Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2012
Comparative StudyAnalgesia and sedation of mechanically ventilated patients - a national survey of clinical practice.
The importance of balanced sedation and pain treatment in intensive care units (ICUs) is evident, but regimes and use of medication differ widely. Previous surveys have focused on the use of various medications and regimes. What has not been explored is the process by which nurses and physicians assess patients' needs and work together toward a defined level of sedation and pain for the ICU patient. The purpose of the study was to determine the use of protocols and medications for sedation and analgesia in Norwegian ICUs and the degree of cooperation between nurses and physicians in using them. ⋯ Potential factors which may improve sedation and pain management of mechanically ventilated patients in Norwegian ICUs are more systematic assessments of pain and sedation, and the use of written protocols. Strategies which reduce side effects should be addressed.
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Acta Anaesthesiol Scand · Jan 2012
Therapeutic hypothermia in adult cardiac arrest because of drowning.
Therapeutic hypothermia in adult victims who suffer cardiac arrest following drowning has been applied in only a small number of cases. In the last 4 years, we have employed therapeutic hypothermia to decrease hypoxia-induced brain injury in these patients. The purpose of the present study was to report the results of the treatment of these patients. ⋯ The present study did not demonstrate an advantage of therapeutic hypothermia in adult cardiac arrest after drowning compared with previous studies treated with conventional therapy. Further prospective studies are needed to evaluate the effects of therapeutic hypothermia.
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Acta Anaesthesiol Scand · Jan 2012
Isoflurane late preconditioning against myocardial stunning is associated with enhanced antioxidant defenses.
We tested the hypothesis that an upregulation of antioxidant proteins [Cu-Zn superoxide dismutase (SOD), Mn SOD, catalase, glutathione peroxidase, and glutathione peroxidase] plays a role in the delayed protection against myocardial stunning produced by isoflurane preconditioning (ISOPC). Findings were compared with late ischemic PC (IPC). ⋯ ISOPC had powerful, delayed anti-stunning effect that was associated with an enhancement of endogenous antioxidant defenses.