Acta Anaesthesiologica Scandinavica最新文献

{"title":"Serious adverse events reporting in recent randomised clinical trials in intensive care medicine – A methodological study protocol","authors":"Marie Qvist Jensen, Marie Warrer Munch, Anders Granholm, Morten Hylander Møller, Marina Bahrenkova, Anders Perner","doi":"10.1111/aas.14512","DOIUrl":"https://doi.org/10.1111/aas.14512","url":null,"abstract":"BackgroundSerious adverse events (SAEs) are common in intensive care unit (ICU) patients. Reporting of SAEs in randomised clinical trials (RCTs) varies why underreporting is likely. We aim to describe the reporting of SAEs from 2020 onwards and to illustrate the recent reporting of SAEs published in major medical journals.MethodsWe will conduct a methodological study assessing pharmacological interventions in RCTs including adult ICU patients. We will search 10 general medical and critical care journals in PubMed. We will include all RCTs published from 2020 onwards. The primary research question is how many RCTs report SAEs in the primary publication. Secondary research questions include how SAEs are reported in the primary publication either as (1) proportion of patients experiencing one or more SAE, (2) all single events occurred, or (3) both strategies combined. We will assess the association between the proportion of patients with reported SAEs and the following trial characteristics: multicentred versus single‐centre RCTs, industry‐sponsored versus academic‐sponsored, published trial protocol versus unpublished work, blinding, trials sample size, and RCTs focusing on COVID‐19 patients versus other populations.DiscussionThe outlined methodological study will provide important information on the reporting of SAEs in recent drug trials in adult ICU patients.","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215868","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":"Quantity: More markers, more merit","authors":"Albert Gyllencreutz Castellheim, Elin M. Thorlacius","doi":"10.1111/aas.14521","DOIUrl":"https://doi.org/10.1111/aas.14521","url":null,"abstract":"","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":"66 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215848","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":"Comment on: \"Is epidural analgesia non-inferior to intrathecal fentanyl as initiation for neuraxial analgesia in early non-spontaneous labor?\"","authors":"Raghuraman M Sethuraman","doi":"10.1111/aas.14460","DOIUrl":"10.1111/aas.14460","url":null,"abstract":"","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1126"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157351","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":"Platelet transfusions in adult ICU patients with thrombocytopenia: A sub-study of the PLOT-ICU inception cohort study.","authors":"Carl Thomas Anthon, Frédéric Pène, Anders Perner, Elie Azoulay, Kathryn Puxty, Andry Van De Louw, Sanjay Chawla, Pedro Castro, Pedro Povoa, Luis Coelho, Victoria Metaxa, Matthias Kochanek, Tobias Liebregts, Thomas Kander, Mirka Sivula, Jo Bønding Andreasen, Lene Bjerregaard Nielsen, Christine Lodberg Hvas, Etienne Dufranc, Emmanuel Canet, Christopher John Wright, Julien Schmidt, Fabrice Uhel, Louai Missri, Mette Krag, Elisabet Cos Badia, Cándido Díaz-Lagares, Sophie Menat, Guillaume Voiriot, Niels Erikstrup Clausen, Kristian Lorentzen, Reidar Kvåle, Andreas Barratt-Due, Thomas Hildebrandt, Aleksander Rygh Holten, Kristian Strand, Morten Heiberg Bestle, Pål Klepstad, Damien Vimpere, Carolina Paulino, Catherina Lueck, Christian Svendsen Juhl, Carolina Costa, Per Martin Bådstøløkken, Lia Susana Aires Lêdo, Morten Hylander Møller, Lene Russell","doi":"10.1111/aas.14467","DOIUrl":"10.1111/aas.14467","url":null,"abstract":"<p><strong>Background: </strong>Platelet transfusions are frequently used in the intensive care unit (ICU), but current practices including used product types, volumes, doses and effects are unknown.</p><p><strong>Study design and methods: </strong>Sub-study of the inception cohort study 'Thrombocytopenia and Platelet Transfusions in the ICU (PLOT-ICU)', including acutely admitted, adult ICU patients with thrombocytopenia (platelet count <150 × 10⁹/L). The primary outcome was the number of patients receiving platelet transfusion in ICU by product type. Secondary outcomes included platelet transfusion details, platelet increments, bleeding, other transfusions and mortality.</p><p><strong>Results: </strong>Amongst 504 patients with thrombocytopenia from 43 hospitals in 10 countries in Europe and the United States, 20.8% received 565 platelet transfusions; 61.0% received pooled products, 21.9% received apheresis products and 17.1% received both with a median of 2 (interquartile range 1-4) days from admission to first transfusion. The median volume per transfusion was 253 mL (180-308 mL) and pooled products accounted for 59.1% of transfusions, however, this varied across countries. Most centres (73.8%) used fixed dosing (medians ranging from 2.0 to 3.5 × 10¹¹ platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 10¹¹ platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (-1 to 8) × 10⁹/L. Outcomes of patients with thrombocytopenia who did and did not receive platelet transfusions varied.