Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1979
Prevalence and prognostic significance of coma after cardiac arrest outside intensive care and coronary units.
In 181 patients resuscitated from cardiac arrest, the prevalence and duration of coma were registered and related to the site of occurrence of cardiac arrest, cardiac rhythm during arrest, age and clinical outcome of the patients. Coma was most frequent after cardiac arrest outside the hospital, as 84% of these patients were comatose for more than 1 h and 56% for more than 24 h; the corresponding values for patients with cardiac arrest in general wards were 63% and 30%, respectively, and for patients with cardiac arrest during ambulance transport, 80% and 44%. Permanent brain damage was extremely rare if the coma lasted less than 6 h (1 out of 62 patients), and relatively rare with a coma duration between 6 and 24 h (5 out of 34 patients). ⋯ Older patients were more vulnerable to coma than younger ones, but coma as such was not more frequent. We found no differences in coma after asystole and ventricular fibrillation. Problems concerning the selection of patients who have a chance of survival, although comatose after cardiac arrest, are discussed.
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Acta Anaesthesiol Scand · Feb 1979
In-line blood warming and microfiltration devices. II. Influence of blood temperature on flow rate and hemolysis during pressure transfusion through microfilters and transfusion sets.
The influence of blood temperature on flow rate and hemolysis was studied. Homogeneous aggregate-free blood was transfused through six different microfilters and transfusion sets, combined with a large-bore venous cannula (Venflon No. 2) at a constant pressure of 20 kPa. Flow rates and plasma hemoglobin for cold (+5 degrees C) and prewarmed (+37 degrees C) blood were determined separately. ⋯ The Fenwal "dry-heat" warmer was found to have a great flow resistance. The pressure transfusion caused only a slight increase in free plasma hemoglobin of cold blood and no increase in prewarmed blood. It seems more practical to warm the entire blood unit before transfusion than to use so-called in-line blood warmers, because prewarming results in a flow rate approximately twice as high as that obtained with coils.
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Acta Anaesthesiol Scand · Feb 1979
In-line blood warming and microfiltration devices. I. Testing of flow and warming properties by pressure transfusion of aggregate-free blood.
Homogeneous microaggregate-free whole blood at +5 degrees C was transfused at constant pressures of 20 and 40 kPa through two micro-filtration and blood warming devices, and the temperature of the blood was recorded before it reached the venous cannula. The flow rates with the Fenwal system were 58 and 139 g/min, whereas the micro-filter MF10B combined with the Portex Coil allowed flow rates of 143 and 224 g/min. The warming capacities of the two warmers were almost equal and this did not prove to be their weak point. ⋯ Increasing the priming volume of the coil would raise the mean infusion temperature. A pressure infusor (Fenwal) was tested, and the internal pressures of the blood bag and the infusor were determined separately. The bag pressure differed significantly from the infusor pressure as the blood bag emptied, making the usefulness of the infusor manometer questionable.
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Acta Anaesthesiol Scand · Jan 1978
Flow requirements in the Hafnia modifications of the Mapleson circuits during spontaneous respiration.
The Mapleson A, B, C and D circuits can be changed into non-polluting circuits by employing continuous gas evacuation directly from the circuit, via an ejector flowmeter (Jørgensen 1974); Mapleson A and C circuits with this modification have been described previously as the Hafnia A and C circuits (Christensen 1976, Thomsen & Jørgensen 1976). If evacuation from a closed reservoir is employed, total removal of the expired and surplus gases from the operating theatre is obtained (Jørgensen & Thomsen 1976). There will be resistance to expiration in all the circuits with a relief valve for the discharge of surplus gas. ⋯ As in any other circuit, the relief valve remains open except during controlled ventilation. A dumping valve may also be included as a safeguard against low pressures (Jørgensen & Thomsen 1976). The flow requirements of the Hafnia B and D circuits and the corresponding Mapleson circuits have been studied in conscious, spontaneously breathing subjects, and the results are discussed in relation to the flow requirements of other semi-closed system.
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Acta Anaesthesiol Scand · Jan 1978
Effects on muscarinic receptors of various agents in reversal of neuro-muscular blockade: a study evaluating atropine, glycopyrron, neostigmine and pyridostigmine.
The effects were studied of various drug combinations, recommended for use in reversal of neuromuscular blockade, on heart rate and salivary secretions in 80 healthy patients anaesthetized with nitrous oxide-oxygen-halothane and relaxed with d-tubocurarine. The drug combinations were mixtures of atropine 1 mg--neostigmine 2.5 mg, atropine 1 mg--pyridostigmine 15 mg, glycopyrron 0.5 mg--neostigmine 2.5 mg, and glycopyrron 0.5 mg--pyridostigmine 15 mg, respectively. It was found that administration of the atropine-containing mixtures induced more pronounced initial increases and delayed decreases in heart rate than the mixtures containing glycopyrron. ⋯ No such difference was found between the atropine and glycopyrron groups. Glycopyrron caused a more intense dryness of the mouth than atropine. A differential attitude towards the use of drugs for reversal of neuromuscular blockade, based on the cardiovascular state of the particular patient, might be recommendable.