Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2011
Randomized Controlled Trial Multicenter StudyScandinavian glutamine trial: a pragmatic multi-centre randomised clinical trial of intensive care unit patients.
Low plasma glutamine concentration is an independent prognostic factor for an unfavourable outcome in the intensive care unit (ICU). Intravenous (i.v.) supplementation with glutamine is reported to improve outcome. In a multi-centric, double-blinded, controlled, randomised, pragmatic clinical trial of i.v. glutamine supplementation for ICU patients, we investigated outcomes regarding sequential organ failure assessment (SOFA) scores and mortality. The hypothesis was that the change in the SOFA score would be improved by glutamine supplementation. ⋯ In summary, a reduced ICU mortality was observed during i.v. glutamine supplementation in the PP group. The pragmatic design of the study makes the results representative for a broad range of ICU patients.
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Acta Anaesthesiol Scand · Aug 2011
Randomized Controlled TrialEffect of PEEP on regional ventilation during laparoscopic surgery monitored by electrical impedance tomography.
Anesthesia per se and pneumoperitoneum during laparoscopic surgery lead to atelectasis and impairment of oxygenation. We hypothesized that a ventilation with positive end-expiratory pressure (PEEP) during general anesthesia and laparoscopic surgery leads to a more homogeneous ventilation distribution as determined by electrical impedance tomography (EIT). Furthermore, we supposed that PEEP ventilation in lung-healthy patients would improve the parameters of oxygenation and respiratory compliance. ⋯ The effect of anesthesia, pneumoperitoneum, and different PEEP levels can be evaluated by EIT-based COV monitoring. An initial recruitment maneuver and a PEEP of 10 cmH(2)O preserved homogeneous regional ventilation during laparoscopic surgery in most, but not all, patients and improved oxygenation and respiratory compliance.