Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2004
Biochemical markers for brain damage after carbon monoxide poisoning.
Carbon monoxide poisoning is associated with high mortality and a substantial risk for brain damage in survivors. Evidence for acute brain dysfunction may be obtained by measuring concentrations of suitable biochemical markers. We hypothesized that increased serum concentrations of Neuron-specific enolase (NSE) and S-100beta protein could be detected after carbon monoxide poisoning and that the concentration would correlate with the severity of intoxication. ⋯ Blood concentrations of NSE and S-100beta protein were not significantly increased after carbon monoxide poisoning and do not seem to be related to a history of unconsciousness.
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Acta Anaesthesiol Scand · Apr 2004
Practices of anaesthesiologists with regard to withholding and withdrawal of life support from the critically ill in Turkey.
To determine practices of Turkish anaesthesiologists with regard to withholding and withdrawal of life support from the critically ill. ⋯ While a number of similarities were found between Turkish anaesthesiologists and those from other countries, some specific differences could be identified, particularly related to consensus decision-making and sharing information with other providers and the value of Ethics Committees in the decision-making process.
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Acta Anaesthesiol Scand · Apr 2004
Changes in diaphragm structure following prolonged mechanical ventilation in piglets.
Prolonged mechanical ventilation and inactivity negatively affect muscle function. The mechanisms for this dysfunction are unclear and clinical studies of respiratory muscle are difficult to carry out. An animal model simulating the critical care environment was used to investigate the effects of 5 days' mechanical ventilation and diaphragm inactivity on diaphragm muscle morphology. ⋯ Five days' mechanical ventilation with sedation and complete diaphragm inactivity resulted in changes in muscle fiber structure. A causal relationship can not be concluded but the acute changes in fiber type distribution and structure suggest that previously reported diaphragm contractile impairment occurs at the level of muscle fibers.
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Acta Anaesthesiol Scand · Apr 2004
Case ReportsConvulsions on anaesthetic induction with sevoflurane in young children.
Increased worldwide use for paediatric anaesthesia of the volatile anaesthetic agent sevoflurane has mainly resulted from its low blood-gas partition coefficient and low airway irritability, providing smooth conditions for rapid induction of anaesthesia. Nevertheless, there are several clinical and experimental reports suggesting a correlation between exposure to sevoflurane and generalized clonic or tonic seizure activity. We report two clinical episodes of convulsions associated with the induction of sevoflurane anaesthesia in young children. ⋯ Both episodes ceased spontaneously. Although no EEG was recorded, it cannot be excluded that both episodes resulted from seizure activity within the CNS. Based on our observations and reports by others we suggest that, until further notice, sevoflurane should be avoided or at least used cautiously in patients where clinical epileptic activity has been verified or is strongly suspected.