The Journal of surgical research
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Hydroxyethyl starch administration has been associated with decreases in hemostasis and has recently been demonstrated to decrease fibrinogen (FI)-thrombin-(FIIa)-Factor XIII (FXIII) interactions in vitro in human plasma. Thus, the purpose of the present study was to determine the effect of in vivo hemodilution with Hextend (6% hydroxyethyl starch, mean molecular weight 450 kDa) on plasma coagulation kinetics. ⋯ Hextend hemodilution in rabbits maintains clot initiation by diminishing both FIIa-FI and FXIIIa-fibrin interactions, whereas clot propagation and strength were reduced by diminished FXIIIa-fibrin interactions.
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We sought to validate the efficiency of intraoperative radiofrequency ablation (RFA) using a prototype loop internally cooled-perfusion (LICP) electrode to induce coagulation in the subcapsular portion of the liver. ⋯ Intraoperative RFA using the LICP electrode induced a well-defined semicircular coagulation with a 3.5-cm axial diameter in the subcapsular region of the liver. This device appears to be promising for the treatment of superficial tumors during intraoperative RFA.
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Comparative Study
Intermittent alveolar overdistension for 30 or 240 minutes does not produce acute lung injury in normal pig lung.
The objective is to study whether alveolar overdistension can induce acute lung injury in pigs as assessed by analysis of respiratory and histological parameters and inflammatory markers. ⋯ In this animal model, ventilation for 4 h with large tidal volume did not cause ventilator-induced lung injury.
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Adherence to evidence-based adverse outcome prevention techniques is a critical factor in providing high-quality patient care, but many of these interventions are not used by physicians. It is unclear if surgeons' risk attitudes and reactions to uncertainty influence their use of these or other interventions. ⋯ There are very limited data on the extent to which surgical decision making is linked to risk taking behavior and "comfort with uncertainty". Understanding the behaviors, attitudes and beliefs that make up surgical "judgment" remains a challenge for those interested in influencing behavior.
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Plasma volume expansion is often performed during adrenergic therapy in the intensive care unit, but little is known about their combined effects. ⋯ Adrenergic drugs altered the hemodynamics at baseline (direct effects), changed the distribution and elimination of infused 0.9% saline (indirect effects) and, finally, modified most hemodynamic responses to plasma dilution (interaction effects).