Abstract:
BACKGROUND:Human factors account for the majority of adverse events in both aviation and medicine. Human factors awareness training entitled "Crew Resource Management (CRM)" is associated with improved aviation safety. We determined whether implementation of CRM impacts outcome in critically ill patients. METHODS:We performed a prospective 3-year cohort study in a 32-bed ICU, admitting 2500-3000 patients yearly. At the end of the baseline year, all personnel received CRM training, followed by 1 year of implementation. The third year was defined as the clinical effect year. All 7271 patients admitted to the ICU in the study period were included. The primary outcome measure was ICU complication rate. Secondary outcome measures were ICU and hospital length of stay, and standardized mortality ratio. RESULTS:Occurrence of serious complications was 67.1/1000 patients and 66.4/1000 patients during the baseline and implementation year respectively, decreasing to 50.9/1000 patients in the post-implementation year (P = 0.03). Adjusted odds ratios for occurrence of complications were 0.92 (95% CI 0.71-1.19, P = 0.52) and 0.66 (95% CI 0.51-0.87, P = 0.003) in the implementation and post-implementation year. The incidence of cardiac arrests was 9.2/1000 patients and 8.3/1000 patients during the baseline and implementation year, decreasing to 3.5/1000 patients (P = 0.04) in the post-implementation year, while cardiopulmonary resuscitation success rate increased from 19% to 55% and 67% (P = 0.02). Standardized mortality ratio decreased from 0.72 (95% CI 0.63-0.81) in the baseline year to 0.60 (95% CI 0.53-0.67) in the post-implementation year (P = 0.04). CONCLUSION:Our data indicate an association between CRM implementation and reduction in serious complications and lower mortality in critically ill patients.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Haerkens MH,Kox M,Lemson J,Houterman S,van der Hoeven JG,Pickkers Pdoi
10.1111/aas.12573subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1319-29issue
10eissn
0001-5172issn
1399-6576journal_volume
59pub_type
杂志文章abstract::Forty-four children, ASA physical status I or II, aged 1.5-14 years and admitted for strabismus surgery, were studied. The study compared the postoperative condition after two different anesthesia methods. All children were premedicated with midazolam rectally, received glycopyrrolate i.v. and were then randomised to ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1992.tb03448.x
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:Penetrating trauma kills rapidly. Thorough and efficient examination and aggressive hemorrhage control is important to save lives. The aim of this study was to assess the skills of civilian Emergency Medical Technicians (EMTs) in bleeding examination and control compared to Army Medics. Our hypothesis was th...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12910
更新日期:2017-08-01 00:00:00
abstract::Fifty patients with chronic resistant cervicobrachialgia were randomly divided into two groups. Twenty-five patients (group A) were treated with cervical epidural steroid/lidocaine injections and 17 patients (group B) were treated with steroid/lidocaine injections into the posterior neck muscles. Another eight patient...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1993.tb03765.x
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:In total hip replacement surgery several anesthesiological techniques can be used. In this study we compared continuous spinal anesthesia (CSA) and postoperative analgesia vs. single-shot spinal anesthesia (SPA) and postoperative patient-controlled intravenous analgesia with morphine (SPA). METHODS:In a pro...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2003.00173.x
更新日期:2003-08-01 00:00:00
abstract::Blood loss has previously been shown to be more detrimental for spontaneously hypertensive (SHR) than for normotensive Wistar-Kyoto (WKY) rats. To evaluate whether this decreased tolerance to blood loss is due to disturbances in circulatory control or to alterations in cellular function caused by the hypertensive dise...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1986.tb02431.x
更新日期:1986-07-01 00:00:00
abstract::As the low blood solubility (blood gas partition coefficient 0.69) of sevoflurane suggests a rapid emergence from anaesthesia, recovery from sevoflurane anaesthesia was compared to isoflurane in outpatient gynaecological laparoscopy. Fifty ASA I or II, consenting women participated in a randomised, controlled and sing...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1995.tb04081.x
