Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2013
Vital dysfunctions after intensive care discharge: prevalence and impact on patient outcome.
Patients discharged from the intensive care unit (ICU) are at increased risk for serious adverse events (SAEs). Recording vital functions and comprehending the consequences of altered vitals on general wards may be suboptimal. This potentially endangers recovery after successful intensive care. We aimed to determine the prevalence of vital dysfunctions after ICU discharge and their effect on patient outcome. ⋯ Simple vital function measurement and attending ward nurse's subjective assessment facilitate early detection of post-ICU patients at risk. The threshold in seeking assistance through MET remains high.
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Acta Anaesthesiol Scand · Jan 2013
Nociceptive stimuli responses at different levels of general anaesthesia and genetic variability.
Changes in skin conductance (SC), clinical stress score (CSS), the bispectral index spectroscopy (BIS) index and the variation in the BIS index may be used to monitor responses to nociceptive stimuli. We wanted to examine these methods during noxious stimulation during general anaesthesia and if the responses were associated with variability in genes related to pain. ⋯ This exploratory study suggests genes that may be tested further with relation to nociceptive response during anaesthesia. SC and CSS may be useful tools for monitoring nociceptive response during general anaesthesia.
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Acta Anaesthesiol Scand · Jan 2013
Open-heart surgery increases cerebrospinal fluid levels of Alzheimer-associated amyloid β.
Neurocognitive dysfunction occurs frequently after open-heart surgery. It has been suggested that cognitive decline after cardiac surgery with cardiopulmonary bypass (CPB) could be a functional consequence of Alzheimer's disease (AD)-like neuropathological changes. The aim of the present study was to evaluate the cerebrospinal fluid (CSF) levels of amyloid β peptide (Aβ(1-42) ) and soluble fragments of amyloid precursor protein (sAPP) as well as the cerebral inflammatory response to open-heart surgery. ⋯ Cardiac surgery with CPB causes a profound cerebral inflammatory response, which was accompanied by increased post-operative CSF levels of the AD biomarker Aβ(1-42) . We hypothesize that these changes may be relevant to Alzheimer-associated amyloid build-up in the brain and cognitive dysfunction after cardiac surgery with CPB.
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Acta Anaesthesiol Scand · Jan 2013
Editorial CommentARDS--insights from Iceland and definitions from Berlin.