Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 93) Show all publications
Birnefeld, J., Petersson, K., Wåhlin, A., Eklund, A., Birnefeld, E., Qvarlander, S., . . . Zarrinkoob, L. (2024). Cerebral blood flow assessed with phase-contrast magnetic resonance imaging during blood pressure changes with noradrenaline and labetalol: a trial in healthy volunteers . Anesthesiology, 140(4), 669-678
Open this publication in new window or tab >>Cerebral blood flow assessed with phase-contrast magnetic resonance imaging during blood pressure changes with noradrenaline and labetalol: a trial in healthy volunteers 
Show others...
2024 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 140, no 4, p. 669-678Article in journal (Refereed) Published
Abstract [en]

Background: Adequate cerebral perfusion is central during general anesthesia. However, perfusion is not readily measured bedside. Clinicians currently rely mainly on MAP as a surrogate even though the relationship between blood pressure and cerebral blood flow is not well understood. The aim of this study was to apply phase contrast MRI to characterize blood flow responses in healthy volunteers to commonly used pharmacological agents that increase or decrease arterial blood pressure.

Methods: Eighteen healthy volunteers aged 30-50 years were investigated with phase contrast MRI. Intraarterial blood pressure monitoring was used. First, intravenous noradrenaline was administered to a target MAP of 20% above baseline. After a wash-out period, intravenous labetalol was given to a target MAP of 15% below baseline. Cerebral blood flow was measured using phase contrast MRI and defined as the sum of flow in the internal carotid arteries and vertebral arteries. CO was defined as the flow in the ascending aorta.

Baseline median cerebral blood flow was 772 ml/min (interquartile range, 674 to 871), and CO was 5,874 ml/min (5,199 to 6,355). The median dose of noradrenaline was 0.17 µg · kg−1 · h−1 (0.14 to 0.22). During noradrenaline infusion, cerebral blood flow decreased to 705 ml/min (606 to 748; P = 0.001), and CO decreased to 4,995 ml/min (4,705 to 5,635; P = 0.01). A median dose of labetalol was 120 mg (118 to 150). After labetalol boluses, cerebral blood flow was unchanged at 769 ml/min (734 to 900; P = 0.68). CO increased to 6,413 ml/min (6,056 to 7,464; P = 0.03).

Conclusion: In healthy awake subjects, increasing MAP using intravenous noradrenaline decreased cerebral blood flow and CO. This data does not support inducing hypertension with noradrenaline to increase cerebral blood flow. Cerebral blood flow was unchanged when decreasing MAP using labetalol.

Place, publisher, year, edition, pages
Wolters Kluwer, 2024
National Category
Neurology Radiology, Nuclear Medicine and Medical Imaging Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-220047 (URN)10.1097/ALN.0000000000004775 (DOI)37756527 (PubMedID)2-s2.0-85187724522 (Scopus ID)
Funder
Region Västerbotten
Available from: 2024-01-26 Created: 2024-01-26 Last updated: 2024-04-08Bibliographically approved
Hedberg, H., Hedberg, P., Aléx, J., Karlsson, S. & Haney, M. (2024). Effects of an advanced first aid course or real-time video communication with ambulance personnel on layperson first response for building-site severe injury events: a simulation study. BMC Emergency Medicine, 24(1), Article ID 2.
Open this publication in new window or tab >>Effects of an advanced first aid course or real-time video communication with ambulance personnel on layperson first response for building-site severe injury events: a simulation study
Show others...
2024 (English)In: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 24, no 1, article id 2Article in journal (Refereed) Published
Abstract [en]

Background: The risk of high-energy trauma injuries on construction sites is relatively high. A delayed response time could affect outcomes after severe injury. This study assessed if an advanced first aid course for first aid response for laypersons (employees or apprentices) in the construction industry or real-time video communication and support with ambulance personnel, or neither, together with access to an advanced medical kit, would have an effect on immediate layperson vital responses in a severe injury scenario.

