Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2025
Impact of nitroglycerin-induced vasodilation on stroke volume and diuretic response in acute heart failure: A protocol for a mechanistic trial.
Acute heart failure is a clinical syndrome characterized by cardiac dysfunction and neurohumoral activation, encompassing complex underlying pathophysiology which may vary across phenotypes. Nitroglycerine is a nitrate donor with vasodilatory effects on both venous capacitance vessels and arterial resistance vessels in higher doses, typically used with the aim of reducing congestion, preload, and afterload. A limited number of studies have proposed that nitroglycerin could promote diuresis and natriuresis. However, the exact hemodynamic effects of nitroglycerin remain uncertain in the clinical setting of acute decompensated heart failure. We hypothesize that intravenous nitroglycerin induces a significant increase in stroke volume and urinary output while lowering cardiac filling pressures. ⋯ This study will assess the acute effects of vasodilation on stroke volume and urinary output in hospitalized patients with AHF. Furthermore, characterizing the hemodynamic profile of the patient prior to vasodilation may help explore which patients will benefit from vasodilation.
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Acta Anaesthesiol Scand · Mar 2025
A descriptive, retrospective single-centre study of air-leak syndrome in intensive care unit patients with COVID-19.
Acute respiratory failure is the predominant presentation of intensive care unit (ICU) patients with COVID-19, and lung protective strategies are recommended to mitigate additional respiratory complications such as air-leak syndrome. The aim of this study is to investigate the prevalence, type, and timing of air-leak syndrome with regards to associated factors and patient outcome in patients with COVID-19 in ICUs at a large Swedish emergency hospital. ⋯ This single-centre cohort study of air leakage into soft tissue in ventilated COVID cases presents findings for associated factors and clinical manifestations, including with different COVID-19 periods and treatments.
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Acta Anaesthesiol Scand · Mar 2025
Conus medullaris termination: Assessing safety of spinal anesthesia in the L2-L3 interspace.
Classic teaching is that spinal anesthesia is safe at or below the L2-L3 interspace. To evaluate this, we sought to determine the percentage of individuals with a conus medullaris termination (CMT) level at or below the L1-L2 interspace. Further, the relationship of CMT level to age, sex, body mass index (BMI), and spinal pathology was examined, as was the reliability of using Tuffier's line (TL) as an anatomical landmark. ⋯ Unlike previous smaller studies, this retrospective study included MRI data from a total of 944 patients. The present study confirms that spinal anesthesia at the L2-L3 interspace or below can be considered safe. The findings indicate that Tuffier's line can be used as a reliable anatomical landmark.
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Acta Anaesthesiol Scand · Mar 2025
Perceptions of eHealth and digitalization among professional anaesthesia personnel: A Swedish national study.
The objective of this study was to evaluate anaesthesia care professionals' perceptions and attitudes regarding the implementation and advancement of digital solutions in perioperative care. ⋯ Swedish anaesthesia personnel are confident that digital solutions may enhance the efficiency of care within the anaesthesia setting. However, varying perceptions on the benefits and necessity of digital solutions are indicated.
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Acta Anaesthesiol Scand · Mar 2025
Observational StudyAdverse event signal analysis of remimazolam using the FDA adverse event reporting system database.
Remimazolam, a novel ultra-short-acting benzodiazepine, has gained popularity in various anesthetic applications due to its pharmacokinetic advantages. However, as its use increases, safety concerns also rise, necessitating thorough examination. Additionally, the limited reports on its side effects require a broader investigation to better understand the drug's safety profile. ⋯ This study analyzed adverse drug events (ADEs) associated with remimazolam using the FAERS database, identifying serious safety signals like allergic reactions, respiratory and cardiac arrests, and vascular access site occlusions, especially in older patients. The findings highlight the need for vigilant monitoring, cautious off-label use, and ongoing post-marketing surveillance.