Publications by authors named "K T Olkkola"
Background: Paracetamol-codeine combination tablet is widely used in pain management after day surgery. For safety reasons, its use has decreased in recent years. Codeine is a prodrug metabolised in the liver by the cytochrome P450 2D6 (CYP2D6) enzyme to morphine that produces the analgesic effect of codeine.
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- Researchers studied how different genetic variations in the CYP2D6 enzyme affect the body's ability to metabolize codeine into morphine, which is vital for determining pain relief and potential side effects.
- A clinical trial involving 1000 patients was conducted, where their CYP2D6 genotypes were analyzed after they were given a standard dose of codeine, and the relationship between their genetic makeup and morphine exposure was modeled.
- The results showed that individuals with certain genetic variations (like CYP2D6*10 and *41) had less effective metabolism of codeine, leading to significantly higher or lower morphine levels in the bloodstream, highlighting the importance of genetic testing for safer opioid prescribing.
Article Synopsis
- The Rapid Practice Guideline (RPG) was created to evaluate the effectiveness of ketamine for sedation in ICU patients on mechanical ventilation compared to other sedatives or usual care, while also highlighting areas for further research.
- A panel of 23 experts, including a patient representative, conducted a systematic review and meta-analysis to gather data, using a structured approach to assess the reliability and implications of the evidence collected.
- The findings indicated considerable uncertainty regarding the effects of ketamine, with low certainty about its benefits on reducing opioid use or mechanical ventilation duration; adjunct ketamine therapy did not significantly affect mortality within 28 days.
Background: This Rapid Practice Guideline (RPG) aimed to provide evidence-based recommendations for ketamine analgo-sedation (monotherapy and adjunct) versus non-ketamine sedatives or usual care in adult intensive care unit (ICU) patients on invasive mechanical ventilation (iMV) and to identify knowledge gaps for future research.
Methods: The RPG panel comprised 23 multinational multidisciplinary panelists, including a patient representative. An up-to-date systematic review and meta-analysis constituted the evidence base.
The Clinical Practice Committee of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine endorses the clinical practice guideline "ESAIC focused guideline for the use of cardiac biomarkers in perioperative risk evaluation." The guideline can provide guidance to Nordic anaesthesiologists on the perioperative use of cardiac biomarkers in patients undergoing non-cardiac surgery.
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