Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2004
Clinical TrialThermodilution cardiac output--are three injections enough?
Bolus thermodilution cardiac output measurements have been a mainstay in clinical monitoring of critically ill patients for more than 30 years. Usually the results of an arbitrarily chosen number (1-6) of thermal indicator injections are averaged to increase the reliability of the measurement. The number of injections needed to achieve a given level of precision has, however, not previously been systematically investigated. ⋯ The current study shows that one needs to average the results of four injections to be 95% confident that the result is within 5% of the 'true' cardiac output and that two series of four measurements have to differ by at least 7% before one can be sure (95%) that a change in cardiac function has taken place.
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Acta Anaesthesiol Scand · Nov 2004
Comparative StudyFluid resuscitation from severe hemorrhagic shock using diaspirin cross-linked hemoglobin fails to improve pancreatic and renal perfusion.
Fluid resuscitation from hemorrhagic shock is intended to abolish microcirculatory disorders and to restore adequate tissue oxygenation. Diaspirin cross-linked hemoglobin (DCLHb) is a hemoglobin-based oxygen carrier (HBOC) with vasoconstrictive properties. Therefore, fluid resuscitation from severe hemorrhagic shock using DCLHb was expected to improve perfusion pressure and tissue perfusion of kidneys and pancreas. ⋯ DCLHb-induced vasoconstriction afforded superior myocardial perfusion, but impaired regional perfusion of the kidneys and the pancreas.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Clinical TrialEffect of ephedrine on the onset time of succinylcholine.
The aim of this study was to evaluate the effect of ephedrine administered prior to induction of anaesthesia on the onset time of succinylcholine for endotracheal intubation. ⋯ The onset time of succinylcholine can be shortened with ephedrine pretreatment.
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Acta Anaesthesiol Scand · Nov 2004
Comment Historical ArticleFurther commentary on Denmark's 1952-53 poliomyelitis epidemic, especially regarding mortality; with a correction.
Berthelsen and Cronqvist recently published an article in Acta Anaesthesiologica Scandinavica including aspects which could lead on to further discussion about the Danish 1952-53 poliomyelitis epidemic. This paper considers how Bjørn Ibsen's initial approach to treatment during the epidemic was successful, as well as how it could have failed; the roles played by ventilatory failure vs. gross neurologic destruction in causing deaths; and compilations from publications of statistics concerning mortality of the epidemic. The Blegdam Hospital concept of 'life-threatening poliomyelitis' is revisited, along with its division into six anatomico-clinical categories for the 345 patients so classified. ⋯ Lassen, has been freely used. Some folklore about aspects of management is mentioned. In the light of other recent research by Dr Berthelsen an essential correction is needed in dating 'Bjørn Ibsen's Day', amending 26 August 1952 to the 27th.
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Acta Anaesthesiol Scand · Nov 2004
Adverse biochemical and physiological effects of prostacyclin in experimental brain oedema.
Prostacyclin (PGI2) and its stable analogues are known to reduce capillary hydraulic permeability. This study explores the biochemical and physiological effects of i.v. infusion of low-dose PGI2 in an experimental model of vasogenic brain oedema. ⋯ In LPS-induced brain oedema i.v. infusion of low-dose PGI2 caused a further increase in ICP and a perturbation of energy metabolism, indicating cerebral ischemia and degradation of cellular membranes.