Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2019
Observational StudyEffects of fibrinogen and platelet transfusion on coagulation and platelet function in bleeding cardiac surgery patients.
Excessive bleeding is a significant problem in cardiac surgery. Fibrinogen and platelet concentrate transfusion are used clinically to improve haemostasis and reduce bleeding but little is known about their functional effects on coagulation and platelet function in patients with ongoing bleeding. ⋯ The results demonstrate improved coagulation and platelet function following fibrinogen and platelet transfusion in patients bleeding after cardiac surgery.
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Acta Anaesthesiol Scand · Apr 2019
Review Meta AnalysisLactate versus acetate buffered crystalloid solutions: Protocol for a scoping review.
Intravenous (IV) fluid therapy has become a ubiquitous intervention in everyday clinical practice. Several types of fluid are available including isotonic crystalloid fluids. Among crystalloid fluids, buffered solutions (derivatives of the original Hartmann's and Ringer's solutions) are increasingly recommended as first-line resuscitation fluids. However, the choice between different buffered solutions appears to be difficult with limited data to support the use of lactate vs. acetate buffered solutions. Accordingly, we aim at systematically describing the body of evidence on the use of the different types of buffered crystalloid solutions in hospitalised patients. ⋯ This outlined scoping review will provide a summary of the current body of evidence on the use, effects and side-effects of buffered crystalloid solutions. This will provide an important update of the current evidence on the use, of "buffered" crystalloid solutions including evidence of potential benefits and harms.
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Acta Anaesthesiol Scand · Apr 2019
Review Meta AnalysisDopamine in critically ill patients with cardiac dysfunction: A systematic review with meta-analysis and trial sequential analysis.
Dopamine has been used in patients with cardiac dysfunction for more than five decades. Yet, no systematic review has assessed the effects of dopamine in critically ill patients with cardiac dysfunction. ⋯ Evidence for dopamine in critically ill patients with cardiac dysfunction is sparse, of low quality, and inconclusive. The use of dopamine for cardiac dysfunction can neither be recommended nor refuted.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialAdductor canal block with a suture-method catheter - A parallel or perpendicular approach?
We performed a randomised blinded pilot study in 16 healthy volunteers to assess whether placing a suture-method catheter in the adductor canal is feasible with two different insertion techniques. ⋯ The suture-method catheter can be placed in the adductor canal with high success rates for initial placement with both techniques.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialRemote ischaemic preconditioning increases serum extracellular vesicle concentrations with altered micro-RNA signature in CABG patients.
Remote ischaemic preconditioning (RIPC) can attenuate myocardial ischaemia/reperfusion injury but its underlying mechanisms remain largely unknown. Recently, extracellular vesicles (EVs) containing microRNAs (miRNAs) were shown to mediate distant intercellular communication that may be involved in cardioprotection. We tested the hypothesis that RIPC in anaesthetized patients undergoing coronary artery bypass (CABG) surgery results in the release of EVs from the ischaemic/reperfused arm into the blood stream harbouring cardioprotective miRNAs. ⋯ Remote ischaemic preconditioning increases serum EV concentrations, most likely by early EV release from the patients' left (RIPC) arm, alters their miRNA signature, and is associated with myocardial protection. Thus, an increased EV concentration with an altered miR-signature may mediate the RIPC effect.