Method: This was a controlled simulation study. Employees or apprentices at a construction site were recruited and randomly allocated into a group with video support or not, and advanced first aid course or not, and where one group had both. The primary outcomes were correct behavior to recognize and manage an occluded airway and correct behavior to stop life-threatening bleeding from a lower extremity injury. Secondary outcomes included head-to-toe assessment performed, placement of a pelvic sling, and application of remote vital signs monitors.

Results: Ninety participants were included in 10 groups of 3 for each of 4 exposures. One group was tested first as a baseline group, and then later after having done the training course. Live video support was effective in controlling bleeding. A first aid course given beforehand did not seem to be as effective on controlling bleeding. Video support and the first aid course previously given improved the ability of bystanders to manage the airway, the combination of the two being no better than each of the interventions taken in isolation. Course exposure and video support together were not superior to the course by itself or video by itself, except regarding placing the biosensors on the injured after video support. Secondary results showed an association between video support and completing a head-to-toe assessment. Both interventions were associated with applying a pelvic sling.

Conclusion: These findings show that laypersons, here construction industry employees, can be supported to achieve good performance as first responders in a major injury scenario. Prior training, but especially live video support without prior training, improves layperson performance in this setting.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2024
Keywords
Bystander, Construction Safety, First aid training, Layperson, Prehospital trauma, Telemedicine, Video, Workplace incident
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-219524 (URN)10.1186/s12873-023-00917-4 (DOI)38185649 (PubMedID)2-s2.0-85181438402 (Scopus ID)
Funder
Umeå UniversitySvenska Byggbranschens Utvecklingsfond (SBUF), 13987
Available from: 2024-01-22 Created: 2024-01-22 Last updated: 2024-01-23Bibliographically approved
Nyberg, A., Olofsson, B., Fagerdahl, A., Haney, M. & Otten, V. T. (2024). Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study. BMJ open quality, 13(1), Article ID bmjoq-2022-002182.
Open this publication in new window or tab >>Longer work experience and age associated with safety attitudes in operating room nurses: an online cross-sectional study
Show others...
2024 (English)In: BMJ open quality, E-ISSN 2399-6641, Vol. 13, no 1, article id bmjoq-2022-002182Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Patient safety is fundamental when providing care in the operating room. Still, adverse events and errors are a challenge for patient safety worldwide. To avoid preventable patient harm, organisations need a positive safety culture, the measurable component of which is known as the safety climate. To best improve the safety climate the current attitudes to safety must first be understood.

AIM: To explore operating room nurses' safety attitudes and their views on how to improve patient safety in operating rooms.

ETHOD: A cross-sectional study using the Swedish-translated version of the Safety Attitudes Questionnaire, Operating Room version. Data were collected using an online survey platform.

RESULTS: 358 operating room nurses completed the questionnaire. The results show that the older age group rated their working conditions and management support as better than the younger age groups. The older age group also rated their stress recognition as lower compared with the younger age groups. The same pattern was seen in terms of work experience, with more-experienced respondents showing a higher mean score for the factor working conditions and a lower mean score for the factor stress recognition as compared with their less-experienced colleagues. When comparing hospital types, county hospital employees had higher factor scores for safety climate, job satisfaction and working conditions than university hospital employees. The respondents' most recurring recommendations for improving patient safety were 'Having better and clearer communication' followed by 'Having enough time to do things the way they should be done'.

