Acta Anaesthesiologica Scandinavica最新文献

{"title":"Comparison of all types of loop-diuretics for chronic heart failure: A protocol for a systematic review and network meta-analysis.","authors":"Sami Taleghani, Jasmin Dam Lukoschewitz, Sandra Tonning, Ida Arentz Taraldsen, Janus C Jakobsen, Johannes Grand","doi":"10.1111/aas.70005","DOIUrl":"10.1111/aas.70005","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic heart failure (CHF) experience congestion-related symptoms such as dyspnoea and oedema, both of which are associated with poor outcomes. Loop diuretics are the cornerstone to treat congestion and to maintain euvolemia. While furosemide is the most used loop diuretic, other loop diuretics may exhibit theoretical advantages. We aim to compare all types of loop diuretics for patients with CHF.</p><p><strong>Methods: </strong>This protocol for a systematic review is conducted with guidance from the Cochrane Handbook and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. We will include randomised clinical trials (RCTs) of loop diuretics with other loop diuretics, placebo, or standard of care in CHF patients. The search will be conducted across the major medical databases (including Medline, Embase, and Cochrane Central Register of Controlled Trials). The searches will begin in February 2025. The primary outcome will be all-cause mortality. Secondary outcomes will be all-cause hospitalization, serious adverse events (SAEs), and changes in body weight (kg). Data will be analysed by traditional meta-analyses, Trial Sequential Analyses (TSA), and network meta analysis. The risk of bias will be assessed using the Cochrane Risk of Bias tool-version 2. The certainty of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) and Confidence in Network Meta-Analysis (CINEMA) approach.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 3","pages":"e70005"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coagulation and platelet function in cold-stored whole blood on missions in a helicopter emergency service.","authors":"José-Gabriel Sato Folatre, Agneta Wikman, Vladimir Radulovic, Göran Sandström, Gabriel Skallsjö, Per Arnell, Sven-Erik Ricksten, Birgitta Romlin","doi":"10.1111/aas.14568","DOIUrl":"10.1111/aas.14568","url":null,"abstract":"<p><strong>Background: </strong>Haemorrhage is a leading cause of morbidity and mortality in trauma, and prehospital transfusion of blood products is often necessary. Whole blood has been proposed to be the best alternative, but it is unclear whether, and how, storage and transport of the blood in a helicopter affects the blood units. We investigated the coagulation capacity and platelet function in whole blood at different time points during helicopter missions.</p><p><strong>Methods: </strong>Twenty units of low-titre group O RhD negative whole blood were collected from healthy volunteers and analysed before, during and after transport in a helicopter. Coagulation and platelet function, as measured by thromboelastography, and blood samples for pH, electrolytes, glucose and lactate were assessed at baseline and 24, 72 and 168 h after storage in the helicopter. Plasma concentrations of coagulation factors and haemoglobin and blood counts were measured at baseline and after 168 h.</p><p><strong>Results: </strong>Plasma concentrations of coagulation factors and haemoglobin did not change during storage and transport. Platelet counts decreased from a baseline mean of 172 ± 29 × 10⁹/L to a mean of 120 ± 28 × 10⁹/L after 168 h, and platelet function worsened slightly but significantly by 8%-9% during storage and transport. pH and glucose decreased while potassium and lactate levels increased after 168 h compared with baseline.</p><p><strong>Conclusion: </strong>Storage and transport of whole-blood units in a rescue helicopter, for up to 168 h, had a slight impact on the blood quality. Storage of whole blood on board of the helicopter holds up to European standard, measured as temperature and haemolysis.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 2","pages":"e14568"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Locoregional anesthesia in patients with Brugada syndrome. A retrospective database analysis.","authors":"Maurizio Tosi, Panagiotis Flamée, Annelies Scholliers, Tine Opsomer, Steven Raeymaeckers, Domien Vanhonacker","doi":"10.1111/aas.14564","DOIUrl":"10.1111/aas.14564","url":null,"abstract":"<p><strong>Background: </strong>The use of local anesthetics (LA) in individuals with Brugada syndrome (BrS) remains a subject of debate due to the lack of large-scale studies confirming their potential risks. This study primarily aimed to evaluate the incidence of new malignant arrhythmias or defibrillation events in patients diagnosed with BrS during the perioperative period, following the administration of local anesthetics, and within 30 days postoperatively. The secondary objective was to analyze the occurrence of adverse effects during hospitalization, as well as 30-day readmission and mortality rates.