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  • 51.
    Johansson, M
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    M Phuong, D
    Department of Microbiology, Bach Mai Hospital, Hanoi, Vietnam.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Infektionskliniken i Östergötland.
    Need for improved antimicrobial and infection control stewardship in Vietnamese intensive care units2011Ingår i: TROPICAL MEDICINE and INTERNATIONAL HEALTH, ISSN 1360-2276, Vol. 16, nr 6, s. 737-743Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Pandgt;Objective Survey of antibiotic consumption, microbial resistance and hygiene precautions in the intensive care units of three hospitals in northern Vietnam. Methods Observational study. Data were collected from the microbiological laboratories. Antibiotic consumption was determined based on quantities of drugs delivered from the pharmacy. A protocol to observe the application of hygiene precautions was developed and used. Bacteria were typed and tested for drug susceptibility using the disc-diffusion method. Results The mean antibiotic consumption was 811 defined daily doses per 1000 occupied bed days. The most commonly used antibiotics were third-generation cephalosporins, followed by carbapenems, amoxicillin and ampicillin. Eighty per cent of bacterial isolates were Gram-negative. The most common pathogens found in blood cultures were Escherichia coli and Klebsiella spp., Pseudomonas spp., Acinetobacter spp., Staphylococcus aureus and Enterococcus faecalis. Acinetobacter and Pseudomonas spp. were the two most frequently isolated bacteria from the respiratory tract and all other sources together. Seventy per cent of Acinetobacter species showed reduced susceptibility to imipenem, 80% to ciprofloxacin and 89% to ceftazidime. Forty-four per cent of Pseudomonas spp. showed reduced susceptibility to imipenem, 49% to ciprofloxacin and 49% to ceftazidime. Escherichia coli was fully susceptible to imipenem, but 57% of samples were resistant to both ciprofloxacin and cefotaxime. Hygiene precautions were poor, and fewer than 50% of patient contacts incorporated appropriate hand hygiene. Conclusion Low antibiotic consumption, poor hygiene precautions and the high level of antibiotic resistance indicate that there is room for improvement regarding antibiotic use and infection control.

  • 52.
    Johansson, Mats
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Escobar Kvitting, John-Peder
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för radiologiska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Flatebø, Torun
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Nicolaysen, Anne
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Nicolaysen, Gunnar
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Inhibition of constitutive nitric oxide synthase does not influence ventilation: matching in normal prone adult sheep with mechanical ventilation2016Ingår i: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 123, nr 6, s. 1492-1499Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Local formation of nitric oxide (NO) in the lung in proportion to ventilation, leading to vasodilation, is a putative mechanism behind ventilation- perfusion matching. We examined the role of local constitutive NO formation on regional distributions of ventilation (V) and perfusion (Q) and ventilation-perfusion matching (V/Q) in mechanically ventilated adult sheep with normal gas exchange.

    Methods

    V and Q were analyzed in lung regions (≈1.5 cm3) before and after inhibition of constitutive nitric oxide synthase (cNOS) with Nω-nitro-L-arginine methyl ester (L-NAME) (25 mg/kg) in seven prone sheep ventilated with PEEP. V and Q were measured using aerosolized fluorescent and infused radiolabeled microspheres, respectively. The animals were exsanguinated while deeply anaesthetized; lungs were excised, dried at total lung capacity and divided into cube units. The spatial location for each cube was tracked and fluorescence and radioactivity per unit weight determined.

    Results

    Pulmonary artery pressure increased significantly after L-NAME (from mean 16.6 to 23.6 mmHg, P<0.01) while there were no significant changes in PaO2, PaCO2 or SD log(V/Q). Distribution of V was not influenced by L-NAME but a small redistribution of Q from ventral to dorsal lung regions resulting in less heterogeneity in Q along the gravitational axis was seen (p<0.01). Perfusion to regions with the highest ventilation (5th quintile of the V distribution) remained unchanged with L-NAME.

    Conclusions

    There was minimal or no influence of cNOS inhibition by L-NAME on the distributions of V and Q, and V/Q in prone anesthetized and ventilated adult sheep with normal gas exchange.

  • 53.
    Johansson, Mats
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Flatebö, Torun
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Nicolaysen, Anne
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Nicolaysen, Gunnar
    Department of Physiology, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Minimal redistribution of regional ventilation-perfusion ratios by 10 and 20 cmH2O positive end-expiratory pressure in prone sheep2014Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background

    Positive end-expiratory pressure (PEEP) has posture dependent effects on the distributions of ventilation (V) and perfusion (Q). We examined if redistribution of regional ventilation-perfusion ratios (V/Q) by PEEP was identical in prone and supine.

    Methods

    Mechanically ventilated sheep (n=16) were studied in prone or supine with 0, 10 and 20 cmH2O PEEP. V and Q were measured with a fluorescent microsphere aerosol and an intravenous infusion of microspheres, respectively. The right lung was dried at total lung capacity and diced into approx. 1000 regions tracking the spatial location of each region.

    Results

    In prone V/Q was close to unity in all horizontal planes with 0 PEEP and remained so with 10 and 20 PEEP. In supine V/Q was imperfect in the most dependent planes with 0 and 10 PEEP. V/Q approached unity in these planes when 20 PEEP was applied, but V/Q in non-dependent planes increased. The slope of the linear relationship between vertical height and V/Q was not different from zero at any PEEP in prone, but was larger than zero with all PEEP levels in supine. Mean V/Q heterogeneity (SDlogV/Q) was lower in prone at all PEEP levels (0 PEEP: 0.22 vs. 0.37,  10 PEEP: 0.21 vs. and 0.32 and 20 PEEP: 0.19 vs. 0.39, P<0.01).

    Conclusions

    Redistribution of regional V/Q was minimal in prone with PEEP and remained close to ideal in all horizontal planes. The absence of high V/Q with PEEP in prone may be clinically important when recruitment fails in the supine posture.

