Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2024
Time to detection of serious adverse events by continuous vital sign monitoring versus clinical practice.
Continuous vital sign monitoring detects far more severe vital sign deviations (SVDs) than intermittent clinical rounds, and deviations are to some extent related to subsequent serious adverse events (SAEs). Early detection of SAEs is pivotal to allow for effective interventions but the time relationship between detection of SAEs by continuous vital sign monitoring versus clinical practice is not well-described at the general ward. ⋯ Continuous vital sign monitoring detects signs of oncoming SAEs in the form of SVD hours before CSD, potentially allowing for earlier and more effective treatments to reduce the extent of SAEs.
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Acta Anaesthesiol Scand · Oct 2024
Patient- and family-centered care in adult ICU (FAM-ICU): A protocol for a feasibility study.
In the intensive care unit (ICU), delirium in patients and long-term mental health challenges in both patients and their family members are highly prevalent. To address these issues, patient- and family-centered care has been recommended to alleviate the burdens associated with critical illness and ICU admission. We have developed the patient- and FAMily-centered care in the adult ICU intervention (FAM-ICU intervention). This multi-component intervention comprises several concrete and manageable components and operationalizing patient- and family-centered care principles in clinical practice. In this protocol, we describe a study aiming to evaluate the feasibility and acceptability of the FAM-ICU intervention in the adult ICU setting, including the feasibility of collecting relevant patient- and family-member outcome data. ⋯ This study will assess the feasibility and acceptability when implementing the FAM-ICU intervention and the feasibility of conducting a main trial to investigate its effectiveness on delirium in patients and the mental health of patients and family members. The data from the feasibility study will be used to guide sample size calculations, trial design, and final data collection methods for a subsequent stepped-wedge randomized controlled trial.
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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.