Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyPrevention of withdrawal movement associated with injection of rocuronium in children: comparison of remifentanil, alfentanil and fentanyl.
We compared the efficacy of remifentanil, alfentanil and fentanyl in reducing withdrawal movement associated with the injection of rocuronium in children. ⋯ Remifentanil, alfentanil and fentanyl all reduced the incidence of withdrawal movement when administered 90 s before the injection of rocuronium compared with saline. Remifentanil was the most effective, followed by alfentanil. Fentanyl was less effective but significantly different from the saline in reducing withdrawal movement in children.
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Acta Anaesthesiol Scand · Oct 2007
Mortality after discharge from the intensive care unit during the early weekend period: a population-based cohort study in Denmark.
As a result of a shortage of intensive care capacity, patients may be discharged prematurely early during weekends which may lead to an increased mortality and risk of readmission to intensive care units (ICU). We examined whether discharge from the ICU during the first part of the weekend was associated with an increased mortality and readmission to the ICU. ⋯ Medical patients discharged from the ICU early in the weekends seem to have an increased mortality and risk of readmission to the ICU.
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Acta Anaesthesiol Scand · Oct 2007
Effect of levosimendan on ventriculo-arterial coupling in patients with ischemic cardiomyopathy.
Levosimendan, a novel calcium sensitizer, enhances myocardial contractility without affecting intracellular calcium concentration. It also dilates peripheral arterial vessels by acting on ATP-dependent K(+) channels. Ventriculo-arterial coupling, the relationship between myocardial contractility and the arterial system, describes the efficiency of the cardiovascular system by analysing the relationship between myocardial contractility expressed by ventricular elastance (E(es)) and arterial elastance (E(a)). The aim of this prospective clinical investigation was to evaluate the effects of levosimendan on ventriculo-arterial coupling in patients with ischemic cardiomyopathy. ⋯ Levosimendan improves ventriculo-arterial coupling and cardiovascular performance in coronary patients with left ventricular dysfunction by enhancing myocardial contractility and reducing arterial elastance.
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Acta Anaesthesiol Scand · Oct 2007
The effect of propofol on actin, ERK-1/2 and GABAA receptor content in neurones.
Interaction with the gamma-aminobutyric acid receptor (GABA(A)R) complex is recognized as an important component of the mechanism of many anaesthetic agents, including propofol. The aims of this study were to investigate the effect of propofol on GABA(A)R, to determine whether exposure of neurones to propofol influences the localization of GABA(A)R within the cell and to look for cytoskeletal changes that may be connected with activation, such as the mitogen-activated protein kinase (MAPK) pathway. ⋯ We believe that propofol triggers a dose-dependent internalization of the GABA(A)beta(2)-subunit. The increase in internal GABA(A)beta(2)-subunit content exhibits a close relationship to actin polymerization and to an increase in ERK-1/2 activation. Actin contributes to the internalization sequestering of the GABA(A)beta(2)-subunit.