  • 54.
    Johansson, Mats
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Wiklund, Andreas
    Department of Anaesthesia and Intensive Care, Karolinska Hospital, Stockholm, Sweden.
    Flatebø, Torun
    Institute of Basic Medical Sciences, Department of Physiology, University of Oslo, Norway..
    Nicolaysen, Anne
    Institute of Basic Medical Sciences, Department of Physiology, University of Oslo, Norway.
    Nicolaysen, Gunnar
    Institute of Basic Medical Sciences, Department of Physiology, University of Oslo, Norway..
    Walther, Sten
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Positive end-expiratory pressure affects regional redistribution of ventilation differently in prone and supine sheep2004Ingår i: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 32, nr 10, s. 2039-2044Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine interactions between positive end-expiratory pressure (PEEP) and posture on regional distribution of ventilation and to compare measurements of regional ventilation with two aerosols: a wet fluorescent microsphere aerosol (FMS, median mass aerodynamic diameter 1.1 μm) and a dry 99mTc-labeled carbon particle aerosol (Technegas, TG, median mass aerodynamic diameter ≈0.1 μm). Design: Experimental study. Setting. Academic laboratory. Subjects: Anesthetized and mechanically ventilated sheep (n = 16). Interventions: Four conditions were studied: prone or supine posture with of without 10 cm H2O PEEP. Measurements and Main results: Comparisons of FMS and TG were made in five animals. The median correlation coefficient of the two ventilation tracers was .95 (range, .91-.96). The mean ventilation per unit weight of dry lung for horizontal planes was almost identical whether measured with TG or FMS. The distribution of ventilation was assessed by analyzing deposition of aerosol in about 1,000 lung regions per animal. Distribution of ventilation down the vertical axis was linear in prone (the slope indicated a dorsal-to-ventral three-fold difference in ventilation) but unimodal in supine animals with the mode in the center of the lung. Redistribution of ventilation with 10 PEEP differed between posture, shifting the mode in supine toward dependent lung regions while eliminating the dorsal-to-ventral gradient in prone. The regional heterogeneity in ventilation was greater in supine sheep at both levels of PEEP, and this was due mostly to greater isogravitational heterogeneity in supine than in prone position. Conclusions: The wet fluorescent microsphere aerosol was as reliable as Technegas for high-resolution measurements of regional ventilation. The markedly different effects of 10 PEEP in supine and prone sheep may have important implications for gas exchange both in noninjured and injured lungs.

  • 55. Larsson, Anders
    et al.
    Blomqvist, Hans
    Frostell, Claes
    Lindén, Viveka
    Sjöstrand, Ulf
    Walther, Sten
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Ventilation vid ARDS: respirator, bukläge, NO eller konstgjord lunga?2000Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 97, s. 2058-2063Artikel i tidskrift (Övrigt vetenskapligt)
  • 56.
    Larsson Viksten, Jessica
    et al.
    Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten.
    Engerström, Lars
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN.
    Steinvall, Ingrid
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Samuelsson, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för läkemedelsforskning. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US (ANOPIVA).
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Medicinska fakulteten.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för Kirurgi, Ortopedi och Onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US (ANOPIVA).
    Children aged 0-16 admitted to Swedish intensive care units and paediatric intensive care units showed low mortality rates.2019Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 108, nr 8, s. 1460-1466Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: This study described the basic characteristics of children aged 0-16 years who were treated in intensive care units (ICUs) and paediatric ICUs (PICUs), compared their outcomes and examined any causes of death.

    METHODS: This was a retrospective cohort study of admissions to 74 ICUs and three PICUs in Sweden that were recorded in the Swedish Intensive Care Registry from January 1, 2008 to December 31, 2012.

    RESULTS: We retrieved data on 12 756 children who were admitted 17 003 times. The case mix differed between the ICUs, which were mainly admissions for injuries, accidents and observation, and PICUs, which were mainly admissions for malformations, genetic abnormalities and respiratory problems (p < 0.001). The median stays in the ICUs and PICUs were 1.4 and 3.5 days (p < 0.001), respectively. The respective crude mortality rates were 1.1% and 2.0, and the Paediatric Index of Mortality version 2 standardised mortality ratios were 0.43 and 0.50. None of these differences were significant. Most deaths were within 24 hours: About 57% in the ICUs, mainly from brain anomalies, and 13% in the PICUs, mainly from circulatory problems.

    CONCLUSION: Sweden had a low mortality rate in both ICUs and PICUs and the children admitted to these two types of unit differed.

  • 57. Lindskog, M
    et al.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Karlström, G
    The Swedish Intensive Care Registry, Karlstad, Sweden.
    Nolin, T
    Mårdh, C
    The Swedish Intensive Care Registry, Kristianstad, Sweden.
    Orwelius, Lotti
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Samuelsson, C
    Är svensk intensivvård könsjämlik?2012Rapport (Övrigt vetenskapligt)
  • 58. Lundin, Å
    et al.
    Nyberg, H
    Svanberg, C
    Hallingbäck, C
    Philipsson, S
    Kindahl, P
    Nilsson, A
    Peterzén, Bengt
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Hur mår den hjärtopererade patienten ett år efter operationen?2012Konferensbidrag (Refereegranskat)
  • 59.
    Mårdh, C
    et al.
    The Swedish Intensive Care Registry, Kristianstad, Sweden.
    Nolin, T
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Karlström, G
    The Swedish Intensive Care Registry, Karlstad, Sweden.
    Möller, C
    Tre års kontinuerlig, öppen nationell uppföljning i Svenska Intensivvårdsregistret (SIR) av avlidna på IVA enligt protkoll - vilka problem har vi haft?2012Konferensbidrag (Refereegranskat)
  • 60. Nilsson, A
    et al.
    Svanberg, C
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Lundin, Å
    Ångest och despression är vanligt 12 mån efter en hjärtoperation och förekomsten är associerad med nedsatt hälsorelaterad livskvalitet omedelbart före operation2013Konferensbidrag (Refereegranskat)
  • 61. Nolin, T
    et al.
    Mårdh, C.
    Karlström, G
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Variationen i antalet organdonationer per landsting minskar när hänsyn tas till donatorns hemvist.2015Konferensbidrag (Refereegranskat)
  • 62.
    Nolin, T
    et al.
    Kristianstad, Sweden .
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Mardh, C
    Kristianstad, Sweden .
    Karlstrom, G
    Karlstad, Sweden .
    A CONTINUOUS AND NATIONWIDE OPEN AUDIT OF THE DECEASED DONATION PROCESS IN SWEDISH ICUS in INTENSIVE CARE MEDICINE, vol 36, issue , pp S211-S2112010Ingår i: INTENSIVE CARE MEDICINE, Springer Science Business Media , 2010, Vol. 36, s. S211-S211Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 63.
    Norman, H
    et al.
    Uppsala University.
    Kandala, K
    Pennsylvania State University.
    Kolluri, R
    Pennsylvania State University.
    Zackrisson, H
    Ulleval University Hospital.
    Nordquist, J
    Uppsala University.
    Walther, Sten
    Ulleval University Hospital.
    Eriksson, LI
    Larsson, L
    A porcine model of acute quadriplegic myopathy: a feasibility study.2006Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 50, s. 1058-1067Artikel i tidskrift (Refereegranskat)
  • 64.
    Nyström, Helena
    et al.
    Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Berkius, Johan
    Department of Anaesthesia and Intensive Care, Västervik Hospital, Västervik, Sweden.
    Ekström, Magnus
    Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund University, Lund, Sweden.
    Walther, Sten
    Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Inghammar, Malin
    Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden.
    Survival after intensive care for COPD exacerbation in patients with and without long-term oxygen therapy: a nationwide cohort study2019Ingår i: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, nr Suppl 63Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Background: Current knowledge about prognosis after intensive care for COPD exacerbation in patients with long-term oxygen therapy (LTOT) is limited.

