Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2024
Veno-venous extracorporeal membrane oxygenation for severe COVID-19 associated acute respiratory distress syndrome: A retrospective, nationwide, Danish cohort study.
Severe acute respiratory syndrome (ARDS) may require veno-venous extracorporeal membrane oxygenation (V-V ECMO). The aim of this study was to provide data on patient selection and outcome in a nationwide cohort study of patients with COVID-19 associated ARDS supported with V-V ECMO. ⋯ A nationwide, Danish cohort study of 68 COVID-19 patients supported with V-V ECMO, showed a 90-day survival of 43%, which is in accordance with reports from comparable cohorts. Age of 60 years or more was associated with an increased risk of mortality. Pre-existing hypertension was associated with a decreased risk of mortality.
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Acta Anaesthesiol Scand · Oct 2024
Insulin requirement trajectories during COVID-19 versus non-COVID-19 critical illness-A retrospective cohort study.
The glycemic response to critical COVID-19 remains uncertain. We aimed to assess the association between COVID-19, insulin requirements, glycemic control, and mortality in intensive care unit (ICU) patients. ⋯ In our cohort of ICU patients, COVID-19 was associated with higher daily insulin requirements per gram of administered carbohydrates, and worse glycemic control. We found no robust association between ICR and increased odds of death at 90 days.
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Acta Anaesthesiol Scand · Oct 2024
Multicenter StudyGlucose evaluation and management in the ICU (GEM-ICU): Protocol for a bi-centre cohort study.
Hyperglycaemia is common in intensive care unit (ICU) patients. Glycaemic monitoring and effective glycaemic control with insulin are crucial in the ICU to improve patient outcomes. However, glycaemic control and insulin use vary between ICU patients and hypo- and hyperglycaemia occurs. Therefore, we aim to provide contemporary data on glycaemic control and management, and associated outcomes, in adult ICU patients. We hypothesise that the occurrence of hypoglycaemia in acutely admitted ICU patients is lower than that of hyperglycaemia. ⋯ This cohort study will provide a contemporary overview of glucose evaluation and management practices in adult ICU patients and, thus, highlight potential areas for improvement through future clinical trials in this area.
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Acta Anaesthesiol Scand · Oct 2024
Randomized Controlled Trial Comparative StudyCocaine versus xylometazoline to prevent epistaxis after nasotracheal intubation: A randomized trial.
Nasotracheal intubation is associated with a risk of epistaxis. Several drugs, including cocaine and xylometazoline may be used as decongestants prior to nasotracheal intubation to prevent this. We hypothesized that xylometazoline would prevent epistaxis more effectively than cocaine, demonstrated by a lower proportion of patients with bleeding after nasotracheal intubation. ⋯ We found no statistically significant difference between cocaine and xylometazoline in preventing epistaxis after nasotracheal intubation, and the choice of vasoconstrictor should be based on other considerations, such as pricing, availability and medicolegal issues.