Acta anaesthesiologica Scandinavica
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Constituents of vascular endothelial surface layer (glycocalyx), e.g. an anchor protein syndecan-1 (SDC-1), can be detected in plasma in many inflammatory conditions. In inflammation, vascular adhesion protein-1 (VAP-1) is rapidly translocated to the apical side of the endothelial cells and may be released to plasma in a soluble form. We hypothesized that glycocalyx injury coincides with VAP-1 activation on endothelial cells. To test the hypothesis, we measured SDC-1 and VAP-1 levels in 20 patients with septic shock. ⋯ We found increased VAP-1 activity and SDC-1 content in critically ill patients with septic shock. Based on our results, the role of VAP-1 in shock pathogenesis should be studied with semicarbazide-sensitive amine oxidase activity blocking agents and substrate affinity testing.
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Acta Anaesthesiol Scand · Mar 2012
Abnormal pre-operative tests, pathologic findings of medical history, and their predictive value for perioperative complications.
Laboratory tests, electrocardiogram (ECG) and chest X-rays still serve as part of the routine assessment before elective surgery in many institutions, even though there is little evidence of their predictive value relating to perioperative complications. This study investigates the correlation of abnormal findings in pre-operative tests and pathologic findings in the medical history with perioperative complications. ⋯ Our results indicate that age, type of surgery and medical history are appropriate predictors of perioperative complications, whereas abnormalities in laboratory tests seem to have restricted ability in predicting adverse perioperative outcome.
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Acta Anaesthesiol Scand · Mar 2012
Central venous oxygen saturation is a good indicator of altered oxygen balance in isovolemic anemia.
Red blood cell transfusion is done primarily as a means to improve oxygen delivery (DO₂). Current transfusion guidelines are based solely on hemoglobin levels, regardless of actual DO₂ need. As central venous oxygen saturation (ScvO₂) may reflect imbalances in DO₂ and consumption (VO₂) the aim of this study was to investigate the value of ScvO₂ as an indicator of oxygen balance in isovolemic anemia. ⋯ The results of this study show that ScvO₂ reflects changes of VO₂/DO₂ in isovolemic anemia better than Hb alone, therefore it may be used as an additional indicator of blood transfusion in clinical practice.
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Acta Anaesthesiol Scand · Mar 2012
Role of active nitrogen molecules in progression of septic shock.
Active nitrogen molecules are formed as a result of cell metabolism. They are essential for cell metabolism, but when produced in excess, they contribute to the pathogenesis of several disease processes. These nitrogen molecules play an important role in vascular instability of septic shock. This study was planned to detect the role of active nitrogen molecules in the progression of septic shock. ⋯ Plasma No₂-/No₃- and TNF-α levels were high in patients with sepsis and septic shock, which increased with severity of sepsis.
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Acta Anaesthesiol Scand · Mar 2012
Randomized Controlled TrialEffects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty: a randomized study.
Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We hypothesized that the adductor-canal-blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo. ⋯ The adductor-canal-blockade significantly reduced morphine consumption and pain during 45 degrees flexion of the knee compared with placebo. In addition, the adductor-canal-blockade significantly enhanced ambulation ability assessed by the TUG test.