    Aims: To investigate survival after ICU admission for COPD exacerbation in patients with and without LTOT.

    Material and methods: Nationwide observational cohort study including all first-time ICU admissions for COPD exacerbation in the Swedish Intensive Care Register 2008-2015. The National Quality Register for Respiratory Failure (Swedevox) provided data on LTOT. Mortality was traced through the Population Register.

    Results: The cohort included 4828 patients (60% women) and 466 had LTOT before first ICU admission. LTOT patients were older (median 74 years (IQR 69-79) vs 72 years (IQR 66-78), p<0.001) and had higher simplified acute physiology score 3 (SAPS3) score; median 60 (IQR 54-68) vs 59 (IQR 52-66), p=0.008).

    Mortality was higher for LTOT patients in the ICU (13.5% vs 7.5%; p<0.001) and at 30 days after ICU admission (37.8% vs 25.0%; p<0.001). In logistic regression adjusted for SAPS3 score and sex, LTOT was associated with increased 30-day mortality (OR 1.8; 95% CI 1.4-2.2).Median survival time from ICU admission was 3.2 months (IQR 0.2-17.7) for LTOT patients and 16.0 months (IQR 1.0-52.8) for patients without LTOT.

  • 65.
    Orwelius, L
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Östergötlands Läns Landsting, Sinnescentrum, Intensivvårdskliniken US. 3Svenska Intensivvårdsregistret.
    Åkerman, E
    3Svenska Intensivvårdsregistret.
    Wickerts, C-J
    3Svenska Intensivvårdsregistret.
    Walther, Sten M.
    Linköpings universitet, Institutionen för medicin och hälsa. 3Svenska Intensivvårdsregistret.
    Hälsorelaterad livskvalitet upp till 12 mpnader efter intensivvård: rikstäckange lärdomar från SIR2015Konferensbidrag (Refereegranskat)
  • 66.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Nordlund, P
    Jonkoping, Sweden .
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    COPING STRATEGY AND PERCEIVED HOPELESSNESS ARE IMPORTANT FOR HEALTH RELATED QUALITY OF LIFE AFTER CRITICAL ILLNESS in INTENSIVE CARE MEDICINE, vol 36, issue , pp S392-S3922010Ingår i: INTENSIVE CARE MEDICINE, Springer Science Business Media , 2010, Vol. 36, s. S392-S392Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 67.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Nordlund, P
    Jonkoping, Sweden .
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    PERCEIVED HOPELESSNESS AFTER ICU CARE IS A PREDICTOR OF LONG TERM SURVIVAL in INTENSIVE CARE MEDICINE, vol 36, issue , pp S385-S3852010Ingår i: INTENSIVE CARE MEDICINE, Springer Science Business Media , 2010, Vol. 36, s. S385-S385Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 68.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för inflammationsmedicin. Linköpings universitet, Hälsouniversitetet.
    Kristenson, Margareta
    Linköpings universitet, Institutionen för medicin och hälsa, Socialmedicin och folkhälsovetenskap. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Health-related quality of life scores after intensive care are almost equal to those of the normal population: a multicenter observational study2013Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 17, nr 5, s. R236-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION:

    Health-related quality of life (HRQoL) in patients treated in intensive care has been reported to be lower compared with age- and sex-adjusted control groups. Our aim was to test whether stratifying for coexisting conditions would reduce observed differences in HRQoL between patients treated in the ICU and a control group from the normal population. We also wanted to characterize the ICU patients with the lowest HRQoL within these strata.

    METHODS:

    We did a cross-sectional comparison of scores of the short-form health survey (SF-36) questionnaire in a multicenter study of patients treated in the ICU (n = 780) and those from a local public health survey (n = 6,093). Analyses were in both groups adjusted for age and sex, and data stratified for coexisting conditions. Within each stratum, patients with low scores (below -2 SD of the control group) were identified and characterized.

    RESULTS:

    After adjustment, there were minor and insignificant differences in mean SF-36 scores between patients and controls. Eight (n = 18) and 22% (n = 51) of the patients had low scores (-2 SD of the control group) in the physical and mental dimensions of SF-36, respectively. Patients with low scores were usually male, single, on sick leave before admission to critical care, and survived a shorter time after being in ICU.

    CONCLUSIONS:

    After adjusting for age, sex, and coexisting conditions, mean HRQoL scores were almost equal in patients and controls. Up to 22% (n = 51) of the patients had, however, a poor quality of life as compared with the controls (-2 SD). This group, which more often consisted of single men, individuals who were on sick leave before admission to the ICU, had an increased mortality after ICU. This group should be a target for future support.

