Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2013
PaO2 oscillations caused by cyclic alveolar recruitment can be monitored in pig buccal mucosa microcirculation.
Cyclic alveolar recruitment and derecruitment play a role in the pathomechanism of acute lung injury and may lead to arterial partial pressure of oxygen (PaO(2) ) oscillations within the respiratory cycle. It remains unknown, however, if these PaO(2) oscillations are transmitted to the microcirculation. The present study investigates if PaO(2) oscillations can be detected in the pig buccal mucosa microcirculation. ⋯ The present study suggests that PaO(2) oscillations caused by cyclic recruitment and derecruitment were transmitted to the buccal mucosa microcirculation. This non-invasive approach of measuring oxygen waves as a surrogate parameter of cyclic recruitment and derecruitment could be used to monitor PaO(2) oscillations at the bedside.
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Acta Anaesthesiol Scand · Mar 2013
Fluctuations in sedation levels may contribute to delirium in ICU patients.
Delirium in patients admitted to the intensive care unit (ICU) is a serious complication potentially increasing morbidity and mortality. The aim of this study was to investigate the impact of fluctuating sedation levels on the incidence of delirium in ICU. ⋯ Fluctuations in sedation levels may contribute to development of delirium in ICU patients. The risk of developing delirium might be reduced by maintaining a stable sedation level or by non-sedation.
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Acta Anaesthesiol Scand · Mar 2013
Comparative StudyRegional venous oxygen saturation versus mixed venous saturation after paediatric cardiac surgery.
Central venous oxygen saturation (ScvO2) remains the gold standard surrogate for tissue oxygen extraction in paediatric cardiac surgery. Near-infrared spectroscopy (NIRS) has been developed as a non-invasive diagnostic tool for regional oxygen saturation. The aim was to compare regional oxygen saturation measured by NIRS with ScvO2 in postoperative paediatric cardiac patients. ⋯ The regional oxygen saturation of brain and kidney did not match ScvO2 as estimation of global tissue perfusion. Nevertheless, NIRS may still provide information regarding regional circulation that may help in the management of neonatal cardiac surgery patients.
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Acta Anaesthesiol Scand · Mar 2013
Patient perspectives on informed consent for anaesthesia and surgery: American attitudes.
Principles of informed consent are ethically, morally, and legally grounded in physicians' responsibility to patients. This study examined patient expectations regarding the informed consent during the perioperative process, specifically risk information exchange, preferred method and timing of delivery, and the roles that patient anxiety and understanding might play. ⋯ Greater awareness of patient preferences and expectations may result in better information exchange between anaesthesia providers and their patients.
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Acta Anaesthesiol Scand · Mar 2013
Sevoflurane induces short-term changes in proteins in the cerebral cortices of developing rats.
Exposure to intravenous or inhaled anesthetic agents has potential deleterious effects on the developing brain. However, the mechanisms are not clear. Herein, we investigated protein expression changes in neonatal rat brains after exposure to sevoflurane, an inhalational anesthetic commonly used for pediatric patients. ⋯ These findings suggest that sevoflurane may cause short-term neuronal apoptosis and disturbances of neuronal migration, differentiation and energy metabolism in neonatal rat brains, and that these disturbances may contribute to its neurodegenerative effects.