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND:About 27% of the population is known to have a patent foramen ovale. It can be opened if the left atrial pressure is less than the right atrial pressure. This pressure reversal has been reported during gynecologic laparoscopic surgery. The present paper describes with help of transesophageal echocardiography...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Epidural opioids are frequently combined with local anaesthetics for an additive antinociceptive effect. We investigated the efficacy of epidural fentanyl to 1.25 or 1.5 mg/ml ropivacaine for post-operative epidural analgesia in children. METHODS:One hundred and eight children undergoing hypospadias repair ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2009.02046.x
更新日期:2009-09-01 00:00:00
abstract::Disturbance of vision is a complication that may occur from absorption of the glycine solution used to irrigate the bladder during transurethral operations. We examined for a possible dose-response relationship between glycine dose, eye symptoms and neurophysiological changes after repeated intermittent intravenous in...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1995.tb04046.x
更新日期:1995-02-01 00:00:00
abstract::A randomized, prospective study was performed to compare recovery characteristics in 41 ASA physical status I-II patients scheduled for ambulatory surgery with either propofol or thiopentone-isoflurane anaesthesia. Particular attention was focused on the recovery time needed to meet discharge criteria. The propofol gr...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1990.tb03111.x
更新日期:1990-07-01 00:00:00
abstract::The effect of lidocaine and halothane on the compound action potential of rat sciatic nerves was studied under hypo-hyperthermic conditions. In drug-free desheathed nerves, a total but reversible cold block occurred at 10-11 degrees C, and an irreversible heat block at 46 degrees C. Cooling potentiated the dose-depend...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1980.tb01555.x
更新日期:1980-08-01 00:00:00
abstract::Bambuterol is a new bronchodilator which is also a reversible inhibitor of plasma cholinesterase. In patients with normal plasma cholinesterase genotype, bambuterol prolongs suxamethonium-induced neuromuscular blockade. In the present study, we investigated the interaction of bambuterol and suxamethonium in nine patie...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1990.tb03153.x
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:The primary aim was to investigate the performance of a National Advisory Committee for Aeronautics based predictive model (NACA-BM) for mortality at 14 days and a reference model using motor GCS (GCS-RM). The secondary aim was to compare the models for impaired consciousness of survivors at 14 days (IC-14; ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13229
更新日期:2019-01-01 00:00:00
abstract::Seizures in patients with no history of epilepsy has been associated with administration of remifentanil in two previous case reports. We present a case where a bolus dose of remifentanil (50 micrograms/kg) was followed by a self terminating generalised tonic-clonic seizure in a patient admitted for acute hip surgery,...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.0001-5172.2004.00294.x
更新日期:2004-02-01 00:00:00
abstract:BACKGROUND:Patients' difficulties following critical illness and the willingness of intensive care units (ICU) to take an expanded responsibility during the recovery period have led to the development of different follow-up programs. The aim of this study was to explore and describe patients' participation in and evalu...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2011.02474.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to investigate whether an initial post-operative lactate level is a predictor of mortality, need for peritoneal dialysis (PD), duration of intubation or length of stay (LOS) in the intensive care unit (ICU) in children undergoing cardiac surgery. METHOD:A retrospective, observa...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2011.02588.x
更新日期:2012-04-01 00:00:00
abstract::In an intensive-care setting we studied the effects of ketoprofen, a dual inhibitor of cyclooxygenase and lipoxygenase, on circulatory and respiratory changes during established endotoxic shock in sheep. Two groups (n = 7 in each) were exposed to E. coli endotoxin, which caused a sharp increase in pulmonary artery pre...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1994.tb03833.x
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:We report a documented grade III IgE-mediated hypersensitivity reaction associated with the use of 2.5% patent blue V dye for sentinel lymph node biopsy during breast cancer surgery. METHODS:Immediately after the reaction, when hemodynamic stability was obtained, plasma histamine was measured whereas serum ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.00912.x