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  • 69.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Gren, H
    The Swedish Intensive Care Registry, Kristianstad, Sweden.
    Mårdh, C
    The Swedish Intensive Care Registry, Kristianstad, Sweden.
    Karlström, G
    The Swedish Intensive Care Registry, Karlstad, Sweden.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Assessing outcome after critical illness by use of a nation intensive care registry (SIR)2012Konferensbidrag (Refereegranskat)
  • 70.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Assessing patient reported outcome measures (PROM) after critical illness using a nationwide intensive care registry2012Ingår i: Proceedings of the 20th International Health Promoting Hospitals and Health Services, 2012Konferensbidrag (Refereegranskat)
  • 71.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Östergötlands Läns Landsting, Sinnescentrum, Intensivvårdskliniken US. Linköpings universitet, Medicinska fakulteten. The Swedish Intensive Care Registry, Karlstad, Sweden .
    Åkerman, E
    Swedish Intensive Care Registry, Karlstad, Sweden /Clinic of Intensive Care and Perioperative Medicine, Skåne University Hospital (Malmö), Malmö, Sweden.
    Wickerts, C-J
    The Swedish Intensive Care Registry, Karlstad, Sweden .
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. The Swedish Intensive Care Registry, Karlstad, Sweden .
    Health-related quality of life at 2, 6 and 12 months after critical illness - lessons learnt from a nationwide follow-up of 4,500 ICU admissions2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction

    The development of intensive care medicine has led to improved survival of patients with complex illnesses and extensive injuries. Survivors are at risk of acquiring physical and functional deficits that may have negative effects on health-related quality of life (HRQoL). The significance of measuring HRQoL has been underlined by critical care researchers since poor HRQoL is associated with an adverse prognosis.

    Objective

    The aim of this work was to examine the development of HRQoL at 2, 6 and 12 months after ICU discharge in a mixed ICU patient population with an ICU-stay > 96 hrs.

    Methods

    We analysed admissions during 2008-2014 to 49 ICUs that submitted follow-up data to the Swedish Intensive Care Registry (SIR, http://www.icuregswe.org). HRQoL was measured using the Short Form 36 (SF36) questionnaire at 2, 6, and 12 months after discharge from ICU. SF36 domains, age, gender, illness severity on admission (SAPS3 probabilities) and length of ICU-stay were analysed for the entire cohort and for important diagnostic groups. SF36 scores were compared to an age- and gender-adjusted Swedish normal population. Differences in SF36 domains were analysed using non-parametric methods. Medians and interquartile ranges are presented.

    Results

    Complete SF36 responses were analysed for 4453, 4019 and 2515 admissions at 2, 6 and 12 months, respectively. HRQoL at 2 months in patients that subsequently were lost to follow-up was generally similar to those with follow-up, but they were younger, less ill and had shorter ICU-stay. Full longitudinal data with complete SF36 responses were obtained in 1438 patients [Age: 66 yrs. (57-73 yrs.), female gender: 37.2%, SAPS3 prob: 0.36 (0.19-0.55), ICU-stay: 7.0 days (4.9-11.5 days)]. SF36 improved over time in all domains (P < 0.001, Table), although some domains remained stable from 6 to 12 months. Patterns of recovery differed between important diagnostic groups (i.e. sepsis, out-of-hospital cardiac arrest, COPD, ARDS). A large proportion of patients (10-25% depending on SF36 domain) had HRQoL scores at 12 months which was below 2 standard deviations of the age- and gender-adjusted Swedish norm. The cardiac arrest group were among those with best, and the COPD group were among those with worst HRQoL at 12 months.

    Conclusions

    HRQoL recovered over 12 months in critically ill patients with a prolonged ICU stay. Recovery varied between diagnostic groups and a large proportion of patients had markedly depressed HRQoL. These findings may have important implications for follow-up and care after critical illness.

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  • 72.
    Parenmark, Fredric
    et al.
    Department of anaesthesia and intensive care, Gävle Sjukhus, Gävle, Sweden.
    Walther, Sten
    Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Increased risk of dying if discharged with inter-hospital transfer due to lack of ICU beds. A nationwide study from the Swedish Intensive Care Registry2019Ingår i: Intensive Care Medicine Experimental, E-ISSN 2197-425X, Vol. 7, nr Supplement 3, s. 634-634, artikel-id 000228Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    INTRODUCTION. Most patients admitted to intensive care are discharged to a general ward in the same hospital, but some patients require transfer to another hospital. Indications for interhospital transfers (IHT) include referral for specialist treatment, lack of intensive care beds at the referring ICU and repatriation to ICU in home hospital [1].

    OBJECTIVES. To review mortality of ICU-patients undergoing IHT and analyse whether different indications for transfer render different mortalities.

    METHODS. Retrospective cohort register study using the Swedish Intensive Care Registry (SIR) during 2016-2018. The SIR collects data from 98.8% of Swedish ICUs including data on discharge from ICUs to other hospitals/ICUs. Transfers were divided into three categories: transfer due to medical reasons, lack of ICU beds or repatriation to ICU in home hospital. We analysed odds ratios (ORs) for dying within 30 days after discharge from ICU using risk adjusted (SAPS3 score) multi-level mixed effect logistic regression with ICUs as random effect.

    RESULTS. We identified 12,356 patients who were discharged to another ICU and hospital, i.e. inter-hospital transfers. The unadjusted mortality 30 days after IHT was 17.2 % compared to 12.4 % if discharged to ward in the same hospital. Mortality after IHT varied with the cause of discharge (Figure).Main diagnoses for transfer due to specialist treatment were subarachnoid haemorrhage, head injury and multi-trauma whilst for lack of ICU beds post cardiac arrest, respiratory failure and pneumonia dominated. Risk adjusted analysis showed a significantly increased risk of dying after discharge due to lack of ICU-beds in comparison with other reasons for IHTs

    CONCLUSION. The adjusted risk of dying within 30 days after interhospital transfer was greater among critically ill patients when the transfer was due to lack of beds in the referring ICU. The increased mortality lingered for at least 6 months underlining the importance to identify causes and intervene to avoid unnecessary loss of life.

