Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2011
Initial fluid resuscitation of patients with septic shock in the intensive care unit.
Fluid is the mainstay of resuscitation of patients with septic shock, but the optimal composition and volume are unknown. Our aim was to evaluate the current initial fluid resuscitation practice in patients with septic shock in the intensive care unit (ICU) and patient characteristics and outcome associated with fluid volume. ⋯ In the ICU, patients with septic shock were resuscitated with a combination of crystalloids, colloids and blood products. Although the more severely shocked patients received higher volumes of crystalloids, colloids and blood products, mortality did not differ between the groups.
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Acta Anaesthesiol Scand · Apr 2011
Randomized Controlled Trial Comparative StudyOnset time and haemodynamic response after thiopental vs. propofol in the elderly: a randomized trial.
The induction dose of hypnotic agents should be reduced in the elderly, but it is not well studied whether thiopental or propofol should be preferred in this group of patients. The aim of this study was to compare onset time, hypnosis level and the haemodynamic response after thiopental vs. propofol for induction of anaesthesia. Our primary hypothesis was that in the elderly, thiopental had a shorter onset time than propofol, defined as time to bispectral index (BIS) <50. ⋯ Thiopental was found to have a faster onset than propofol in elderly surgical patients.
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Acta Anaesthesiol Scand · Apr 2011
Randomized Controlled TrialTiming of intravenous patient-controlled remifentanil bolus during early labour.
Remifentanil labour analgesia is superior to nitrous oxide but less potent than epidural analgesia. The short onset and offset times of effect suggest that the timing of the bolus in the contraction cycle could have importance. We hypothesised that administering a remifentanil bolus during contraction pause would improve analgesia in early labour. ⋯ Administering a remifentanil bolus during the uterine contraction pause does not improve pain relief.
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Acta Anaesthesiol Scand · Apr 2011
Randomized Controlled TrialCardiac outcome after sevoflurane versus propofol sedation following coronary bypass surgery: a pilot study.
Studies of volatile anesthetic administration during coronary artery bypass grafting (CABG) report reduced serum levels of post-operative cardiac troponin-T (cTnT). Our primary objective was to evaluate whether short-term sedation with sevoflurane in the intensive care unit (ICU)--after CABG--could affect the release of cTnT, compared with propofol sedation. ⋯ Post-operative short-term sevoflurane sedation following CABG, in comparison with propofol, did not affect the cTnT values at 12 h post-operatively and clinical outcome was equal between groups. The result from the post hoc analysis, with less cTnT change over time, is nevertheless hypothesis-generating and warrants a larger study.
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Acta Anaesthesiol Scand · Apr 2011
Pre-hospital transcranial Doppler in severe traumatic brain injury: a pilot study.
Investigation of the feasibility and usefulness of pre-hospital transcranial Doppler (TCD) to guide early goal-directed therapy following severe traumatic brain injury (TBI). ⋯ Our preliminary study suggests that TCD could be used in pre-hospital care to detect patients whose cerebral perfusion may be impaired.