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Open radical retropubic prostatectomy (ORRP) is associated with moderate pain. We hypothesized that a transversus abdominis plane (TAP) block would reduce post-operative pain, morphine consumption and opioid-related side effects compared with wound infiltration and placebo in this population. METHODS:This w...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aas.12080
更新日期:2013-04-01 00:00:00
abstract::The psychological reactions to hospitalization, anaesthesia, and operation in a group of 107 children from 1 to 12 years old, anaesthetized with ketamine or halothane after randomization were investigated through questionnaires, which the parents answered 1 month postoperatively. The percentage of replies was 96.3%. F...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1977.tb01258.x
更新日期:1977-01-01 00:00:00
abstract:BACKGROUND:A controversy exists whether beneficial analgesic effects of epidural analgesia over intravenous analgesia influence the rate of post-operative complications and the length of hospital stay. There is some evidence that favours epidural analgesia following major surgery in high-risk patients. However, there i...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2008.01734.x
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the effects of an intraoperative MgSO4 infusion on arterial oxygenation and lung mechanics in patients with moderate COPD undergoing cancer larynx surgery under general anesthesia (GA). Our primary outcome was arterial oxygenation determined by the PaO2 and PaO2 /FiO2...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13684
更新日期:2020-11-01 00:00:00
abstract::A standardized rat endotoxin shock model was used to assess the differential effects of four commonly used anesthetics upon hemodynamics before and during endotoxin shock. Forty-nine male Sprague-Dawley rats weighing 307 +/- 4 g were divided into five groups:freely-moving conscious, enflurane (2%), isoflurane (1.4%), ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1987.tb02619.x
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Mechanical ventilation (MV) can result in inflammation and subsequent lung injury. Toll-like receptor (TLR)4 and NF-κB are proposed to play a crucial role in the MV-induced inflammatory response. Resveratrol (RVT) exhibits anti-inflammatory effects in vitro and in vivo supposedly by interfering with TLR4 sig...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12276
更新日期:2014-04-01 00:00:00
abstract::We have evaluated the high-frequency oscillatory ventilation (HFOV) combined with intermittent mandatory ventilation (IMV) in critically ill neonates and infants using the Babylog 8000 SW 4.0. We used HFOV combined with IMV as a rescue mode in 10 neonates and infants aged 1 day to 17 months, who were receiving maximal...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1996.tb04509.x
更新日期:1996-07-01 00:00:00
abstract::In acute lung injury (ALI), where pulmonary microvascular permeability is increased, transvascular fluid filtration depends mainly on the hydrostatic capillary pressure. In the presence of intrapulmonary vasoconstriction pulmonary capillary pressure (PCP) may increase thereby promoting transvascular fluid filtration a...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1994.tb03970.x
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Wound infiltration with local anesthetics does not reliably produce satisfactory postoperative analgesia, and the dose of local anesthetic which may be safely administered is limited by the potential for systemic toxicity. This study evaluated the efficacy of a slow-release liposomal bupivacaine formulation ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04666.x
更新日期:1997-02-01 00:00:00
abstract::Focus-Assessed Transthoracic Echocardiography (FATE) is a point-of-care ultrasound protocol allowing the fast evaluation of the cardio-pulmonary status. It has been well established that patients with an exacerbation of chronic obstructive lung disease and lung oedema benefit from the sitting position. These and other...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2010.02330.x
更新日期:2011-01-01 00:00:00
abstract::Principle goals of sedation for eye surgery are to provide patient comfort and to allow the patient to stay calm during both retrobulbar injection and surgery. Insufficient sedation may not prevent the patient from moving during retrobulbar injection, whereas very deep sedation may result in respiratory complications ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1996.tb04388.x
更新日期:1996-01-01 00:00:00
abstract::Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1984.tb02109.x
更新日期:1984-10-01 00:00:00