</p><p><strong>Conclusions: </strong>Among acutely admitted, adult ICU patients with thrombocytopenia, 20.8% received platelet transfusions in ICU of whom most received pooled products, but considerable variation was observed in product type, volumes and doses across countries. Prophylactic platelet transfusions were associated with limited increases in platelet counts.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1018-1030"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141260514","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":"Nitrous oxide inhalation: History and experiences.","authors":"Golo Kronenberg, Erich Seifritz, Sebastian Olbrich","doi":"10.1111/aas.14462","DOIUrl":"10.1111/aas.14462","url":null,"abstract":"","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1129"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178626","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":"Empirical meropenem versus piperacillin/tazobactam for adult patients with sepsis (EMPRESS) trial: Protocol.","authors":"Anders Granholm, Marie Warrer Munch, Nick Meier, Fredrik Sjövall, Marie Helleberg, Frederik Boëtius Hertz, Benjamin Skov Kaas-Hansen, Hans-Christian Thorsen-Meyer, Lars Wiuff Andersen, Bodil Steen Rasmussen, Jakob Steen Andersen, Trine Lynge Albertsen, Maj-Brit Nørregaard Kjær, Aksel Karl Georg Jensen, Theis Lange, Anders Perner, Morten Hylander Møller","doi":"10.1111/aas.14441","DOIUrl":"10.1111/aas.14441","url":null,"abstract":"<p><strong>Background: </strong>Piperacillin/tazobactam may be associated with less favourable outcomes than carbapenems in patients with severe bacterial infections, but the certainty of evidence is low.</p><p><strong>Methods: </strong>The Empirical Meropenem versus Piperacillin/Tazobactam for Adult Patients with Sepsis (EMPRESS) trial is an investigator-initiated, international, parallel-group, randomised, open-label, adaptive clinical trial with an integrated feasibility phase. We will randomise adult, critically ill patients with sepsis to empirical treatment with meropenem or piperacillin/tazobactam for up to 30 days. The primary outcome is 30-day all-cause mortality. The secondary outcomes are serious adverse reactions within 30 days; isolation precautions due to resistant bacteria within 30 days; days alive without life support and days alive and out of hospital within 30 and 90 days; 90- and 180-day all-cause mortality and 180-day health-related quality of life. EMPRESS will use Bayesian statistical models with weak to somewhat sceptical neutral priors. Adaptive analyses will be conducted after follow-up of the primary outcome for the first 400 participants concludes and after every 300 subsequent participants, with adaptive stopping for superiority/inferiority and practical equivalence (absolute risk difference <2.5%-points) and response-adaptive randomisation. The expected sample sizes in scenarios with no, small or large differences are 5189, 5859 and 2570 participants, with maximum 14,000 participants and ≥99% probability of conclusiveness across all scenarios.</p><p><strong>Conclusions: </strong>EMPRESS will compare the effects of empirical meropenem against piperacillin/tazobactam in adult, critically ill patients with sepsis. Due to the pragmatic, adaptive design with high probability of conclusiveness, the trial results are expected to directly inform clinical practice.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1107-1119"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070120","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":"Potential organ donors during two years at the second largest hospital in Norway.","authors":"Gunhild Holmaas, Edle Hilton, Stein Foss, Gaute K Wathle, Reidar Kvåle","doi":"10.1111/aas.14455","DOIUrl":"10.1111/aas.14455","url":null,"abstract":"<p><strong>Background: </strong>Western Norway has the lowest number of actual deceased organ donors per million inhabitants in Norway. We wished to find the total number of potential donors and donor organs during 2 years at Haukeland University Hospital, the largest hospital in the region, and evaluate where and why potential donors were lost.</p><p><strong>Methods: </strong>We evaluated all patients who died at Haukeland University Hospital in 2018-19. We checked if intensive care patients, filling the criteria as organ donors after brain death, became donors, and the reasons why potential donors were lost. We also estimated the number of potential donors after circulatory death. We checked if patients transferred from the intensive care units and patients never admitted to intensive care were potential donors. Location, gender, age, and possible number of organs were registered.