  • 73.
    Rimes-Stigare, Claire
    et al.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Frumento, Paolo
    Institute Environm Medical IMM, Sweden; Karolinska Institute, Sweden.
    Bottai, Matteo
    Institute Environm Medical IMM, Sweden; Karolinska Institute, Sweden.
    Martensson, Johan
    Karolinska Institute, Sweden; Austin Hospital, Australia.
    Martling, Claes-Roland
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Karlstrom, Goran
    Swedish Intens Care Registry, Sweden.
    Bell, Max
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Evolution of chronic renal impairment and long-term mortality after de novo acute kidney injury in the critically ill; a Swedish multi-centre cohort study2015Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 19, nr 221Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Acute Kidney Injury (AKI) is common in critical ill populations and its association with high short-term mortality is well established. However, long-term risks of death and renal dysfunction are poorly understood and few studies exclude patients with pre-existing renal disease, meaning outcome for de novo AKI has been difficult to elicit. We aimed to compare the long-term risk of Chronic Kidney Disease (CKD), End Stage Renal Disease (ESRD) and mortality in critically ill patients with and without severe de novo AKI. Method: This cohort study was conducted between 2005 and 2011 in Swedish intensive care units (ICU). Data from 130134 adult patients listed on the Swedish intensive care register-database was linked with other national registries. Patients with pre-existing CKD (4192) and ESRD (1389) were excluded, as were cases (26771) with incomplete data. Patients were classified according to AKI exposure during ICU admission. Outcome in the de novo AKI group was compared to the non-exposed (no-AKI) intensive care control group. Primary outcome was all-cause mortality. Follow-up ranged from one to seven years (median 2.1 years). Secondary outcomes were incidence of CKD and ESRD and median follow-up was 1.3 years. Results: Of 97 782 patients, 5273 (5.4%) had de novo AKI. These patients had significantly higher crude mortality at one (48.4% vs. 24.6%) and five years (61.8% vs. 39.1%) compared to the control group. The first 30% of deaths in AKI patients occurred within 11 days of ICU admission whilst the 30-centile in the no-AKI group died by 748 days. CKD was significantly more common in AKI survivors at one year (6.0% vs. 0.44%) than in no-AKI group (adjusted incidence rate ratio (IRR) 7.6). AKI patients also had significantly higher rates of ESRD at one (2.0% vs. 0.08%) and at five years (3.9% vs. 0.3%) than those in the comparison group (adjusted IRR 22.5). Conclusion: This large cohort study demonstrated that de novo AKI is associated with increased short and long-term risk of death. AKI is independently associated with increased risk of CKD and ESRD as compared to an ICU control population. Severe de novo AKI survivors should be routinely followed-up and their renal function monitored.

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  • 74. Robertsen, A
    et al.
    Hanoa, R
    Heskestad, B
    Walther, Sten
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Local audit of active cooling in traumatic brain injury.2007Ingår i: in Acta anaesthesiologica Scandinavica. Supplementum, ISSN 0515-2720, vol 51, 2007, Vol. 51, s. 13-13Konferensbidrag (Refereegranskat)
  • 75.
    Rydenfelt, Kristina
    et al.
    Department of Anaesthesiology and Intensive Care, Akershus University Hospital, Lørenskog, Norway.
    Engerström, Lars
    Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Strömberg, Ulf
    Department of Research, Development and Education, Halland Hospital, Halmstad, Sweden.
    Samuelsson, Carolina
    Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö/Lund, Sweden/Department of Anesthesiology and Intensive Care, Halland Hospital, Halmstad, Sweden.
    In-hospital versus 30-day mortality in the critically ill – a 2-year Swedish intensive care cohort analysis.2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    Background: Standardised mortality ratio (SMR) is a common quality indicator in critical care and is the ratio between observed mortality and expected mortality. Typically, in-hospital mortality is used to derive SMR, but the use of a time-fixed, more objective, endpoint has been advocated. This study aimed to determine the relationship between in-hospital mortality and 30-day mortality on a comprehensive Swedish intensive care cohort.

    Methods: A retrospective study on patients >15 years-old, from the Swedish Intensive Care Register (SIR), where intensive care unit (ICU) admissions in 2009-2010 were matched with the corresponding hospital admissions in the Swedish Hospital Discharge Register. Recalibrated SAPS (Simplified Acute Physiology Score) 3 models were developed to predict and compare in-hospital and 30-day mortality. SMR based on in-hospital mortality and on 30-day mortality were compared between ICUs and between groups with different case-mixes, discharge destinations and length of hospital stays.

    Results: Sixty-five ICUs with 48861 patients, of which 35610 were SAPS 3 scored, were included. Thirty-day mortality (17%) was higher than in-hospital mortality (14%). The SMR based on 30-day mortality and that based on in-hospital mortality differed significantly in 7/53 ICUs, for patients with sepsis, for elective surgery-admissions and in groups categorised according to discharge destination and hospital length of stay.

    Conclusion: Choice of mortality end-point influences SMR. The extent of the influence depends on hospital-, ICU- and patient cohort characteristics as well as inter-hospital transfer rates, since all these factors influence the difference between SMR based on 30-day mortality and SMR based on in-hospital mortality.

  • 76.
    Rydenfelt, Kristina
    et al.
    Akershus University Hospital, Norway.
    Engerström, Lars
    Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US. Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Walther, Sten
    Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Strömberg, Ulf
    Halland Hospital, Sweden.
    Samuelsson, Carolina
    Skåne University Hospital, Sweden; Halland Hospital, Sweden.
    In-hospital vs. 30-day mortality in the critically ill - a 2-year Swedish intensive care cohort analysis2015Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, nr 7, s. 846-858Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Standardised mortality ratio (SMR) is a common quality indicator in critical care and is the ratio between observed mortality and expected mortality.

    Typically, in-hospital mortality is used to derive SMR, but the use of a time-fixed, more objective, end-point has been advocated. This study aimed to determine the relationship between in-hospital mortality and 30-day mortality on a comprehensive Swedish intensive care cohort.

    Methods

    A retrospective study on patients >15 years old, from the Swedish Intensive Care Register (SIR), where intensive care unit (ICU) admissions in 2009–2010 were matched with the corresponding hospital admissions in the Swedish Hospital Discharge Register. Recalibrated SAPS (Simplified Acute Physiology Score) 3 models were developed to predict and compare in-hospital and 30-day mortality. SMR based on in-hospital mortality and on 30-day mortality were compared between ICUs and between groups with different case-mixes, discharge destinations and length of hospital stays.

    Results

    Sixty-five ICUs with 48861 patients, of which 35610 were SAPS 3 scored, were included. Thirty-day mortality (17%) was higher than in-hospital mortality (14%). The SMR based on 30-day mortality and that based on in-hospital mortality differed significantly in 7/53 ICUs, for patients with sepsis, for elective surgery-admissions and in groups categorised according to discharge destination and hospital length of stay.

    Conclusion

    Choice of mortality end-point influences SMR. The extent of the influence depends on hospital-, ICU- and patient cohort characteristics as well as inter-hospital transfer rates, as all these factors influence the difference between SMR based on 30-day mortality and SMR based on in-hospital mortality.

