Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2013
Metabolic effects of three different inotropic strategies in the newborn piglet myocardium.
Neonates undergoing congenital heart surgery frequently need post-operative inotropic support. Knowledge about the effect of inotropes on myocardial metabolism in the newborn heart is limited, and the choice of inotropic therapy is based mainly on evidence from studies in adults. The aim of this study was to compare the effect of three inotropic strategies on the myocardial metabolism in a neonatal pig model. ⋯ Milrinone and adrenaline induced significantly higher lactate levels in neonatal piglets. The increase was not caused by myocardial ischaemia, but rather due to a beta-stimulation-induced glycolysis.
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Acta Anaesthesiol Scand · Apr 2013
Minimal alveolar concentration of sevoflurane for maintaining bispectral index below 50 in morbidly obese patients.
Morbid obesity is associated with important differences in pharmacokinetics and pharmacodynamics. The aim of this study was to determine minimum alveolar concentration of sevoflurane for maintaining bispectral index (BIS) below 50 (MACBIS50 ) in morbidly obese patients undergoing bariatric surgery using the Continual Reassessment Method (CRM) method. ⋯ The calculated values (1.8% and 1.6%) were higher than that previously reported in normal adult patients (0.97%; 95% CI 0.89-1.1%) and less than that reported in children (2.8%; 95% CI 2.7-3.1%).
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Acta Anaesthesiol Scand · Apr 2013
Case ReportsAtypical upswing at initial part of phase III in capnograms due to technical cause.
We sporadically experienced three paediatric cases of atypical upswing at the initial part of phase III in the capnograms via side-stream capnometer immediately following endotracheal intubation and mechanical ventilation. No fault was found in the monitor or anaesthetic system including breathing circuits, carbon dioxide (CO2 ) sampling tube, water trap, and unidirectional valves. The upsurge of CO2 disappeared with increasing the respiratory rate; however, it reappeared with decreasing the respiratory rate and vice versa. We experimentally reproduced the phenomenon of overshooting CO2 measurement after the luer lock connection of the sample gas line at the water trap had been unscrewed a little bit.
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Acta Anaesthesiol Scand · Apr 2013
The effect of the molecular adsorbent recirculating system on moxifloxacin and meropenem plasma levels.
Adequate plasma antibiotic concentrations are necessary for effective elimination of invading microorganism; however, extracorporeal organ support systems are well known to alter plasma concentrations of antibiotics, requiring dose adjustments to achieve effective minimal inhibitory concentrations in the patient's blood. ⋯ Our data provide evidence that moxifloxacin and meropenem are effectively removed from the patient's blood by MARS, leading to low plasma levels. Dose adjustments of both antibiotic compounds may be required.