Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2009
Clinical TrialGastrointestinal symptoms in intensive care patients.
Gastrointestinal (GI) problems are not uniformly assessed in intensive care unit (ICU) patients and respective data in available literature are insufficient. We aimed to describe the prevalence, risk factors and importance of different GI symptoms. ⋯ GI symptoms occur frequently in ICU patients. Absence of bowel sounds and GI bleeding are associated with impaired outcome. Prevalence of GI symptoms at the first day in ICU predicts the mortality of the patients.
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Acta Anaesthesiol Scand · Mar 2009
Recombinant factor VIIa and fibrinogen display additive effect during in vitro haemodilution with crystalloids.
Major blood loss requires fluid resuscitation for maintaining hemodynamic stability. Excessive volume infusions predispose to dilutional coagulopathy through loss, consumption and dilution of cells and proteins involved in haemostasis. Further treatment with fibrinogen concentrate and/or recombinant activated factor VII (rFVIIa) may be initiated, although the haemostatic effects in a situation with haemodilution are not fully detailed. The present study evaluates haemostatic effect of fibrinogen and rFVIIa and their combination in an in vitro model of haemodiluted whole blood with two commonly used crystalloids. ⋯ The combination of fibrinogen and rFVIIa displays an additive effect and improves overall in vitro whole blood clot formation in a model of in vitro crystalloid-induced haemodilution.
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Acta Anaesthesiol Scand · Mar 2009
Case ReportsIntracerebral monitoring in comatose patients treated with hypothermia after a cardiac arrest.
Induced mild hypothermia (32-34 degrees C) has proven to reduce ischemic brain injury and improve outcome after a cardiac arrest (CA). The aim of this investigation was to study the occurrence of increased intracranial pressure (ICP) and neurochemical metabolic changes indicating cerebral ischemia, after CA and cardiopulmonary resuscitation (CPR), when induced hypothermia was applied. ⋯ Intracerebral microdialysis and ICP monitoring may be used in selected patients not requiring anticoagulants and PCI to obtain information regarding the common disturbances of intracranial dynamics after CA. The results of this study underline the importance of inducing hypothermia quickly after CA and emphasize the need for developing tools for guidance of the re-warming.
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Acta Anaesthesiol Scand · Mar 2009
Clinical TrialMajor complications after 400 continuous popliteal sciatic nerve blocks for post-operative analgesia.
A continuous popliteal sciatic nerve block (CPSNB) has been performed with increasing frequency for post-operative analgesia after foot surgery. Major complications associated with the placement of a perineural catheter remain rarely studied. The aim of this study was to prospectively determine the incidence of major complications (neurological and infectious) in post-operative adult patients with a continuous popliteal catheter inserted by the anatomical posterior approach for analgesia after foot surgery. ⋯ Major complications after the use of CPSN are not in fact rare. The incidence of severe neuropathy or infection complications is, respectively, 0.50% and 0.25%. However, the insertion of CPSN could be considered effective and is associated with only a few minor complications.