  • 77.
    Samuelson, K.
    et al.
    Lund University Hospital.
    Persfalk, B-M
    Östergötlands Läns Landsting, Anestesi- och operationscentrum, Anestesi- och intensivvårdskliniken VIN.
    Linden, M.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Validation of the nursing care recording system 20082009Ingår i: in ACTA ANAESTHESIOLOGICA SCANDINAVICA, vol 53, 2009, Vol. 53, s. 73-73Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 78.
    Samuelsson, Carolina
    et al.
    Skåne University Hospital, Sweden; Halland Hospital, Sweden.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Karlstrom, Goran
    Swedish Intens Care Registry, Sweden.
    Nolin, Thomas
    Kristianstad Central Hospital, Sweden.
    Walther, Sten
    Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Medicinska fakulteten. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin.
    Gender differences in outcome and use of resources do exist in Swedish intensive care, but to no advantage for women of premenopausal age2015Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 19, nr 129Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Preclinical data indicate that oestrogen appears to play a beneficial role in the pathophysiology of and recovery from critical illness. In few previous epidemiologic studies, however, have researchers analysed premenopausal women as a separate group when addressing potential gender differences in critical care outcome. Our aim was to see if women of premenopausal age have a better outcome following critical care and to investigate the association between gender and use of intensive care unit (ICU) resources. Methods: On the basis of our analysis of 127,254 consecutive Simplified Acute Physiology Score III-scored Swedish Intensive Care Registry ICU admissions from 2008 through 2012, we determined the risk-adjusted 30-day mortality, accumulated nurse workload score and ICU length of stay. To investigate associations with sex, we used logistic regression and multivariate analyses on the entire cohort as well as on two subgroups stratified by median age for menopause (up to and including 45 years and older than 45 years) and six selected diagnostic subgroups (sepsis, multiple trauma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, pneumonia and cardiac arrest). Results: There was no sex difference in risk-adjusted mortality for the cohort as a whole, and there was no sex difference in risk-adjusted mortality in the group 45 years of age and younger. For the group of patients older than 45 years of age, we found a reduced risk-adjusted mortality in men admitted for cardiac arrest. For the cohort as a whole, and for those admitted with multiple trauma, male sex was associated with a higher nurse workload score and a longer ICU stay. Conclusions: Using information derived from a large multiple ICU register database, we found that premenopausal female sex was not associated with a survival advantage following intensive care in Sweden. When the data were adjusted for age and severity of illness, we found that men used more ICU resources per admission than women did.

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  • 79.
    Sjöberg, Folke
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Intensive care registries and the evolution of the concept of quality of care - reflections from the 10-year anniversary symposium of the Swedish Intensive Care Registry2012Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 56, nr 9, s. 1073-1077Artikel i tidskrift (Övrigt vetenskapligt)
  • 80. Stattin, K
    et al.
    Linder, A
    Wickerts, C J
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    An obeservational study of percutaneous vs. surgical tracheostomy in the critically ill. A comparison of outcome in Swedish intensive care units2013Konferensbidrag (Refereegranskat)
  • 81.
    Steins, Krisjanis
    et al.
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Kommunikations- och transportsystem. Linköpings universitet, Tekniska högskolan.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Hälsouniversitetet.
    A generic simulation model for planning critical care resource requirements2013Ingår i: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 68, nr 11, s. 1148-1155Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Intensive care capacity planning based on factual or forecasted mean admission numbers and mean length of stay without taking non-linearity and variability into account is fraught with error. Simulation modelling may allow for a more accurate assessment of capacity needs. We developed a generic intensive care simulation model using data generated from anonymised patient records of all admissions to four different hospital intensive care units. The model was modified and calibrated stepwise to identify important parameters and their values to obtain a match between model predictions and actual data. The most important characteristic of the final model was the dependency of admission rate on actual occupancy. Occupancy, coverage and transfers of the final model were found to be within 2% of the actual data for all four simulated intensive care units. We have shown that this model could provide accurate decision support for planning critical care resource requirements.

  • 82.
    Steins, Krisjanis
    et al.
    Linköpings universitet, Institutionen för teknik och naturvetenskap, Kommunikations- och transportsystem. Linköpings universitet, Tekniska högskolan.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Developing a Generic Simulation Model for Planning of Intensive Care Resource NeedsManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The estimation of intensive care resource needs is often made on incomprehensive grounds as simple calculations fail to account for the complexity and variability in the patient flow. The aim of the study was to develop and validate a generic intensive care unit simulation model which could reproduce resource use, i.e. occupancy and coverage, as found in data from the Swedish Intensive Care Registry (SIR). The generic ICU model was developed using a stepwise modification and calibration approach in order to identify important parameters and their values to obtain a match between model predictions and actual data in four selected ICUs. The final version of the model included special logic for handling elective surgery patients, holding beds for dealing with overutilizations, and a mathematical model to describe admission rate dependency on actual occupancy. The results from model calibration indicate that simple models cannot adequately describe the behavior in all studied ICUs. It is necessary to include certain patient characteristics as well as to account properly for dependencies in input data in order to have the model predict ICU resource use as observed in historical data.

  • 83.
    Strand, K
    et al.
    Stavanger University Hospital.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Martner, J
    Sahlgrens University Hospital.
    Nolin, T
    Kristianstad Hospital.
    Ala-Kokko, T
    Oulu University Hospital.
    Reinikainen, M
    Kuopio University Hospital.
    Mussalo, P
    Intensium Ltd.
    Flaatten, H
    Haukeland Hospital.
    TIME FROM ADMISSION TO DEATH IN THE ICU2009Ingår i: in INTENSIVE CARE MEDICINE, vol 35, 2009, Vol. 35, s. 119-119Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 84.
    Strand, Kristian
    et al.
    Akershus University Hospital.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Reinikainen, Matti
    North Karelia Central Hospital.
    Ala-Kokko, Tero
    Oulu University Hospital.
    Nolin, Thomas
    Kristianstad Hospital.
    Martner, Jan
    Sahlgrenska University Hospital.
    Mussalo, Petteri
    Tieto Healthcare and Welfare.
    Soreide, Eldar
    Stavanger University Hospital.
    Flaatten, Hans K
    Haukeland Hospital.
    Variations in the length of stay of intensive care unit nonsurvivors in three scandinavian countries2010Ingår i: CRITICAL CARE, ISSN 1466-609X, Vol. 14, nr 5Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors. Methods: Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression). Results: Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II. Conclusions: Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries.

