Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2004
Clinical TrialChanges in visual and auditory response time during conscious sedation with propofol.
Using a push-button device, we investigated whether visual or auditory response time would increase with increasing sedation, and assessed the responsiveness score of the Observer's Assessment of Alertness/Sedation (OAA/S) scale at the point of first loss of response to visual or auditory stimulation. ⋯ VRT and ART were linearly prolonged with increasing sedation. Visual response may be useful in monitoring conscious sedation.
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Acta Anaesthesiol Scand · Sep 2004
Comparative StudyNursing staff resources in direct patient care: comparison of TISS and ICNSS.
The aim was to study the variation in the nursing workload and nursing staff resources in direct patient care. ⋯ Intensive Care Nursing Scoring System gives additional information about the nursing staff resources and yields a higher number of nurses needed in direct patient care even when TISS scores show the number of nurses to be adequate.
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Acta Anaesthesiol Scand · Sep 2004
Survey of routines for sedation of patients on controlled ventilation in Nordic intensive care units.
Sedation strategies and practice for patients on controlled ventilation is variable from place to place as well as over time. Less sedation results in shorter ventilation time and new ventilatory modes permit more awake patients. Previous works estimated sedative and analgesic use in Nordic ICUs some years ago, but current practice is not known. We therefore designed this study to describe pharmacological and practical routines for sedation of patients on controlled ventilation. ⋯ Most units used a sedation scale, although other strategies to reduce the sedation level had not yet been fully introduced. Differences in pharmacological strategies were found between the Nordic countries, and some favourite drugs could be identified.
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Acta Anaesthesiol Scand · Sep 2004
Case ReportsSevoflurane-induced malignant hyperthermia during cardiopulmonary bypass and moderate hypothermia.
A 56-year old man was admitted for elective mitral valve repair and coronary artery bypass surgery due to mitral valve leakage and unstable angina. After induction of anaesthesia he developed a combined metabolic and respiratory acidosis. ⋯ The first arterial blood gas sample taken in the intensive care unit showed relapse of the acidosis and we administered an infusion of 150 mg dantrolene over 3 hours. The patient gradually recovered without sequel and MH was verified by muscle biopsy testing.
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Acta Anaesthesiol Scand · Sep 2004
Hyperoxic ventilation at the critical hematocrit: effects on myocardial perfusion and function.
Hemodilution reduces hematocrit (Hct) and blood oxygen content. Tissue oxygenation is mainly preserved by increased cardiac output. As myocardial O2-demands increase, coronary vasodilatation becomes necessary to increase myocardial blood flow. Myocardial ischemia occurs at a critical Hct-value (Hctcrit), with accompanying exhaustion of coronary reserve. Hyperoxic ventilation is known to both reverse peripheral tissue hypoxia at Hctcrit and also to induce coronary vasoconstriction. This study aimed to determine whether hyperoxic ventilation at Hctcrit further exacerbates myocardial ischemia and dysfunction. ⋯ Hyperoxic ventilation at Hctcrit is followed by coronary vasoconstriction and reduction of coronary blood flow. However, myocardial oxygenation and function is maintained, as increased O2-content (in particular dissolved O2) preserves myocardial oxygenation.