Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Mar 2013
Comparative StudyIntraosseous samples can be used for opioid measurements--an experimental study in the anaesthetized pig.
The intraosseous route provides access to the systemic circulation in an emergency situation when other forms of vascular access are unavailable and there is an urgent need for fluid or drug therapy. The intraosseous access has also been used for collecting samples for laboratory testing. A question that may arise in an unconscious or severely exhausted patient is whether this condition is caused by an unknown drug. We aimed to evaluate whether intraosseous samples could be used to measure opioids and to study the accuracy and precision of such measurements. ⋯ Our findings suggest that intraosseous samples can be used for the analysis of opioids if an IV route is not available.
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Scand. J. Clin. Lab. Invest. · Mar 2013
Albumin-induced coagulopathy is less severe and more effectively reversed with fibrinogen concentrate than is synthetic colloid-induced coagulopathy.
Synthetic colloids cause dilutional coagulopathy. The aims of our study were to determine whether the natural colloid albumin induces a lesser degree of coagulopathy compared to synthetic colloids, and the comparative effectiveness of fibrinogen concentrate to reverse coagulopathy following dilution with these solutions. ⋯ Hemodilution using albumin induced a lesser degree of coagulopathy compared with the synthetic colloids. In addition, albumin-induced coagulopathy was more effectively reversed following addition of fibrinogen concentrate compared with coagulopathy induced by synthetic colloids.
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Scand. J. Clin. Lab. Invest. · Oct 2012
Clinical TrialThe volume-expanding effects of autologous liquid stored plasma following hemorrhage.
Plasma use has increased since studies have suggested that early treatment with blood components in trauma with severe hemorrhage may improve outcome. Plasma is also commonly used to correct coagulation disturbances in non-bleeding patients. Little is known about the effects of plasma transfusion on plasma volume. We report a prospective interventional study in which the plasma volume-expanding effect of autologous plasma was investigated after a controlled hemorrhage. ⋯ Stored liquid plasma has a plasma volume expanding effect up to 86% of its infused volume with a duration of at least 3 h.
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Scand. J. Clin. Lab. Invest. · Oct 2012
Subarachnoid haemorrhage induces an inflammatory response followed by a delayed persisting increase in asymmetric dimethylarginine.
Subarachnoid haemorrhage (SAH) is associated with an inflammatory systemic response and cardiovascular complications. Asymmetric dimethyl arginine (ADMA), an endogenous inhibitor of nitric oxide synthase, mediates vasoconstriction and might contribute to cerebral vasoconstriction and cardiovascular complications after SAH. ADMA is also involved in inflammation and induces endothelial dysfunction. The aim of this study was to evaluate whether and how CRP (marker for systemic inflammation) and ADMA increased in patients during the acute phase (first week) after SAH. The ADMA level was also assessed in the patients in a non-acute phase (three months), and in healthy controls. ⋯ After SAH, CRP and ADMA in serum increased significantly during the first week and ADMA remained elevated 3 months later.
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Scand. J. Clin. Lab. Invest. · Jul 2012
Comparative StudyReproducibility of thrombelastometry (ROTEM®): point-of-care versus hospital laboratory performance.
Thrombelastometry (ROTEM®) has gained wide acceptance in detecting and tailoring acquired hemostatic changes in adults and children. We investigated in this observational trial whether the reproducibility of this point-of-care testing was influenced by performance at the bedside or in the hospital laboratory. In addition, difference in time of performance between both measurements was compared. ⋯ Minor differences were found for the InTEM clot formation time (CFT) showing a mean bias of 10.79 seconds. Time saving was 11 minutes (8-16 minutes) if ROTEM® measurements were performed bedside (p < 0.001). In conclusion, there were minimal effects on ROTEM® measurements irrespective of whether they were performed in the hospital laboratory or at the bedside by a single trained staff member, while the latter saved valuable time.