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  • 85. von Walter, J
    et al.
    Berkius, J
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    En observationsstudie av initial ventilatorbehandling vid KOL exacerbation2013Konferensbidrag (Refereegranskat)
  • 86.
    von Walter, J
    et al.
    Nyköping Hospital, Sweden.
    Berkius, Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Västervik Hospital, Sweden.
    Wickerts, CJ
    Danderyd Hospital and Karolinska Institutet, Stockholm.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Immediate intubation vs. intubation delayed by a non-invasive ventilation trial in COPD patients with acute respiratory failure: a nationwide observational cohort study of long term survival2013Ingår i: Intensive Care Medicine, Supplement 2, Volume 39, 2013Konferensbidrag (Refereegranskat)
  • 87.
    Wahlter, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Domino, K
    Robb, G
    Hlastala, M
    Positive end-expiratory pressure redistributes perfusion to dependent lung regions in supine but not in prone lambs.1999Ingår i: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 27, s. 37-45Artikel i tidskrift (Refereegranskat)
  • 88.
    Wahlter, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Wenyao, S
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi.
    Lennquist, Sten
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, GE: endokir.
    Pulmonary dynamics of radiolabelled erythrocytes and leucocytes in early gram-negative sepsis in pigs.1999Ingår i: European Journal of Surgery, ISSN 1102-4151, E-ISSN 1741-9271, Vol. 165, s. 979-985Artikel i tidskrift (Refereegranskat)
  • 89.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Low bacterial resistance in the Nordic countries - how do we stay low?2009Ingår i: in ACTA ANAESTHESIOLOGICA SCANDINAVICA, vol 53, 2009, Vol. 53, s. 27-29Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 90.
    Walther, Sten
    Linköpings universitet, Institutionen för biomedicin och kirurgi, Kirurgi. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Linköpings universitet, Hälsouniversitetet.
    Nebulized corticosteroid in septic lung injury: An experimental study in pigs1992Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Sepsis is occasionally complicated by the adult respiratory distress syndrome (ARDS). Auto injury by immunocompetent cells are given a central role in the pathogenesis, but our understanding of the mechanisms remains fragmentary. Treatment in septic ARDS is mainly supportive, no causal therapy exists. Mortality is high at 50-70%.

    The main purposes of the prese~t series of experiments in pigs were to study mechanisms involved in Gram positive and Gram negative septic lung injury, and to investigate effects of intrapulmonary delivery of nebulized drug on mediators of injury and on pulmonary integrity and function. Nebulized corticosteroid with a high anti-inflammatory activity, beclomethasone dipropionate 10 and 50 pg/kg given every 6 hours, improved gas exchange, lung mechanics, pulmonary and systemic haemodynamics and outcome for a 44 hour observation period in pigs with staphylococcal sepsis. The pulmonary effects of a corticosteroid with still higher anti-inflammatory activity, fluticasone 100pg/kg, given in endotoxaemia were similar to those seen after beclomethasone dipropionate in staphylococcal sepsis, the main difference was an increase in pulmonary artery pressures followingfluticasone. Angiotensin converting enzyme (ACE) activity in serum was analyzed and related to the stabilized systemic haemodynamics which were found in pigs treated with nebulized corticosteroid. The results indicated an association between systemic vasoregulation and ACE activity in sepsis, but they did not support that blood pressure was preserved by an ACE-dependent mechanism in corticosteroid treated pigs. Sepsis increased pulmonary sequestration of radiolabelled autologous granulocytes. This increase was significantly attenuated by nebulized beclomethasone dipropionate. The endotoxin-induced immediate accumulation of radiolabelled transferrin in the lungs, whichprobably indicated increased transcapillary protein flow, was abolished by fluticasone.

    In conclusion, nebulized corticosteroid given in moderate doses in sepsis reduced pulmonaty granulocyte sequestration, abolished pulmonary capillary protein leak and attenuated pulmonary dysfunction with resultant increase in survival. These protective effects of nebulized corticosteroid inexperimental septic lung injury indicate a therapeutic role in the treatment of ARDS.

  • 91.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    The use of registry data in research.2015Konferensbidrag (Refereegranskat)
  • 92.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Agvald-Öhman, Christina
    Blomqvist, Hans
    Monnet, Dominique
    Nilsson, Lennart
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Klinisk mikrobiologi.
    Hanberger, Håkan
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Infektionsmedicin. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    Multiresistenta bakterier kan bli allt större hot på svenska IVA.2006Ingår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 103, nr 49, s. 3930-3933Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

      

  • 93.
    Walther, Sten
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Erlandsson, M.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet.
    Olsson-Liljequist, B.
    Smittskyddsinstitutet, Solna, Sweden.
    Hanberger, Håkan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Infektionsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Medicincentrum, Infektionskliniken i Östergötland.
    The Icustrama Study Group (2002),
    Burman, L.G.
    Smittskyddsinstitutet, Solna, Sweden.
    Cars, O.
    Smittskyddsinstitutet, Solna, Sweden.
    Gill, Hans
    Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik. Linköpings universitet, Tekniska högskolan.
    Hoffman, Mikael
    Linköpings universitet, Institutionen för medicin och hälsa, Klinisk farmakologi. Linköpings universitet, Hälsouniversitetet.
    Isaksson, Barbro
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Laboratoriemedicinskt centrum, Klinisk mikrobiologi.
    Kahlmeter, G.
    Department of Clinical Microbiology, Växjö lasarett.
    Lindgren, S.
    Nilsson, Lennart
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Klinisk mikrobiologi. Linköpings universitet, Hälsouniversitetet.
    Antibiotic prescription practices, consumption and bacterial resistance in a cross section of Swedish intensive care units2002Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, Vol. 46, nr 9, s. 1075-1081Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The purpose of this work was to study usage of antibiotics, its possible determinants, and patterns of bacterial resistance in Swedish intensive care units (ICUs).

    Methods: Prospectively collected data on species and antibiotic resistance of clinical isolates and antibiotic consumption specific to each ICU in 1999 were analyzed together with answers to a questionnaire. Antibiotic usage was measured as defined daily doses per 1000 occupied bed days (DDD1000).

