Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2010
Sex differences in cerebral injury after severe haemorrhage and ventricular fibrillation in pigs.
Experimental studies of haemorrhagic shock have documented a superior haemodynamic response and a better outcome in female animals as compared with male controls. Such sexual dimorphism has, nevertheless, not been reported after circulatory arrest that follows exsanguination and shock. We aimed to study differences in cerebral injury markers after exsanguination cardiac arrest in pre-pubertal piglets. The hypothesis was that cerebral injury is less extensive in female animals, and that this difference is independent of sexual hormones or choice of resuscitative fluid. ⋯ After resuscitation from haemorrhagic circulatory arrest, cerebral reperfusion is greater, and BBB permeability and neuronal injury is smaller in female piglets. An increased cerebral cortical iNOS and nNOS expression in males implies a mechanistic relationship with post-resuscitation neuronal injury and warrants further investigation.
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Acta Anaesthesiol Scand · Mar 2010
Sevoflurane-induced post-conditioning has no beneficial effects on neuroprotection after incomplete cerebral ischemia in rats.
The aim of this study was to investigate whether sevoflurane-induced post-conditioning has a neuroprotective effect against incomplete cerebral ischemia in rats. ⋯ These findings show that sevoflurane administration after ischemia does not provide neuroprotection in rats subjected to incomplete cerebral ischemia.
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Acta Anaesthesiol Scand · Mar 2010
Pre-operative fasting: a nationwide survey of German anaesthesia departments.
Shorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. ⋯ Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.
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The use of neuromuscular blocking agents (NMBAs) is widespread in anesthetic practice; little is known about the current use of these drugs in Italy. This survey was conducted to obtain information about the most commonly used clinical tests and the train-of-four (TOF) ratios that are considered as being reliable for assessing recovery from neuromuscular blockade at the end of anesthesia and the estimated occurrence rates of post-operative paralysis in Italian hospitals. ⋯ Most Italian anesthetists assess the recovery from neuromuscular blockade only by clinical signs. There is poor awareness about the inability of such techniques to indicate even a significant amount of residual neuromuscular block. A more extensive use of quantitative instrumental monitoring is required for the more rational use of NMBAs.
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Acta Anaesthesiol Scand · Mar 2010
Validation and clinical feasibility of nitrogen washin/washout functional residual capacity measurements in children.
The functional residual capacity (FRC) is an important parameter in pediatric respiratory monitoring but it is difficult to assess in the clinical setting. We have introduced a modified N(2) washout method utilizing a change of F(I)O(2) of 0.1 for FRC measurement in adult respiratory monitoring. This study validated the algorithm in a pediatric lung model and investigated the stability and feasibility in a pediatric peri-operative and intensive care setting. ⋯ FRC was satisfactorily measured by a modified N(2) algorithm and may be included as a monitoring variable in pediatric respiratory care. Pediatric FRC monitoring demands strictly stable conditions as measurements are performed close to the limits of the monitor's specifications.