CONCLUSION: More focus on safety with increasing age and experience was observed in this cohort. Need for improvements is reported for patient safety in operating rooms, mainly when it comes to communication and workload. To improve and develop patient safety in the operating room, the organisational safety climate needs to be actively managed and developed. One step in actively managing the safety climate may be efforts to retain experienced operating room nurses.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Attitudes, Nurses, Patient safety, Safety culture, Surgery
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-219813 (URN)10.1136/bmjoq-2022-002182 (DOI)38212132 (PubMedID)2-s2.0-85182094382 (Scopus ID)
Funder
The Kempe FoundationsUmeå University
Available from: 2024-01-23 Created: 2024-01-23 Last updated: 2024-01-23Bibliographically approved
Møller, M. H., Alhazzani, W., Oczkowski, S., Belley-Cote, E. & Haney, M. (2023). Intensive care medicine rapid practice guidelines in Acta Anaesthesiologica Scandinavica. Acta Anaesthesiologica Scandinavica, 67(5), 566-568
Open this publication in new window or tab >>Intensive care medicine rapid practice guidelines in Acta Anaesthesiologica Scandinavica
Show others...
2023 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 67, no 5, p. 566-568Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
awake proning, COVID-19, ICM-RPGs, intensive care medicine rapid practice guidelines
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-205372 (URN)10.1111/aas.14215 (DOI)000936947700001 ()36794852 (PubMedID)2-s2.0-85148643126 (Scopus ID)
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2023-07-13Bibliographically approved
Gottfridsson, P., Law, L., Aroch, R., Myrberg, T., Hultin, M., Lindqvist, P. & Haney, M. (2023). Left atrial contraction strain during a Valsalva manoeuvre: A study in healthy humans. Clinical Physiology and Functional Imaging, 43(3), 165-169
Open this publication in new window or tab >>Left atrial contraction strain during a Valsalva manoeuvre: A study in healthy humans
Show others...
2023 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 43, no 3, p. 165-169Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac mechanics are influenced by loading conditions as well as sympathetic tone. Left atrial (LA) contractile function assessed by two-dimensional (2D) strain has been described in the setting of controlled preload alterations; however, studies show conflicting findings about change or direction of change. We hypothesized that the controlled preload reduction and the sympathetic nervous system activation that occurs during a standardized Valsalva manoeuvre would bring about a change in LA contraction strain.a

METHODS: Healthy young adults of both sexes were recruited. Transthoracic echocardiographic ultrasound images were collected before and during a Valsalva manoeuvre. Standard imaging windows for LA strain assessment were used and the images were copied and stored for later offline analysis. These were assessed for adequate atrial wall visualization in 2D strain assessment. Paired comparisons were carried out using Student's T test.

RESULT: Thirty-eight participants were included and there were 22 complete studies with paired pre- and during Valsalva manoeuvre. LA contraction strain at baseline was 10.5 ± 2.8% (standard deviation) and during the Valsalva manoeuvre 10.6 ± 4.6%, p = 0.86.

CONCLUSION: The Valsalva manoeuvre, a combination of preload reduction and sympathetic nervous system activation, seems not to be associated with a change in LA contraction strain in healthy young individuals. LA contraction strain should be interpreted in the context of both atrial loading conditions and prevailing autonomic nervous system activity.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
contractile function, echocardiography, left atrium, preload, speckle tracking, sympathetic nervous system
National Category
Anesthesiology and Intensive Care Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-202113 (URN)10.1111/cpf.12806 (DOI)000902530500001 ()36533722 (PubMedID)2-s2.0-85145300941 (Scopus ID)
Funder
Region Västerbotten
Available from: 2023-01-02 Created: 2023-01-02 Last updated: 2023-09-05Bibliographically approved
Larsson, N., Nording, M. L., Tydén, J., Johansson, J., Lindberg, R. & Haney, M. (2023). Oxylipin profiles during the first day of mechanical ventilation in an intensive care unit cohort: research letter [Letter to the editor]. Anesthesiology, 138(5), 561-563
Open this publication in new window or tab >>Oxylipin profiles during the first day of mechanical ventilation in an intensive care unit cohort: research letter
Show others...
2023 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 138, no 5, p. 561-563Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Wolters Kluwer, 2023
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-206880 (URN)10.1097/ALN.0000000000004518 (DOI)000989777900012 ()36857438 (PubMedID)2-s2.0-85152244324 (Scopus ID)
Available from: 2023-04-20 Created: 2023-04-20 Last updated: 2023-09-05Bibliographically approved
Zickerman, C., Brorsson, C., Hultin, M., Johansson, G., Winsö, O. & Haney, M. (2023). Preoperative anxiety level is not associated with postoperative negative behavioral changes in premedicated children. Acta Anaesthesiologica Scandinavica, 67(6), 706-713
Open this publication in new window or tab >>Preoperative anxiety level is not associated with postoperative negative behavioral changes in premedicated children
Show others...
2023 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 67, no 6, p. 706-713Article in journal (Refereed) Published
Abstract [en]