</p><p><strong>Methods: </strong>A retrospective cohort study was performed on patients with BrS who underwent locoregional anesthesia between January 1, 1996, and September 30, 2020. Anesthetic records and electronic medical records were thoroughly reviewed for up to 30 days following each administration of local anesthetics.</p><p><strong>Results: </strong>A total of 47 procedures involving patients with BrS who underwent locoregional anesthesia were analyzed. The patients were categorized into three groups: 27 in the peripheral nerve block (PNB) group, 13 in the epidural anesthesia group, and 9 in the spinal anesthesia group. One patient in the PNB group experienced intraoperative ventricular fibrillation following the administration of ajmaline. No other adverse events were observed.</p><p><strong>Conclusion: </strong>In this retrospective study, our findings do not indicate an increased arrhythmogenic risk or a higher incidence of adverse events associated with the administration of local anesthetics in patients with BrS. However, the available data are insufficient to confirm the safety of local anesthetic use in this population. Enhanced vigilance is recommended when administering local anesthetics to individuals with BrS. Prospective studies are necessary to further evaluate and establish the safety profile of local anesthetics in this patient group.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 2","pages":"e14564"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of estimating equations for the assessment of glomerular filtration rate in critically ill patients versus outpatients.","authors":"Katalin Kiss, Aso Saeed, Sven-Erik Ricksten, Gudrun Bragadottir","doi":"10.1111/aas.14540","DOIUrl":"10.1111/aas.14540","url":null,"abstract":"<p><strong>Background: </strong>Estimating equations for the assessment of glomerular filtration rate (GFR) have been poorly investigated in the critical care setting. We evaluated the agreement between the GFR measured with ⁵¹CrEDTA/iohexol (mGFR) and four estimating equations based on serum concentrations of creatine and/or cystatin C (eGFR) in two cohorts: critically ill patients and outpatients with normal-to-moderately reduced GFR.</p><p><strong>Methods: </strong>Forty-three patients in the critical care group and 48 patients in the outpatient group were included. GFR was measured (mGFR) by plasma infusion clearance of ⁵¹Cr-EDTA/iohexol (critical care group) and the single injection, one-sample plasma ⁵¹Cr-EDTA clearance technique (outpatients). The following estimating equations (eGFR) were used: the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for creatinine (CKD-EPI_Cr), cystatin C (CKD-EPI_{Cys C}), creatinine+cystatin C (CKD-EPI_{Cr + Cys C}) and the Lund-Malmö creatinine+cystatin C equation (LM_{Cr + Cys C}). Agreement between mGFR and eGFR was assessed by the Bland-Altman method and accuracy by calculating P30 and P10.</p><p><strong>Results: </strong>In the critically ill group, the bias between the estimating equations and mGFR was -3.6 to 2.8 mL/min/1.73 m², while the error was 121%-127% and the accuracy (P30) 33%-40%. In the outpatients, the bias between the estimating equations and mGFR was -13.0 to 7.6 mL/min/1.73 m², while the error was 31%-41% and the accuracy (P30), 67%-96%.</p><p><strong>Conclusions: </strong>All four equations performed poorly in assessing GFR in the critically ill cohort with an unacceptably high error and low accuracy in contrast to the outpatient group. To accurately assess GFR in critically ill patients, GFR must be measured not estimated.</p><p><strong>Editorial comment: </strong>For the assessment of glomerular filtration rate (GFR), it can be measured directly, but is frequently estimated using a point measure of serum creatinine concentration. In this study, ICU case GFR estimations, by different adjusted equations, done also for a cohort of outpatients, showed that these serum creatinine-based estimations for ICU cases are not highly precise or reliable.