Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2019
Multicenter Study Observational StudyAssessment of volume status and volume responsiveness in the ICU: Protocol for an observational, multicentre cohort study.
Expansion of the intravascular compartment is common to treat haemodynamic instability in ICU patients. The most useful and accurate variables to guide and evaluate a fluid challenge remain debated and incompletely investigated resulting in significant variability in practice. The analogue mean systemic pressure has been reported as a measure of the intravascular volume state. ⋯ This study investigating 2 cohorts that encompass a wide variety of reasons for haemodynamic instability will illustrate the applicability of the analogue mean systemic pressure and derived variables to assess the volume state and responsiveness. The results may guide the rationale and design of interventional studies.
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Acta Anaesthesiol Scand · Sep 2019
Multicenter Study Observational StudyAge-associated outcomes after survived out-of-hospital cardiac arrest and subsequent target temperature management.
The registry of the German Society of Intensive Care and Emergency Medicine was founded to analyze outcome of modern post-resuscitation care. ⋯ Increasing age was associated with a higher mortality, but not with an unfavorable neurological outcome. The majority of survivors had a favorable neurologic outcome 6 months after cardiac arrest.
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Acta Anaesthesiol Scand · Aug 2019
Review Randomized Controlled Trial Multicenter StudyHandling Oxygenation Targets in the Intensive Care Unit (HOT-ICU)-Protocol for a randomised clinical trial comparing a lower vs a higher oxygenation target in adults with acute hypoxaemic respiratory failure.
Acutely ill adults with hypoxaemic respiratory failure are at risk of life-threatening hypoxia, and thus oxygen is often administered liberally. Excessive oxygen use may, however, increase the number of serious adverse events, including death. Establishing the optimal oxygenation level is important as existing evidence is of low quality. We hypothesise that targeting an arterial partial pressure of oxygen (PaO2 ) of 8 kPa is superior to targeting a PaO2 of 12 kPa in adult intensive care unit (ICU) patients with acute hypoxaemic respiratory failure. ⋯ The HOT-ICU trial will test the hypothesis that a lower oxygenation target reduces 90-day mortality compared with a higher oxygenation target in adult ICU patients with acute hypoxaemic respiratory failure.
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Acta Anaesthesiol Scand · Aug 2019
Multicenter Study Observational StudyPain management after total hip arthroplasty at five different Danish hospitals: A prospective, observational cohort study of 501 patients.
The available literature does not present a "gold standard" for post-operative pain treatment after total hip arthroplasty (THA). The aim of this prospective observational study was to explore and document post-operative pain treatment, including outcomes, in a large cohort of patients undergoing THA at five different Danish hospitals. ⋯ Analgesic treatment routines differed between hospitals. Pain levels, however, did not differ substantially and were in general low at rest and moderate during mobilisation. No non-opioid analgesic treatment demonstrated consistent analgesic superiority.
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Acta Anaesthesiol Scand · Mar 2019
Randomized Controlled Trial Multicenter StudyIndications for fluid resuscitation in patients with septic shock: Post-hoc analyses of the CLASSIC trial.
Fluid resuscitation is recommended in septic shock, but the specific indications for fluids have not been established. Our aim was to investigate the indications currently used for fluid resuscitation and the effect of fluid on these indications in patients with septic shock admitted to the intensive care unit (ICU). ⋯ In ICU patients with septic shock, low blood pressure, high lactate, and low urinary output were the most frequent indications for fluid. The effects of fluids when given on these indications were less clear, but may dependent on the time course of sepsis resuscitation.