Background: Anesthesia preinduction anxiety in children can according to some studies lead to long-term anxiety and negative behavioral changes (NBC), while other studies have not found this effect. This secondary analysis from a recent premedication trial comparing clonidine and midazolam aimed to test the relation between preoperative anxiety assessed with modified Yale Preoperative Anxiety Scale (mYPAS) and postoperative NBCs assessed with Post Hospital Behavior Questionnaire (PHBQ), regardless of premedication type.

Methods: This is a planned secondary analysis from a published premedication comparison trial in an outpatient surgery cohort, children aged 2–7 years. Participant and preoperative factors, particularly preoperative anxiety as mYPAS scores, were assessed for association with development of postoperative NBCs.

Results: Fifty-four of the 115 participants had high preinduction anxiety (mYPAS >30), and 19 of 115 developed >3 postoperative NBCs 1 week after surgery. There was no association between preinduction anxiety level as mYPAS scores and the development of postoperative NBCs at 1 week after surgery (10 of 19 had both, p =.62) nor after 4- or 26-weeks post-surgery. Only lower age was associated with development of NBCs postoperatively.

Conclusions: Based on the findings from this cohort, high preinduction anxiety does not appear to be associated with NBCs postoperatively in children premedicated with clonidine or midazolam.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
children, postoperative negative behavioral changes, postoperative recovery, preoperative anxiety
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-206762 (URN)10.1111/aas.14240 (DOI)000962252500001 ()36928794 (PubMedID)2-s2.0-85151972127 (Scopus ID)
Funder
Umeå UniversityRegion Västerbotten
Available from: 2023-05-02 Created: 2023-05-02 Last updated: 2023-12-05Bibliographically approved
Åkesson, O., Abrahamsson, P., Johansson, G., Haney, M., Falkenback, D., Hermansson, M., . . . Johansson, J. (2023). Surface microdialysis measures local tissue metabolism after Ivor Lewis esophagectomy; an attempt to predict anastomotic defect. Diseases of the esophagus, 36(8), Article ID doac111.
Open this publication in new window or tab >>Surface microdialysis measures local tissue metabolism after Ivor Lewis esophagectomy; an attempt to predict anastomotic defect
Show others...
2023 (English)In: Diseases of the esophagus, ISSN 1120-8694, E-ISSN 1442-2050, Vol. 36, no 8, article id doac111Article in journal (Refereed) Published
Abstract [en]

