscular blockade via e-learning - a multicentre interrupted time-series study (INVERT study).
Neuromuscular monitoring should be applied routinely to avoid residual neuromuscular block. However, anaesthetists often refrain from applying it, even when the equipment is available. We aimed to increase neuromuscular monitoring in six Danish anaesthesia departments via e-learning. ⋯ We found no overall effect of the e-learning module on application of neuromuscular monitoring, although the post-course test indicated an effect on anaesthetists' knowledge in this field.