Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2010
Effects of surfactant replacement on alveolar overdistension and plasma cytokines in ventilator-induced lung injury.
Overdistension of the lung causes ventilator-induced lung injury (VILI) accompanied by surfactant abnormalities and inflammatory changes. We investigated the effects of surfactant replacement on overdistension of the terminal airspaces and plasma cytokine levels in VILI. ⋯ In rats with VILI, surfactant replacement reversed overdistension of the terminal airspaces that may induce barotrauma, but not upregulation of MIP-2, IL-6, and IL-10 within 2 h.
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Acta Anaesthesiol Scand · Mar 2010
Randomized Controlled TrialTime course of rocuronium-induced neuromuscular block after pre-treatment with magnesium sulphate: a randomised study.
A previously published study suggested that pre-treatment with magnesium sulphate (MgSO(4)) had no impact on the speed of onset of rocuronium-induced neuromuscular block. We set out to verify this assumption. ⋯ Magnesium sulphate given 15 min before propofol anaesthesia reduces the onset time of rocuronium by about 35% and prolongs the total recovery time by about 25%.
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Acta Anaesthesiol Scand · Mar 2010
Randomized Controlled TrialPersistent sensory dysfunction in pain-free herniotomy.
Persistent post-herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin herniotomy. ⋯ Persistent sensory dysfunction is common in pain-free post-herniotomy patients. Future studies of sensory function in persistent post-herniotomy pain should compare the findings to the present data in order to characterize individual patients and potentially identify subgroups, which may aid in allocation of patients to pharmacological or surgical treatment.
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Acta Anaesthesiol Scand · Mar 2010
ReviewChest physiotherapy with positive expiratory pressure breathing after abdominal and thoracic surgery: a systematic review.
A variety of chest physiotherapy techniques are used following abdominal and thoracic surgery to prevent or reduce post-operative complications. Breathing techniques with a positive expiratory pressure (PEP) are used to increase airway pressure and improve pulmonary function. No systematic review of the effects of PEP in surgery patients has been performed previously. ⋯ Only one of the included trials showed any positive effects of PEP compared to other breathing techniques. Today, there is scarce scientific evidence that PEP treatment is better than other physiotherapy breathing techniques in patients undergoing abdominal or thoracic surgery. There is a lack of studies investigating the effect of PEP over placebo or no physiotherapy treatment.
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Acta Anaesthesiol Scand · Mar 2010
Case ReportsUnexpected cardiovascular collapse from massive air embolism during endoscopic retrograde cholangiopancreatography.
A 72 year-old woman with cholangiocarcinoma presented for endoscopic retrograde cholangio pancreatography (ERCP) for diagnostic intraductal endoscopy under GETA. During the technically difficult procedure the patient became suddenly hypoxic, hypotensive, bradycardic, and progressed to PEA code (ETCO2 5 mmHg). ACLS was initiated. ⋯ Within 5 minutes pulses returned; the patient was transferred to the ICU. MRI revealed two watershed infarcts in the right frontal lobe. The patient fully recovered and returned a month later for an uneventful ERCP.