Acta anaesthesiologica Scandinavica
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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
Randomized Controlled TrialAssociations between enteral nutrition and outcomes in the SUP-ICU trial: Results of exploratory post hoc analyses.
Enteral nutrition may affect risks of gastrointestinal bleeding, pneumonia and mortality in critically ill patients and may also modify the effects of pharmacological stress ulcer prophylaxis. We undertook post hoc analyses of the stress ulcer prophylaxis in the intensive care unit trial to assess for any associations and interactions between enteral nutrition and pantoprazole. ⋯ Enteral nutrition was associated with an increased risk of pneumonia and a reduced risk of gastrointestinal bleeding. The interaction between pantoprazole and enteral nutrition suggesting an increased risk of mortality requires further study.
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Acta Anaesthesiol Scand · Oct 2024
ReviewESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation: Endorsement by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine.
The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline "ESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation." The guideline can provide guidance to Nordic anaesthesiologists on the perioperative use of cardiac biomarkers in patients undergoing non-cardiac surgery.
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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
Absorption pharmacokinetics and feasibility of intranasal dexmedetomidine in patients under general anaesthesia.
The use of intranasal dexmedetomidine is hampered by a limited understanding of its absorption pharmacokinetics. ⋯ Administration of intranasal dexmedetomidine in the supine position during general anaesthesia is feasible with good bioavailability. This administration method has slower absorption when compared to awake patients in upright position, with consequent concentrations attained after TMAX for several hours.