    Results: Data were obtained for 38 ICUs providing services to a population of approximately 6 million. The median antibiotic consumption was 1257 DDD1000 (range 584–2415) and correlated with the length of stay but not with the illness severity score or the ICU category. Antibiotic consumption was higher in the ICUs lacking bedside devices for hand disinfection (2193 vs. 1214 DDD1000, p=0.05). In the ICUs with a specialist in infectious diseases responsible for antibiotic treatment the consumption pattern was different only for use of glycopeptides (58% lower usage than in other ICUs: 26 vs. 11 DDD1000,P=0.02). Only 21% of the ICUs had a written guideline on the use of antibiotics, 57% received information on antibiotic usage at least every 3 months and 22% received aggregated resistance data annually. Clinically significant antimicrobial resistance was found among Enterbacter spp. to cephalosporins and among Enterococcus spp. to ampicillin.

    Conclusions: Availability of hand disinfection equipment at each bed and a specialist in infectious diseases responsible for antibiotic treatment were factors that correlated with lower antibiotic consumption in Swedish ICUs, whereas patient-related factors were not associated with antibiotic usage.

  • 94.
    Walther, Sten
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Genaridis, Apostolos
    Södersjukhuset, Stockholm, Sweden.
    Berkius, Johan
    Västerviks sjukhus, Västervik, Sweden.
    Wickerts, Carl-Johan
    Swedish Intensive Care Registry, Sweden.
    The effect of non-invasive ventilation on long-term survival in acute hypoxemic respiratory failure. An observational study of 12,428 patients stratified by the Berlin definition gas exchange criteria.2015Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, nr 121, artikel-id AP-04Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Introduction: Noninvasive positive pressure ventilation (NIV) has become a standard therapy for the treatment of respiratory failure in chronic obstructive pulmonary disease (COPD), while the increasing early use in patients with hypoxemic acute respiratory failure (ARF) is controversial. The aim of the present study was to examine the influence of NIV and particularly when NIV was followed by invasive ventilation (NIV+InvV) in hypoxic ARF.

    Methods: The use of early NIV and invasive mechanical ventilation (InvV) was examined in patients admitted with respiratory failure to 70 ICUs during 2008–2014. Exclusions were age < 16 years, patients with COPD, and when oxygenation or ventilation support data were missing. The ratio of PaO2 to FiO2 (P/F) was used to group patients with mild (26.7–40.0 kPa), moderate (13.3–26.6 kPa) and severe (< 13.3 kPa) ARF. Survival was analyzed using a multivariable Cox model after stratification by P/F ratio and adjusting for hospital category, age, comorbidities and derangements in acute physiology (except P/F ratio) as defined in the SAPS3 model.

    Table 1

     Source: https://www.eventure-online.com/parthen-uploads/154/SSAI/img1_264369_fyTYZNs1w9.jpg

    Results: NIV was the initial mode in 48.7% of pts. with hypoxemic ARF. NIV only and NIV+InvV were associated with increased mortality compared to invasive ventilation only (Table). Conclusion: The use of early NIV in hypoxemic ARF was high. NIV was associated with increased mortality which may be explained by residual confounding (i.e. presence/absence of care limitations), although the finding with NIV+InvV is of concern. Early NIV must be used with care in hypoxemic ARF until proper studies have identified patients who truly benefit from NIV.

    Ladda ner (png)
    Table (Abstract)
  • 95.
    Walther, Sten
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Gill, H
    n/a.
    Hanberger, H
    n/a.
    Letter: Implementation of selective digestive decontamination in the intensive care unit: a word of caution2010Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 54, nr 4, s. 526-527Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 96.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Harrison, D
    Brady, A
    Rowan, K
    Characteristics and outcome of admissions to general intensive care units following cardiac surgery2004Ingår i: European Journal of Anaesthesiology,2004, 2004, s. 25-25Konferensbidrag (Övrigt vetenskapligt)
  • 97.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Johansson, MJ
    Flateboe, T
    Linkoping Univ Hosp, Ctr Heart, S-58185 Linkoping, Sweden.
    Nicolaysen, A
    Linkoping Univ Hosp, Ctr Heart, S-58185 Linkoping, Sweden.
    Nicolaysen, G
    Linkoping Univ Hosp, Ctr Heart, S-58185 Linkoping, Sweden.
    Effects of posture and PEEP on ventilation (V) and perfusion (Q) heterogeneity in sheep2000Ingår i: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 93, nr 3A, s. A1340-Konferensbidrag (Övrigt vetenskapligt)
  • 98.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Jonasson, U
    Outcome of the elderly critically ill after intensive care in an era of cost containment2004Ingår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 48, s. 417-422Artikel i tidskrift (Refereegranskat)
  • 99.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och vård, Anestesiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Jonasson, U
    Fransson, G
    Nordlund, P
    Variation i bedömning av vårdtyngd (VTL) - erfarenheter från nio intesivvårdsavdelningar i sydöstra Sverige.2000Ingår i: SFAI-tidningen, ISSN 0283-8818, Vol. 6, s. 69-71Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 100.
    Walther, Sten
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Jonasson, U
    Gill, Hans
    Linköpings universitet, Tekniska högskolan. Linköpings universitet, Institutionen för medicinsk teknik, Medicinsk informatik.
    Comparison of the Glasgow Coma Scale and the Reaction Level Scale for assessment of cerebral responsiveness in the critically ill2003Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 29, nr 6, s. 933-938Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The Glasgow Coma Scale (GCS) is a well-known source of error in outcome prediction models. We compared assessment of cerebral responsiveness with the GCS and the Reaction Level Scale (RLS) in two otherwise similar outcome prediction models. Design and setting: Prospective, observational study in a general intensive care unit. Patients and participants: All admissions of patients with or at risk of developing impaired brain function between 1997 and 1998 (n=534). Measurements and results: Admissions were scored by RLS and APACHE II (includes scoring with the GCS). The RLS scores were transformed to APACHE II central nervous system scores according to a predetermined protocol. APACHE II estimated probability of death was calculated conventionally with the GCS and the RLS. Vital status 90 days after admission was secured from a national database. Bias and precision was 0.5% and 16.6%, respectively. The area under receiver operating characteristic curves was slightly but significantly greater with the RLS-based APACHE 11 model than with the GCS-based model (0.92 vs. 0.90). Discrimination was improved primarily in admissions with low and intermediate probability of death. Conclusions: Scoring of cerebral responsiveness with the RLS instead of the GCS was associated with minimal bias of the APACHE 11 probability of death estimate. Assessment of consciousness in critically ill with the RLS deserves further evaluation.

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