Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2014
Observational StudyMinimal impairment in pulmonary function following laparoscopic surgery.
Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head-down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic cholecystectomy. We hypothesised that arterial oxygenation would be more impaired after hysterectomy performed in the head-down position than after cholecystectomy in the head-up position. ⋯ Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after laparoscopic cholecystectomy, but no clinically significant differences in postoperative pulmonary gas exchange or spirometry were found between laparoscopic hysterectomy and laparoscopic cholecystectomy.
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Acta Anaesthesiol Scand · Feb 2014
Observational StudyHypoglycaemia and predisposing factors among clinical subgroups treated with intensive insulin therapy.
In previous studies, conflicting intensive insulin therapy (IIT) results have been observed, whereby IIT-related mortality seems to be lower in specific clinical subgroups. The aim of this study was to assess differences in glycaemic control, the risk of critical hypoglycaemia (≤ 2.2 mmol/l), the associated predisposing factors, and the in-hospital mortality in different clinical subgroups treated with IIT. ⋯ The risk of critical hypoglycaemia and the associated predisposing factors depended on the clinical subgroup involved. Critical hypoglycaemia is a potential threat for our patients, and the high risk of critical hypoglycaemia in some clinical subgroups appeared to reverse the benefits of IIT. As a result, it is crucial that the different subgroups involved in a study are defined to further interpret the potential benefits of IIT and the risk of critical hypoglycaemia.
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The work hours of Norwegian physicians are under scrutiny because of an increased public focus on patient safety. Ample international research indicate harmful effects of doctor fatigue based on studies on physicians working long weeks and on-call shifts of more than 30 consecutive hours. There is a lack of research on effects relevant for short or intermediate length of work weeks and call shifts. This study intended to study cognitive effects of short or intermediate duration in-hospital calls. ⋯ Reaction times were increased after 18 h night calls and non-significant increases in reaction times were apparent after the other on-call shifts. Self reported sleepiness was increased post-call. We were not able to conclude whether executive function or memory was negatively affected post-call.
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Acta Anaesthesiol Scand · Feb 2014
Brain death increases COX-1 and COX-2 expression in the renal medulla in a pig model.
Brain death is linked to a systemic inflammatory response that includes prostaglandins and cytokines among its mediators. The levels of cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2) affect graft survival, but it remains unknown whether these enzymes are modified during brain death. The aims of this study were to investigate the organ expression of COX and to analyse the cytokine response in the plasma, cerebrospinal fluid (CSF), and organs in a porcine model of intracerebral haemorrhage and brain death. ⋯ Brain death increases the expression of COX-1 and COX-2 mRNA in the renal medulla. The release of cytokines into the plasma and CSF did not vary between the groups.