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"e14540"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of a 72-h infusion of prostacyclin (1 ng/kg/min) in mechanically ventilated patients with pulmonary infection and endotheliopathy-protocol for the multicenter randomized, placebo-controlled, blinded, investigator-initiated COMBAT-ARF trial.","authors":"Peter Søe-Jensen, Niels E Clausen, Morten H Bestle, Lars P K Andersen, Theis Lange, Pär I Johansson, Jakob Stensballe","doi":"10.1111/aas.14565","DOIUrl":"10.1111/aas.14565","url":null,"abstract":"<p><strong>Background: </strong>Acute respiratory failure (ARF) is common in critically ill patients, and 50% of patients in intensive care units require mechanical ventilation [3, 4]. The COVID-19 pandemic revealed that COVID-19 infection induced ARF caused by damage to the microvascular pulmonary endothelium. In a randomized clinical trial, mechanically ventilated COVID-19 patients with severe endotheliopathy, as defined by soluble thrombomodulin (sTM) ≥ 4 ng/mL, were randomized to evaluate the effect of a 72-h infusion of low-dose prostacyclin 1 ng/kg/min or placebo. Twenty-eight-day mortality was 21.9% versus 43.6% in the prostacyclin and the placebo groups, respectively (RR 0.50; CI 0.24 to 0.96 p = .06). The aim of the current trial is to investigate if this beneficial effect and safety of prostacyclin also are present in any patient with suspected pulmonary infection requiring mechanical ventilation and concomitant severe endotheliopathy.</p><p><strong>Materials and methods: </strong>This is a multi-center, randomized, blinded, clinical investigator-initiated phase 3 trial in mechanically ventilated patients with suspected pulmonary infection and severe endotheliopathy, as defined by sTM ≥4 ng/mL. Patients are randomized 1:1 to a 72-h infusion of low-dose prostacyclin (iloprost) 1 ng/kg/min or placebo (an equal volume of saline). Four-hundred fifty patients will be included. The primary endpoint is 28-day all-cause mortality. Secondary endpoints include 90-day mortality, days alive without vasopressor, mechanical ventilation, and renal replacement therapy in the ICU within 28 and 90 days, and the number of serious adverse reactions or serious adverse events within the first 7 days.</p><p><strong>Discussion: </strong>This trial will investigate the efficacy and safety of prostacyclin vs. placebo for 72-hours in mechanically ventilated patients with any suspected pulmonary infection and severe endotheliopathy, as defined by sTM ≥4 ng/mL. Trial endpoints focus on the potential effect of prostacyclin to reduce 28-day all-cause mortality.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 1","pages":"e14565"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11660193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative pain management in patients with preexisting opioid dependence-A scoping review protocol.","authors":"Nikoline Svensson, Magnus Grønbæk Henriksen, Ann Merete Møller","doi":"10.1111/aas.14556","DOIUrl":"10.1111/aas.14556","url":null,"abstract":"<p><strong>Background: </strong>Opioid-dependent patients with chronic pain conditions present a significant challenge for anesthesiologists when managing acute postsurgical pain. Opioid-dependent patients can experience tolerance, physical dependence, and hyperalgesia. These patients have an increased risk of poorly managed acute postoperative pain, which can ultimately lead to suffering and potentially an overall increase in length of hospitalization and healthcare cost. However, this is an under-researched field. This scoping review aims to investigate effective strategies in managing postoperative pain in patients with preexisting opioid dependence.</p><p><strong>Methods: </strong>A scoping review will be conducted on postoperative pain management in patients with preexisting opioid dependence. This review will be prepared according to the JBI methodology for scoping reviews and to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR). We will conduct a comprehensive search across multiple databases. Backward citation searching of the final included articles will also be conducted. Data extraction will include trial and participant characteristics, intervention details, and reported outcomes.</p><p><strong>Results: </strong>In the final review the results will be presented as a descriptive summary with supplementary tables, figures, and graphs where applicable.