Anastomotic defect (AD) after esophagectomy can lead to severe complications with need for surgical or endoscopic intervention. Early detection enables early treatment and can limit the consequences of the AD. As of today, there are limited methods to predict AD. In this study, we have used microdialysis (MD) to measure local metabolism at the intrathoracic anastomosis. Feasibility and possible diagnostic use were investigated. Sixty patients planned for Ivor Lewis esophagectomy were enrolled. After construction of the anastomosis, surface MD (S-MD) probes were attached to the outer surface of the esophageal remnant and the gastric conduit in close vicinity of the anastomosis and left in place for 7 postoperative days (PODs). Continuous sampling of local tissue concentrations of metabolic substances (glucose, lactate, and pyruvate) was performed postoperatively. Outcome, defined as AD or not according to Esophagectomy Complications Consensus Group definitions, was recorded at discharge or at first postoperative follow up. Difference in concentrations of metabolic substances was analyzed retrospectively between the two groups by means of artificial neural network technique. S-MD probes can be attached and removed from the gastric tube reconstruction without any adverse events. Deviating metabolite concentrations on POD 1 were associated with later development of AD. In subjects who developed AD, no difference in metabolic concentrations between the esophageal and the gastric probe was recorded. The technical failure rate of the MD probes/procedure was high. S-MD can be used in a clinical setting after Ivor Lewis esophagectomy. Deviation in local tissue metabolism on POD 1 seems to be associated with development of AD. Further development of MD probes and procedure is required to reduce technical failure.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
anastomotic leakage, esophagectomy, glucose, lactate, microdialysis
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology
Identifiers
urn:nbn:se:umu:diva-202678 (URN)10.1093/dote/doac111 (DOI)000903762100001 ()36572400 (PubMedID)2-s2.0-85166362437 (Scopus ID)
Available from: 2023-01-12 Created: 2023-01-12 Last updated: 2023-09-05Bibliographically approved
Laake, J. H., Astvad, M., Bentsen, G., Escher, C., Haney, M., Hoffmann-Petersen, J., . . . Tønnessen, T. I. (2022). A policy for diversity, equity, inclusion and anti-racism in the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI). Acta Anaesthesiologica Scandinavica, 66(1), 141-144
Open this publication in new window or tab >>A policy for diversity, equity, inclusion and anti-racism in the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI)
Show others...
2022 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 66, no 1, p. 141-144Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2022
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:umu:diva-187674 (URN)10.1111/aas.13978 (DOI)000694991000001 ()34462910 (PubMedID)2-s2.0-85114692852 (Scopus ID)
Available from: 2021-09-20 Created: 2021-09-20 Last updated: 2023-03-24Bibliographically approved
Zickerman, C., Hult, A.-C., Hedlund, L., Winsö, O., Johansson, G. & Haney, M. (2022). Clonidine Versus Midazolam Premedication and Postoperative Negative Behavioral Changes in Younger Children: A Randomized Controlled Trial. Anesthesia and Analgesia, 135(2), 307-315
Open this publication in new window or tab >>Clonidine Versus Midazolam Premedication and Postoperative Negative Behavioral Changes in Younger Children: A Randomized Controlled Trial
Show others...
2022 (English)In: Anesthesia and Analgesia, ISSN 0003-2999, E-ISSN 1526-7598, Vol. 135, no 2, p. 307-315Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Postoperative negative behavioral changes (NBCs) are common among children, but risk for this is thought to be reduced with premedication. Midazolam has for many years been a standard premedication for children. More recently, the alpha-2 adrenergic agonist clonidine has also become popular as a preanesthetic sedative. We hypothesized that clonidine was superior to midazolam for limiting new NBCs in children as assessed using the Post Hospital Behavior Questionnaire (PHBQ).

METHODS: This was a prospective, randomized, controlled, blinded study, including 115 participants aged 24 to 95 months and their parents. The participants underwent ear, nose, or throat outpatient surgery and were randomly allocated to premedication with oral midazolam 0.5 mg/kg or oral clonidine 4 µg/kg. Participants were anesthetized by protocol. At home, later, parents were asked to complete the PHBQ assessment instrument for postoperative NBCs for the participants 1 week, 1 month, and 6 months after the surgery. A secondary outcome, preinduction anxiety, was assessed using modified Yale Preoperative Anxiety Scale (mYPAS).

RESULTS: The primary outcome, more than 3 NBCs in an individual case at 1 week, showed no difference in proportions between treatment in the clonidine group compared to the midazolam group, (12/59 or 20% vs 7/56 or 13%, respectively, odds ratio 1.39, 95% confidence interval [CI], 0.75-2.58; P =.32). A secondary result showed a higher preinduction anxiety level in the clonidine compared to the midazolam group (mYPAS >30, 43/59 or 71% vs 12/56 or 21%, respectively; P <.001).

CONCLUSIONS: These results did not show a clinical or statistically significant difference, with respect to the primary outcome of behavior changes at 1 week, between the cohorts that received midazolam versus clonidine as a premedication.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology
Identifiers
urn:nbn:se:umu:diva-198329 (URN)10.1213/ANE.0000000000005915 (DOI)000825790300022 ()35203087 (PubMedID)2-s2.0-85134632034 (Scopus ID)
Available from: 2022-08-03 Created: 2022-08-03 Last updated: 2023-06-26Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4049-8910

Search in DiVA

Show all publications