Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2012
Randomized Controlled Trial Comparative StudyRelationship between positive end-expiratory pressure and internal jugular vein cross-sectional area.
Application of positive end-expiratory pressure (PEEP) has been used to increase the cross-sectional area (CSA) of the right internal jugular vein (IJV) in order to facilitate catheterisation. We aimed to determine the PEEP level at which the maximum increase of CSA occurred. ⋯ The application of PEEP effectively increases the CSA of the right IJV. The PEEP giving the largest CSA is 12 cm H(2) O.
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Acta Anaesthesiol Scand · Aug 2012
Pleural effusion decreases left ventricular pre-load and causes haemodynamic compromise: an experimental porcine study.
Although pleural effusion is a common complication in critically ill patients, detailed knowledge is missing about the haemodynamic impact and the underlining mechanisms. The aim of this study was to evaluate the haemodynamic effect of incremental pleural effusion by means of invasive haemodynamic parameters and transthoracic echocardiography. ⋯ Incremental volumes of unilateral pleural effusion induced a significant haemodynamic impact fully reversible after drainage. Pleural effusion causes a significant decrease of left ventricular pre-load in a diverse picture of haemodynamic compromise.
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Acta Anaesthesiol Scand · Aug 2012
Desflurane-induced and ischaemic postconditioning against myocardial infarction are mediated by Pim-1 kinase.
Anaesthetic-induced (APOST) and ischaemic postconditioning (IPOST) against myocardial infarction are mediated via phosphatidylinositol-3-kinase/Akt. Pim-1 kinase is acting downstream of Akt and has recently been demonstrated to enhance cardiomyocyte survival. We tested the hypothesis that both APOST and IPOST are mediated by Pim-1 kinase. ⋯ These data suggest that Pim-1 kinase mediates both desflurane-induced postconditioning and IPOST in mice.
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Acta Anaesthesiol Scand · Aug 2012
Oxygen transport and mitochondrial function in porcine septic shock, cardiogenic shock, and hypoxaemia.
The relevance of tissue oxygenation in the pathogenesis of organ dysfunction during sepsis is controversial. We compared oxygen transport, lactate metabolism, and mitochondrial function in pigs with septic shock, cardiogenic shock, or hypoxic hypoxia. ⋯ We conclude that despite shock and renal hypoperfusion, tissue hypoxia is not a major pathophysiological issue in early and established faecal peritonitis. The reasons for reduced skeletal muscle tissue ATP levels in the presence of well-preserved in-vitro muscle mitochondrial respiration should be further investigated.
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Acta Anaesthesiol Scand · Aug 2012
Measuring the effects of sevoflurane on electroencephalogram using sample entropy.
Monitoring the effect of anesthetic drugs on the neural system is a major ongoing challenge for anesthetists. During the past few years, several electroencephalogram (EEG)-based methods such as the response entropy (RE) as implemented in the Datex-Ohmeda M-Entropy Module have been proposed. In this paper, sample entropy is used to quantify the predictability of EEG series, which could provide an index to show the effect of sevoflurane anesthesia. The dose-response relation of sample entropy is compared with that of RE. ⋯ The results demonstrate that sample entropy can estimate the sevoflurane drug effect on the EEG more effectively than the commercial RE index with a stronger noise resistance.