Acta anaesthesiologica Scandinavica
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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
Comparative StudyHaemodynamics and cerebral oxygenation during arthroscopic shoulder surgery in beach chair position under general anaesthesia.
Patients undergoing surgery in beach chair position (BCP) are at risk of cerebral ischaemia. We determined the prevalence and risk factors of jugular venous bulb oxygen desaturation (SjvO(2) < 50%) in BCP. It was also examined whether regional cerebral tissue oxygen saturation (SctO(2) ) measured by near-infrared spectroscopy and SjvO(2) are interchangeable for assessment of cerebral oxygenation. ⋯ The incidence of jugular desaturation in BCP was 41%, and P/R anaesthesia and hypotension were associated with its occurrence while undergoing surgery under general anaesthesia. SctO(2) may not replace SjvO(2) for the determination of cerebral oxygenation.
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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.
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Acta Anaesthesiol Scand · Aug 2012
Effect of lipopolysaccharide, cytokines, and catecholamines on brain natriuretic peptide release from human myocardium.
During sepsis and septic shock, elevated plasma concentrations of brain natriuretic peptide (BNP) have been reported but may be related to several underlying mechanisms. The aim of the present experimental study was to investigate the effect of lipopolysaccharide (LPS), tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), interleukin 6 (IL-6), dobutamine (Dobu), epinephrine (Epi), and norepinephrine (Nor) on BNP synthesis by atrial human myocardium in vitro. ⋯ In vitro, LPS, Dobu, Epi, and Nor induced BNP synthesis by human atrial myocardium.