Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2010
Multicenter StudyLactate concentrations in the rectal lumen in patients in early septic shock.
Previously, we observed that rectal luminal lactate was higher in non-survivors compared with survivors of severe sepsis or septic shock persisting >24 h. The present study was initiated to further investigate this tentative association between rectal luminal lactate and mortality in a larger population of patients in early septic shock. ⋯ In this prospective, observational study of unselected patients with early septic shock, there was no difference in the concentration of lactate in the rectal lumen between non-survivors and survivors.
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Acta Anaesthesiol Scand · Aug 2010
Randomized Controlled TrialNorepinephrine causes a pressure-dependent plasma volume decrease in clinical vasodilatory shock.
Recent experimental studies have shown that a norepinephrine-induced increase in blood pressure induces a loss of plasma volume, particularly under increased microvascular permeability. We studied the effects of norepinephrine-induced variations in the mean arterial pressure (MAP) on plasma volume changes and systemic haemodynamics in patients with vasodilatory shock. ⋯ Norepinephrine causes a pressure-dependent decrease in the plasma volume in patients with vasodilatory shock most likely caused by transcapillary fluid extravasation.
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Acta Anaesthesiol Scand · Aug 2010
Comparative StudyA clinical prospective comparison of anesthetics sensitivity and hemodynamic effect among patients with or without obstructive jaundice.
To compare isoflurane anesthesia in patients with or without hyperbilirubinemia undergoing hepatobiliary surgery. ⋯ Patients with obstructive jaundice have an increased sensitivity to isoflurane, more hypotension and bradycardia during anesthesia induction and maintenance and a prolonged recovery time compared with controls.
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The conflicting results from studies over tight glucose control in intensive care unit (ICU) patients ask for a continuous on-line real-time glucose monitoring in future. Here, intravenous microdialysis was tested in ICU patients and healthy volunteers. Primary aims were technical feasibility and accuracy. ⋯ Technical feasibility was good, but the accuracy was not sufficient and the variability between the recording periods was high without calibrations. The non-availability of suitable peripheral veins was a problem in many patients screened but not included in the study. Intravenous microdialysis to obtain continuous on-line real-time glucose monitoring is technically feasible, but accuracy needs to be improved.
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Acta Anaesthesiol Scand · Aug 2010
Diagnostic criteria in patients with complex regional pain syndrome assessed in an out-patient clinic.
Specific criteria have been described and accepted worldwide for diagnosing patients with complex regional pain syndrome (CRPS). Nevertheless, a clear-cut diagnosis cannot be confirmed in a number of cases. ⋯ The diagnostic criteria used to determine CRPS should be further improved. A large number of referred patients experienced substantial pain, without receiving adequate medication. Disease-related medication is unrelated to CRPS-specific disease activity. Knowledge of underlying mechanisms is warranted before an adequate pharmaceutical intervention can be considered.