Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2016
Perceived cognitive impairments after critical illness: a longitudinal study in survivors and family member controls.
Many former intensive care unit (ICU) patients report difficulties in cognitive functions especially in their daily life. We aimed to measure perceived cognitive impairments in daily life in survivors of critical illness and their family member controls (FMC). ⋯ A substantial part of former patients were affected by post-ICU cognitive impairment in daily life. Pre-existing cognitive impairments were a risk factor. These patients would probably profit from tailored neurorehabilitative therapy. Therefore, an efficient tool to identify potential patients for neurorehabilitation is needed. The questionnaire revealed good psychometric properties. We recommend a comprehensive validation of the questionnaire in this patient population.
-
Acta Anaesthesiol Scand · Sep 2016
Effect of sevoflurane anaesthesia on hepatic blood flow in infants with obstructive hepatobiliary disease.
Currently most studies on anaesthetic effects on hepatic blood flow of cirrhotic patients have been performed on adults or experimental animals. We performed this study to evaluate the effect of sevoflurane anaesthesia on hepatic blood flow in infants with obstructive jaundice by Doppler ultrasound. ⋯ For infants with obstructive jaundice that had reduced portal blood flow and compensatory increase in hepatic artery blood flow, sevoflurane may produce a protective effect on hepatic blood flow.
-
Acta Anaesthesiol Scand · Sep 2016
The rare Arg181Cys mutation in the μ opioid receptor can abolish opioid responses.
Genetic variability contributes to variable clinical response to opioids. This study emerged from the observation of three Norwegian patients who showed no or extraordinary poor response to very high doses of opioids. We suspected a genetic defect and applied a 'most likely candidate gene' approach to investigate this possibility. ⋯ The Arg181Cys mutation occurs at clinically relevant frequencies and produces a signaling dead hMOR which may abolish or significantly reduce opioid effects in affected individuals. Anesthesiologists and practitioners in pain medicine should be aware of this mutation as a possible explanation for inefficiency of opioids and consider genotyping in relevant cases. Individuals homozygous for the mutation may need a highly personalized approach to pain therapy.
-
Acta Anaesthesiol Scand · Sep 2016
Visuospatial ability and novice brachial plexus sonography performance.
The knowledge on the type and influence of visuospatial ability on sonography performance relevant for ultrasound-guided regional anaesthesia remains incomplete. The aim of this study was to determine whether four different factors of visuospatial ability are important in determining proficiency and procedure time of novices performing brachial plexus sonography. These factors were spatial visualisation, flexibility of closure, spatial relations and speed of closure. ⋯ Spatial visualisation, spatial relations and speed of closure, but not flexibility of closure, influence sonography performance. Visuospatial ability testing can identify novices who will require extra assistance in learning ultrasound relevant for regional anaesthesia. (
-
Acta Anaesthesiol Scand · Sep 2016
Open lung approach ventilation abolishes the negative effects of respiratory rate in experimental lung injury.
We recently reported that a high respiratory rate was associated with less inflammation than a low respiratory rate, but caused more pulmonary edema in a model of ARDS when an ARDSNet ventilatory strategy was used. We hypothesized that an open lung approach (OLA) strategy would neutralize the independent effects of respiratory rate on lung inflammation and edema. This hypothesis was tested in an ARDS model using two clinically relevant respiratory rates during OLA strategy. ⋯ Contrary to previous findings with the ARDSNet strategy, respiratory rate did not influence lung inflammatory response or pulmonary edema during OLA ventilation in experimental ARDS. This indicates that changing the respiratory rate when OLA ventilation is used will not exacerbate lung injury.