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  • Andreasen, Anne SofieCopenhagen Univ Hosp Herlev, Denmark (author)

New-onset atrial fibrillation in critically ill adult patients-an SSAI clinical practice guideline

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • WILEY,2023
  • electronicrdacarrier

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  • LIBRIS-ID:oai:DiVA.org:liu-195776
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-195776URI
  • https://doi.org/10.1111/aas.14262DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)
  • Background: Acute or new-onset atrial fibrillation (NOAF) is the most common cardiac arrhythmia in critically ill adult patients, and observational data suggests that NOAF is associated to adverse outcomes. Methods: We prepared this guideline according to the Grading of Recommendations Assessment, Development and Evaluation methodology. We posed the following clinical questions: (1) what is the better first-line pharmacological agent for the treatment of NOAF in critically ill adult patients?, (2) should we use direct current (DC) cardioversion in critically ill adult patients with NOAF and hemodynamic instability caused by atrial fibrillation?, (3) should we use anticoagulant therapy in critically ill adult patients with NOAF?, and (4) should critically ill adult patients with NOAF receive follow-up after discharge from hospital? We assessed patient-important outcomes, including mortality, thromboembolic events, and adverse events. Patients and relatives were part of the guideline panel. Results: The quantity and quality of evidence on the management of NOAF in critically ill adults was very limited, and we did not identify any relevant direct or indirect evidence from randomized clinical trials for the prespecified PICO questions. We were able to propose one weak recommendation against routine use of therapeutic dose anticoagulant therapy, and one best practice statement for routine follow-up by a cardiologist after hospital discharge. We were not able to propose any recommendations on the better first-line pharmacological agent or whether to use DC cardioversion in critically ill patients with hemodynamic instability induced by NOAF. An electronic version of this guideline in layered and interactive format is available in MAGIC: https://app.magicapp.org/#/guideline/7197. Conclusions: The body of evidence on the management of NOAF in critically ill adults is very limited and not informed by direct evidence from randomized clinical trials. Practice variation appears considerable.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Wetterslev, MikCopenhagen Univ Hosp Rigshosp, Denmark (author)
  • Sigurdsson, Martin IngiLandspitali Natl Univ Hosp Iceland, Iceland; Univ Iceland, Iceland (author)
  • Bove, JeppeOdense Univ Hosp, Denmark (author)
  • Kjaergaard, JesperCopenhagen Univ Hosp Rigshosp, Denmark (author)
  • Aslam, Tayyba NazOslo Univ Hosp, Norway; Univ Oslo, Norway (author)
  • Jarvela, KatiTampere Univ Hosp, Finland (author)
  • Poulsen, MetteAarhus Univ Hosp, Denmark (author)
  • de Geer, LinaLinköpings universitet,Avdelningen för klinisk kemi och farmakologi,Medicinska fakulteten,Region Östergötland, ANOPIVA US(Swepub:liu)linde65 (author)
  • Agarwal, ArnavMcMaster Univ, Canada; McMaster Univ, Canada; MAGIC Evidence Ecosyst Fdn, Norway (author)
  • Kjaer, Maj-Brit NorregaardCopenhagen Univ Hosp Rigshosp, Denmark (author)
  • Moller, Morten HylanderCopenhagen Univ Hosp Rigshosp, Denmark; Univ Copenhagen, Denmark (author)
  • Copenhagen Univ Hosp Herlev, DenmarkCopenhagen Univ Hosp Rigshosp, Denmark (creator_code:org_t)

Related titles

  • In:Acta Anaesthesiologica Scandinavica: WILEY67:8, s. 1110-11170001-51721399-6576

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