Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2014
Observational StudyIs paediatric trauma severity overestimated at triage? An observational follow-up study.
Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). ⋯ There was no difference in the proportion of paediatric and adult trauma patients transported to the TC, neither overall nor among severely injured patients. Paediatric trauma patients admitted to the TC were, however, significantly less injured than adults.
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Acta Anaesthesiol Scand · Jan 2014
Comparative StudyMeasurements of cardiac output obtained with transesophageal echocardiography and pulmonary artery thermodilution are not interchangeable.
Echocardiography is increasingly becoming an integrated tool for circulatory evaluation in the intensive care unit and the operating room. Therefore, it is imperative to know the reproducibility of measurements obtained by echocardiography. In this study, a comparison of cardiac output (CO) measurements obtained with transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC) thermodilution (TD) was carried out to test the precision, accuracy and trending ability of CO measurements obtained with TEE. ⋯ In comparison, CO measurements obtained with TEE and PAC TD had wide limits of agreement, a larger percentage error than would be expected from the precision of the two methods, and a poor trending ability. Thus, TEE is not interchangeable with PAC TD for measuring CO.
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Acta Anaesthesiol Scand · Jan 2014
Infusion rate and plasma volume expansion of dextran and albumin in the septic guinea pig.
Intravenous fluid treatment of hypovolaemia in states of increased capillary permeability, e.g. sepsis, is often accompanied by adverse oedema formation. A challenge is therefore to achieve and maintain normovolaemia using as little plasma volume substitution as possible to minimise interstitial oedema. In the present study, we evaluated the importance of infusion rate for the plasma volume expanding effects of 6% dextran 70 and 5% human albumin in a guinea pig sepsis model. ⋯ The study performed on a guinea pig sepsis model showed that the plasma volume expanding effects of fixed volumes of 6% dextran 70 and 5% albumin were greater when given at a slow than at a fast infusion rate.
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Acta Anaesthesiol Scand · Jan 2014
Changes in the sublingual microcirculation during major abdominal surgery and post-operative morbidity.
Little is known about perioperative microcirculatory changes during major abdominal surgery, and the main objectives of this study were to evaluate perioperative microcirculatory alterations in this setting, and if changes in microcirculatory parameters are associated with post-operative morbidity and/or with changes in parameters reflecting oxygen delivery. ⋯ Perioperative changes in the sublingual microcirculatory parameters measured with the SDF-imaging technique appear to be minor, and no association with outcome after major abdominal surgery could be demonstrated. Changes in ScvO2 and serum lactate do not reflect sublingual microcirculatory alterations in this setting.