</p><p><strong>Conclusion: </strong>The planned scoping review will map out the current evidence about effective strategies to manage postoperative pain in patients with preexisting opioid dependence. We will aim to identify research gaps that can be used as support in the development of further research.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 1","pages":"e14556"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thromboelastography or rotational thromboelastometry guided algorithms in bleeding patients: An updated systematic review with meta-analysis and trial sequential analysis.","authors":"A D Kvisselgaard, S A Wolthers, A Wikkelsø, L B Holst, B Drivenes, A Afshari","doi":"10.1111/aas.14558","DOIUrl":"10.1111/aas.14558","url":null,"abstract":"<p><strong>Background: </strong>Bleeding patients face significant morbidity and mortality due to impaired haemostasis. Haemostatic resuscitation has evolved, yet the optimal approach remains unclear. The primary objective was to assess the benefits and risks of transfusion guided by TEG/ROTEM versus standard of care in bleeding patients in an updated review.</p><p><strong>Methods: </strong>This systematic review of randomised controlled trials with meta-analyses and trial sequential analysis was conducted according to Cochrane Collaboration methodology, PRISMA and GRADE guidelines. A literature search was conducted in five major databases. Both paediatric and adult patients were included. The primary outcome was mortality, and secondary outcomes were the administration of blood products, blood loss, surgical reintervention, and dialysis-dependent renal injury.</p><p><strong>Results: </strong>This systematic review included 31 randomised trials (n = 2756), with most patients undergoing elective cardiac surgery. TEG-/ROTEM-guided algorithms reduced the amount of transfused fresh frozen plasma (RR 0.5, 95% CI 0.32-0.72, I²: 94%), platelets (RR 0.7, 95% CI 0.55-0.91, I²: 57%), the risk for surgical reintervention (RR 0.65, 95% CI 0.47-0.94, I²: 0%), and bleeding with a standard mean difference of -0.31 (95% CI -0.55 to -0.08, I²: 75%). No statistically significant difference was demonstrated for mortality (RR 0.76, 95% CI 0.57-1.00, I²: 5%). According to GRADE methodology, the certainty of the evidence was very low for all outcomes. Trial sequential analysis of mortality analysis indicated that 54% of the optimal information size was reached with an alpha-boundary RR of 0.81 (95% CI 0.63-1.03).</p><p><strong>Conclusions: </strong>TEG-/ROTEM-guided transfusion algorithms may reduce the risk of mortality, bleeding volume, and the need for fresh frozen plasma and platelets, but the evidence is very uncertain. Further, the results were primarily based on the adult population undergoing elective cardiac surgery.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 1","pages":"e14558"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient- and family-centered care in adult ICU (FAM-ICU): A protocol for a feasibility study.","authors":"Søs Bohart, Tina Waldau, Anne Sofie Andreasen, Ann Merete Møller, Thordis Thomsen","doi":"10.1111/aas.14539","DOIUrl":"10.1111/aas.14539","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Method: </strong>We will conduct a pre-/post two-group study design. We plan to recruit 30 adult ICU patients and their close family members at Herlev University Hospital in Denmark. The pre-group (n = 15) will receive usual care and the post-group (n = 15) will receive the FAM-ICU intervention. The FAM-ICU intervention involves interdisciplinary training of the ICU team and a systematic approach to information sharing and consultations with the patients and their family. Feasibility outcomes will include recruitment and retention rates, intervention fidelity, and the feasibility of participant outcome data collection. Acceptability will be assessed through questionnaires and interviews with clinicians, patients, and family members. Data collection is scheduled to begin in January 2025.</p><p><strong>Discussion: </strong>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.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"e14539"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for scoping review: Mapping the landscape of acute pain management in sports-related musculoskeletal injuries.","authors":"Ibrahim Mohammed Abdul Khalek, Zeynep N Mert, Ann Merete Møller","doi":"10.1111/aas.14547","DOIUrl":"10.1111/aas.14547","url":null,"abstract":"<p><strong>Background: </strong>Acute pain management is critical in sports-related musculoskeletal injuries to facilitate recovery and minimize long-term impact. While current practices vary, incorporating both pharmacological and non-pharmacological approaches, the quality and breadth of existing evidence have not been thoroughly assessed. This scoping review aims to explore the clinical role of different pain management strategies and provide a comprehensive overview of the field.