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- Ejnell, Hasse, et al.
(författare)
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Nationella rekommendationer för trakeotomi och trakeostomivård : [National recommendations for tracheotomy and tracheostomy care. Consensus for safe tracheostomy care of adult patients]
- 2020
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Ingår i: Läkartidningen. - : Sveriges läkarförbund. - 0023-7205 .- 1652-7518. ; 117
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Tidskriftsartikel (refereegranskat)abstract
- This article describes new Swedish guidelines for the care of adult patients having a tracheostomy. A national expert panel of ENT and anaesthesiology specialists appointed by each national specialist association reviewed fatal patient cases involving tracheostomy failure as well as national and international guidelines to produce a "best of practice" document. The main recommendation is that the health care provider has the full responsibility to ensure that the combined surgical competence at the hospital can handle acute airway problems also under difficult anatomical conditions. The distribution of percutaneous and surgical tracheotomy should be weighted to ensure the competence in both.
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| 2. |
- Nellgård, Per, et al.
(författare)
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National recommendations for tracheotomy and for tracheostomy care
- 2017
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Ingår i: Abstracts from the Scandinavian Society of Anesthesiology and Intensive Care Medicine 34th Congress. - : John Wiley & Sons. ; , s. 1034-1035
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Konferensbidrag (refereegranskat)abstract
- Background: Every year 2000 tracheotomies are performed in Sweden. Severe or lethal complications and shortcomings in the valuation of risks pre-, per- and postoperatively occurs. This work intends, based on best available evidence, to reduce injuries related to tracheotomy.Material and Method: Anaesthesiologists and otorhinolaryngologists from University Hospitals compiled a document with guidelines to reduce risks to cause severe complications and death at tracheotomy operations. Landstingens Omse- € sidiga Fors € €akringsbolag (LOF, Swedish insur- € ance company for publicly funded health care providers) also took part.Results: Surgical tracheotomy is recommended for children and adults with known or expected difficult intubation such as Cormack-Lehane IIIIV, short/thick neck, distance between cricoid cartilage and jugulum<15 mm, neck circumference >45 cm, tumors in head and neck area, BMI >35, rheumatoid arthritis, severe obstructive sleep apnea syndrome, high intracranial pressure, unstable neck fracture and coagulopathies. Acta Anaesthesiologica Scandinavica 61 (2017) 962–1062 1034 ª 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd SSAI ABSTRACTS Percutaneous tracheostomy (PCT) could be performed in intensive care patients. A tracheotomy cannula with an inner cannula should be used. Common complications include acute obstruction of tracheal cannula, dislocation, emphysema of the neck, trauma to dorsal tracheal wall. Some deaths have occurred due to lack of education to perform a surgical tracheotomy in patients where percutaneous tracheostomy were not possible to perform.Conclusion: Tracheotomy should be performed at hospitals where competence exist for surgical tracheotomy, including patients with difficult anatomy, regardless of the tracheotomy technique. At each hospitals the distribution between percutaneous and surgical tracheostomies must be weighted as to preserve overall competence for both techniques. A guideline of acute tracheal cannula occlusion is presented (Figure).
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| 5. |
- Hertegård, Stellan, et al.
(författare)
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Cross-linked hyaluronan used as augmentation substance for treatment of glottal insufficiency : safety aspects and vocal fold function
- 2002
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 112:12, s. 2211-2219
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine safety aspects and vocal fold function after vocal fold augmentation with a cross-linked hyaluronan derivative (hylan B gel) as compared with bovine collagen. STUDY DESIGN; A prospective, randomized trial. METHODS: Eighty-three patients with glottal insufficiency were treated with injection augmentation with hylan B gel and bovine collagen and were examined at 1, 6, and 12 months after treatment. Seventy patients with unilateral vocal fold paresis (n = 35) or atrophy (n = 35) were randomly assigned to receive either hylan B gel (n = 47) or collagen (n = 23) injections into one vocal fold. Thirteen patients with glottal insufficiency caused by scar defects or paresis resulting from malignant disease were included in a nonrandomized group and were treated only with hylan B gel. Evaluations were made from patients' subjective ratings (visual analogue scales), digitized videostroboscopic measurements, phonetograms, maximum phonation time, and phonation quotients. RESULTS: Twelve months after injections, the patients' self-ratings were significantly improved for both the hylan B gel and the collagen groups. In addition, the videostroboscopic measurements showed significantly improved glottal closure for both groups. However, for the hylan B gel group, vibration amplitude and glottal area variations were preserved, and this group showed significantly less resorption at the injected vocal fold edge. Furthermore, maximum phonation time had increased significantly for the hylan B gel patients (collagen, nonsignificant). No serious adverse events were observed; three patients injected with hylan B gel had temporary inflammation at the injection site, which resolved without sequelae. CONCLUSIONS: The results showed that both hylan B gel and collagen can be safely used for injection treatment of glottal insufficiency. Both treatments resulted in significantly improved voice as rated by the patients. However, the patients treated with hylan B gel showed better vocal fold status and longer maximum phonation time at 12 months after treatment as compared with patients treated with collagen.
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| 7. |
- Olofsson Hallén, Katarina, et al.
(författare)
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Interactions between Human, Technology and Organization in Building Information Modelling (BIM) - A scoping review of critical factors for the individual user
- 2023
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Ingår i: International Journal of Industrial Ergonomics. - : Elsevier BV. - 0169-8141 .- 1872-8219. ; 97
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Forskningsöversikt (refereegranskat)abstract
- Building Information Modelling (BIM) is a process, often mentioned as an enabler of various benefits within Architecture – Engineering – Construction (AEC), of creating and managing information for a built asset. Despite the potential benefits associated with BIM, the use seems to have been relatively inefficient. One explanation may be the lack of system perspective in the implementation and use of BIM. The aim of this study was to map critical factors influencing the use of BIM based on existing research, including interactions among the three subsystems human, technology and organization. A scoping review was performed analyzing 46 included articles. The results showed that BIM is a holistic and social system, that the technology itself is insufficient, and that the acceptance of BIM is a significant critical factor for its efficient implementation and use. The research on how humans interact with the technology of BIM, and how the organization can facilitate those interactions, is however limited. Relevance to industry: Learnings from this study include that the AEC industry, by approaching BIM as a holistic and social system and recognizing the role of the individual user, can add another piece of the puzzle to achieving the effective use of BIM.
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