Acta anaesthesiologica Scandinavica
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Transfusion of red blood cells (RBCs) remains controversial in patients with septic shock, but current practice is unknown. Our aim was to evaluate RBC transfusion practice in septic shock in the intensive care unit (ICU), and patient characteristics and outcome associated with RBC transfusion. ⋯ Most patients with septic shock received RBCs during shock, and these patients had higher disease severity and lower haemoglobin levels than those not transfused. In spite of this, mortality did not differ between groups neither in the unadjusted or adjusted analyses. However, neither the design nor the sample size allows us to make inferences about treatment effects, which underlines the need for large randomised, clinical trials on transfusion in septic shock.
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Acta Anaesthesiol Scand · Jul 2012
Thiopental dose requirements for induction of anaesthesia and subsequent endotracheal intubation in patients with complete spinal cord injuries.
Dose requirements of thiopental depend on patient characteristics and infusion rate. We determined thiopental dose requirements for induction of anaesthesia, and the effects of remifentanil on cardiovascular and bispectral index (BIS) responses to tracheal intubation in spinal cord-injured (SCI) patients undergoing general anaesthesia. ⋯ These results suggest that the dose requirements of thiopental for induction of general anaesthesia and subsequent tracheal intubation are reduced in the SCI patients.
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Acta Anaesthesiol Scand · Jul 2012
Haemodynamic stability and pulmonary shunt during spontaneous breathing and mechanical ventilation in porcine lung collapse.
We investigated the haemodynamic stability of a novel porcine model of lung collapse induced by negative pressure application (NPA). A secondary aim was to study whether pulmonary shunt correlates with cardiac output (CO). ⋯ This porcine lung collapse model is reasonably stable in terms of haemodynamics for at least 2 h irrespective of the mode of ventilation. SB achieves higher PaO(2) /FiO(2) and lower Q(va) /Q(t) compared with MV. During SB, Q(va) /Q(t) seems to be less, if at all, affected by CO compared with MV.
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Acta Anaesthesiol Scand · Jul 2012
Comparative StudyAgreement between cardiac outputs by four-dimensional echocardiography and thermodilution method is poor.
The objective of the study was to determine the agreement of cardiac output (CO) measured by four-dimensional echocardiography (4D echo) to simultaneously obtain CO from pulmonary artery catheter (PAC) using thermodilution technique. ⋯ The agreement between COs by 4D echo and standard PAC thermodilution technique was poor. 4D echo underestimates CO as compared with PAC. This is most likely caused by the analysis software or low frame rate inherent to the technique.