</p><p><strong>Results: </strong>Of 1453 in-hospital deaths, 20 brain-dead patients became actual donors. One brain-dead and two other potential donors, one of them discharged to a bed ward, were not evaluated at the intensive care units. Relatives refused in five patients. Three fulfilled the Norwegian criteria from 2021 as organ donors after circulatory death. Ten potential donors after brain death were never admitted to intensive care and died on neurological or neurosurgical wards. If all potential organ donors were realised, the number of donors would double. The number of transplanted organs would increase less, as organs used per donor would drop from 3.50 to 2.90.</p><p><strong>Conclusion: </strong>Our study cannot explain the low number of donors in our region compared with the rest of Norway. If all potential donations were implemented, the number of actual donors would double. Patients dying outside the intensive care units represent the largest potential source for extra donors, maximally increasing the number of donors by 42%, high-quality livers 44% and kidneys 18%. Introducing organ donation after circulatory death may increase the number of donors by 15% and the number of high-quality livers and kidneys by 12%.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1041-1049"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155116","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":"Blood transfusion practices in paediatric perioperative care: Insights from the TUPAC initiative.","authors":"Florian Piekarski, Thomas Engelhardt","doi":"10.1111/aas.14458","DOIUrl":"10.1111/aas.14458","url":null,"abstract":"","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1016-1017"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141086465","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":"In response to \"Nitrous oxide inhalation: History and experiences,\" a letter to the Editor by Kroneberg et al.","authors":"Petra Valtonen, Saara Markkanen, Kaija Järventausta, Mirja Tenhunen, Maija-Liisa Kalliomäki","doi":"10.1111/aas.14469","DOIUrl":"10.1111/aas.14469","url":null,"abstract":"","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1130-1131"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454512","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":"A standard operating procedure for prehospital anaesthesia and its effect on mortality-An observational study.","authors":"Harry Ljungqvist, Jussi Pirneskoski, Anssi Saviluoto, Timo Iirola, Hetti Kirves, Jouni Nurmi","doi":"10.1111/aas.14459","DOIUrl":"10.1111/aas.14459","url":null,"abstract":"<p><strong>Background: </strong>Prehospital anaesthesia is a complex intervention performed for critically ill patients. To minimise complications, a standard operating procedure (SOP) outlining the process is considered valuable. We investigated the implementation of an SOP for prehospital anaesthesia in helicopter emergency medical services (HEMS).</p><p><strong>Methods: </strong>We performed a retrospective observational study of patients receiving prehospital anaesthesia by Finnish HEMS from January 2012 to August 2019. The intervention studied was the implementation of an SOP at two of the five bases during 2015-2016. Patients were stratified according to whether they were anaesthetised before, during or after implementation and the primary outcomes were 1- and 30-day mortality. Secondary outcomes included anaesthesia quality indicators. Confounding factors was assessed via logistic regression.</p><p><strong>Results: </strong>A total of 3902 tracheal intubations were performed without an SOP, 430 during implementation and 1525 after implementation. The SOP had a significant effect on 1-day mortality during implementation with an odds ratio (OR) of 0.56, 95% confidence interval (95% CI) 0.37-0.81 and a further trend towards benefit after implementation (OR 0.84, 95% CI 0.68-1.04), but no difference in 30-day mortality (OR after implementation 1.10, 95% CI 0.92-1.30). Implementation of an SOP improved first-pass success rate from 87.3% to 96.5%, p < 0.001.</p><p><strong>Conclusion: </strong>Implementation of an SOP for prehospital anaesthesia was associated with a trend towards lower 1-day mortality and an improved first-pass success but did not affect 30-day mortality. Despite this, we advocate prehospital systems to consider implementation of a prehospital anaesthesia SOP as immediate performance markers improved significantly.</p>","PeriodicalId":6909,"journal":{"name":"Acta Anaesthesiologica Scandinavica","volume":" ","pages":"1068-1075"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155114","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}