</p><p><strong>Methods: </strong>The review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews and adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR) guidelines. Searches will be conducted in major peer-reviewed databases and relevant gray literature. Studies involving athletes of any level undergoing treatment for acute musculoskeletal injuries will be considered. Data extraction will include study and participant characteristics, intervention details, reported outcomes, efficacy comparisons, and economic analyses.</p><p><strong>Results: </strong>This review will provide a descriptive synthesis of the data, utilizing statistical analysis, figures, and tables where relevant to introduce the different treatment modalities. In line with PRISMA-P and PRISMA-ScR guidelines, this scoping review incorporates studies of diverse designs. The data synthesis involves descriptive statistics and narrative presentations, aimed at exploring the relationship between study results and research objectives.</p><p><strong>Conclusion: </strong>This scoping review will evaluate various pain management interventions for acute musculoskeletal injuries in sports, mapping the current evidence and identifying gaps in research. The findings will help inform clinical practices and guide future research efforts to optimize pain management strategies in sports medicine.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"e14547"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences and attitudes on acetate- versus lactate-buffered crystalloid solutions for intravenous fluid therapy-An international survey.","authors":"Karen Louise Ellekjaer, Praleene Sivapalan, Sheila N Myatra, Lasse Grønningsæter, Johanna Hästbacka, Paul J Young, Andrew J Boyle, Marlies Ostermann, Carmen A Pfortmueller, Ieva Jovaišienė, Jan De Waele, Annika Reintam Blaser, Abdulrahman Al-Fares, Ashish K Khanna, Yaseen M Arabi, Tomoko Fujii, Eric Keus, Mervyn Mer, Fayez Alshamsi, Maria Cronhjort, Anders Perner, Morten H Møller","doi":"10.1111/aas.14553","DOIUrl":"10.1111/aas.14553","url":null,"abstract":"<p><strong>Background: </strong>Clinical practice guidelines recommend use of buffered crystalloid solutions in critically ill patients but do not distinguish between solutions based on different buffering anions, that is, acetate- versus lactate-buffered solutions. We therefore surveyed relevant physicians about their preferences and attitudes toward each solution.</p><p><strong>Methods: </strong>We conducted an international online survey of anesthesiologists (within perioperative care) and intensive care unit (ICU) physicians. The survey comprised 13 questions on respondents' attitudes and preferences regarding the use of acetate- and/or lactate-buffered crystalloid solutions, including their opinions on a potential clinical trial comparing these solutions and the clinical importance of such a trial.</p><p><strong>Results: </strong>A total of 1321 respondents participated, with a response rate of 34%, ranging from 14% to 96% across 18 countries. Most surveyed physicians reported using buffered crystalloid solutions \"very often\" (76%) or \"often\" (16%). Availability of acetate- and lactate-buffered solutions varied, as 35% of respondents reported having both types available, 35% reported having only acetate-, and 24% reported having only lactate-buffered solutions available. Most respondents (87%) would support a randomized trial in adult emergency surgical patients and ICU patients comparing an acetate- versus lactate-buffered crystalloid solution. The median rating of the clinical importance of this question was 5 (interquartile range 4-6) on a scale from 1 to 9.</p><p><strong>Conclusions: </strong>In this international survey, the reported use of buffered crystalloid solutions was high. Availability of the different solutions varied widely. The support for a potential randomized trial was high, with the clinical importance rated important but not critical by most respondents.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"69 1","pages":"e14553"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}