Acta anaesthesiologica Scandinavica. Supplementum
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Acta Anaesthesiol Scand Suppl · Jan 1991
ReviewActions and interactions of mediator systems and mediators in the pathogenesis of ARDS and multiorgan failure.
A great variety of mediators and mediator systems are involved in the disturbance of the microcirculation and vascular permeability following polytrauma and sepsis. The locally accentuated, organ related activation and the cooperation of several of these mediators and mediator systems over a longer period of time seem to be responsible for the development of an acute organ failure in terms of ARDS and MOF. Cytokines from macrophages seem to be the determining factors converting a primarily functional and reversible systemic vascular reaction into organ related morphological lesions. This pathogenetic complexity has to be considered in future concepts for therapy and prophylaxis with regard to the hierarchical rank of the mediators involved.
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Acta Anaesthesiol Scand Suppl · Jan 1990
ReviewQuantitative surface electromyography (qEMG): applications in anaesthesiology and critical care.
During general anaesthesia and in lowered vigilance states such as after major trauma and during heavy sedation or analgesic medication, patients' ability to communicate with their surroundings is limited. Subjective intuitional interpretation may be the only means to ascertain a patient's emotional state, mood, and pain perception. Electromyographic detection and quantification of minimal and covert facial mimic muscle activity in anaesthesiology and critical care was an interesting concept worth further evaluation. ⋯ Inadequate anaesthesia was always reflected by an increase in facial qEMG, albeit this often was also evident to the naked eye. The arousal at the end of anaesthesia was always associated with an abrupt increase in facial qEMG activity, which often was preceded by a more gradual, predictive rise. Auditory stimulation was also effective in increasing qEMG.(ABSTRACT TRUNCATED AT 400 WORDS)