Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2012
The implementation of a perioperative checklist increases patients' perioperative safety and staff satisfaction.
The implementation of the 'Surgical Safety Checklist' caused a significant reduction in the incidence of complications and mortality among patients undergoing surgery. The aim of the present study was to evaluate perioperative safety standards and the quality of interprofessional cooperation before and after the introduction of a safety checklist from staff members' point of view. ⋯ Our attitude surveys demonstrate that from the OR staff's perspective, in the perioperative setting, safety-relevant factors can be handled significantly better and with greater awareness by implementing a safety checklist as proposed by the World Health Organization.
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Constituents of vascular endothelial surface layer (glycocalyx), e.g. an anchor protein syndecan-1 (SDC-1), can be detected in plasma in many inflammatory conditions. In inflammation, vascular adhesion protein-1 (VAP-1) is rapidly translocated to the apical side of the endothelial cells and may be released to plasma in a soluble form. We hypothesized that glycocalyx injury coincides with VAP-1 activation on endothelial cells. To test the hypothesis, we measured SDC-1 and VAP-1 levels in 20 patients with septic shock. ⋯ We found increased VAP-1 activity and SDC-1 content in critically ill patients with septic shock. Based on our results, the role of VAP-1 in shock pathogenesis should be studied with semicarbazide-sensitive amine oxidase activity blocking agents and substrate affinity testing.
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Acta Anaesthesiol Scand · Mar 2012
Randomized Controlled TrialEffects of intravenous dexmedetomidine on low-dose bupivacaine spinal anaesthesia in elderly patients.
Dexmedetomidine (DMT) has been shown to prolong spinal anaesthesia. We evaluated the effects of intravenous DMT on low-dose bupivacaine spinal anaesthesia in elderly patients. ⋯ Intravenous DMT prolonged the duration of spinal anaesthesia and improved post-operative analgesia. However, more profound sedation with desaturation was observed with more frequent bradycardia, and delayed recovery should be considered in elderly patients.
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Acta Anaesthesiol Scand · Mar 2012
Randomized Controlled TrialThe use of aortic occlusion balloon catheter without fluoroscopy for life-threatening post-partum haemorrhage.
This article describes the use of a balloon catheter introduced via the femoral artery into the abdominal aorta without the use of fluoroscopy to stabilize six patients with life-threatening post-partum haemorrhage. The femoral artery was localized blindly or with the use of ultrasound. ⋯ In these six cases, the procedures were carried out by interventional radiologists. However, this procedure can also be performed by anaesthesiologists or surgeons who are trained in vascular access techniques.