Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2011
Isoflurane decreases death of human embryonic stem cell-derived, transcriptional marker Nkx2.5(+) cardiac progenitor cells.
Cardiac progenitor cells (CPCs) derived from human embryonic stem cells (hESCs) can multiply and generate cardiomyocytes, offering their tremendous potential for cardiac regenerative therapy. However, poor survival under stressful conditions is a major hurdle in the regeneration. We investigated whether isoflurane-induced preconditioning can increase hESC-derived CPC survival under oxidative stress. ⋯ Isoflurane increased hESC-derived Nkx2.5(+) CPC survival under oxidative stress, and mitoK(ATP) channels may be involved in the protective effect.
-
Acta Anaesthesiol Scand · Oct 2011
Positive end-expiratory pressure-induced changes in end-expiratory lung volume measured by spirometry and electric impedance tomography.
A bedside tool for monitoring changes in end-expiratory lung volume (ΔEELV) would be helpful to set optimal positive end-expiratory pressure (PEEP) in acute lung injury/acute respiratory distress syndrome patients. The hypothesis of this study was that the cumulative difference of the inspiratory and expiratory tidal volumes of the first 10 breaths after a PEEP change accurately reflects the change in lung volume following a PEEP alteration. ⋯ We conclude that spirometric measurements of inspiratory-expiratory tidal volumes agree well with impedance changes monitored by EIT and can be used bedside to estimate PEEP-induced changes in EELV.
-
Acta Anaesthesiol Scand · Oct 2011
Influence of prone positioning on the measurement of transpulmonary thermodilution-derived variables in critically ill patients.
Patients with respiratory failure undergoing prone positioning (PP) are often monitored by the transpulmonary thermodilution (TPTD) technique. However, it remains unclear whether the measurement of TPTD-derived variables is influenced by PP. We investigated the effects of 135° PP on the accuracy of TPTD-derived variables and their changes over an 8-10 h period of time. ⋯ EVLWI and GEDVI measurements are possibly influenced by prone positioning. In spite of statistical significance, the differences in EVLWI and GEDVI are low and presumably of no clinical relevance.
-
Acta Anaesthesiol Scand · Oct 2011
Movement-evoked breakthrough cancer pain despite intrathecal analgesia: a prospective series.
Intrathecal analgesia (ITA) is a valuable treatment option for intractable cancer-related pain. However, the issue of movement-evoked breakthrough pain (BTP) has not been specifically investigated in the ITA setting. The aim of the study was to evaluate the effect of ITA on spontaneous resting pain intensity (SRPI), doses of non-ITA opioids, and specifically on movement-evoked pain intensity (MEPI). ⋯ Movement-evoked BTP was a major clinical problem throughout the study month despite otherwise successful ITA. Improving the quality of life of patients with intractable cancer-related pain should include developing strategies to better deal with movement-evoked BTP.