Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2001
Randomized Controlled Trial Clinical TrialEffects of hypertonic 75 mg/ml (7.5%) saline on extracellular water volume when used for preloading before spinal anaesthesia.
Prevention of hypotension during spinal anaesthesia is commonly achieved using fluid preloading. This may result in a substantial amount of excess free water retained in the body after spinal anaesthesia. We aimed to evaluate the effects of 7.5% hypertonic saline on extracellular water volume and haemodynamics when used for fluid preloading before spinal anaesthesia. ⋯ Hypertonic 75 mg/ml (7.5%) saline is an alternative for preloading before spinal anaesthesia in situations where excess free water administration is not desired. It is effective in small doses of 1.6 ml/kg, which increase the extracellular water, plasma volume and cardiac output, and thus maintain haemodynamic stability during spinal anaesthesia.
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Acta Anaesthesiol Scand · Jul 2001
Meta AnalysisThe influence of a dominating centre on a quantitative systematic review of granisetron for preventing postoperative nausea and vomiting.
We performed a meta-analysis on granisetron in the prevention of postoperative nausea and vomiting (PONV) and further investigated whether total results and the dose-response characteristics may be significantly affected by a single centre. ⋯ Overall results and dose-response characteristics of meta-analyses may be significantly altered by one dominating centre. Further, if data of a dominating centre do not appear to be valid for other centres, it may seem advisable to either exclude them from the analysis or to perform sub-group analyses so that results without the data from the dominating centre are available.
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Acta Anaesthesiol Scand · Jul 2001
Dynamic changes in cerebral oxygenation related to deep hypothermia and circulatory arrest evaluated by near-infrared spectroscopy.
Total circulatory arrest in deep hypothermia, which is used in corrective surgery of complex cardiovascular malformations, has been said to cause brain injury. Near-infrared spectroscopy (NIRS) is a new non-invasive method that potentially monitors changes in cerebral oxygenation and tissue oxygen utilisation. The aim of this experimental study in rabbits was to evaluate the change in intravascular and intracellular oxygenation patterns during cooling, deep hypothermic circulatory arrest and rewarming using a commercially available NIRS-cerebral oximeter. ⋯ The change in the NIRS-derived haemoglobin oxygenation parameters may reflect physiological changes in systemic and cerebral haemodynamics. CytOxaa3 values may represent related effects on cellular oxygenation. Thus, continuous, real-time NIRS-monitoring may identify critical periods with inadequate brain tissue oxygenation, particularly during DHCA. The neurological implications of the observed changes in NIRS oxygenation parameters, however, require further quantitative morphological evaluation of the brain in animals surviving a longer reperfusion and observation period.
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Acta Anaesthesiol Scand · Jul 2001
Studies on fluid extravasation related to induced hypothermia during cardiopulmonary bypass in piglets.
Hypothermia, commonly used for organ protection during cardiopulmonary bypass (CPB), has been associated with changes in plasma volume, hemoconcentration and microvascular fluid shifts. Fluid pathophysiology secondary to hypothermia and the mechanisms behind these changes are still largely unknown. In a recent study we found increased fluid needs during hypothermic compared to normothermic CPB. The aim of the present study was to characterize the distribution of the fluid given to maintain normovolemia. In addition, we wanted to investigate the quantity and quality of the fluid extravasated during hypothermic compared to normothermic CPB. ⋯ During hypothermic CPB an increased extravasation of fluid from the intravascular to the interstitial space was found. As no leakage of proteins could be demonstrated, based on stable values for albumin and protein masses throughout the experiments, the extravasated fluid contained mainly water and small solutes.
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Acta Anaesthesiol Scand · Jul 2001
Risk factors for nosocomial intensive care infection: a long-term prospective analysis.
To identify risk factors for nosocomial infection in intensive care and to provide a basis for allocation of resources. ⋯ Trauma cases, with open fractures, were the patients most at risk of infection, despite low disease severity scores. Resources to prevent nosocomial infection should be allocated to these patients.