Acta anaesthesiologica Scandinavica
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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.
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Acta Anaesthesiol Scand · Apr 2019
Predictive performance of a new pharmacokinetic model for propofol in underweight patients during target-controlled infusion.
In a previous study, the modified Marsh and Schnider models respectively showed negatively- and positively-biased predictions in underweight patients. To overcome this drawback, we developed a new pharmacokinetic propofol model-the Choi model-for use in underweight patients. In the present study, we evaluated the predictive performance of the Choi model. ⋯ The new propofol pharmacokinetic model (the Choi model) developed for underweight patient showed adequate performance for clinical use.
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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 AnalysisDexmedetomidine for the management of delirium in critically ill patients-A protocol for a systematic review.
Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially treat delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in the management of delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the management of delirium. ⋯ This systematic review can potentially aid clinicians in decision making and benefit the many critically ill patients developing delirium.
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Acta Anaesthesiol Scand · Apr 2019
Review Meta AnalysisDexmedetomidine for the prevention of delirium in critically ill patients - A protocol for a systematic review.
Delirium is a common complication in critically ill patients and carries an increased risk of mortality and morbidity. Dexmedetomidine can potentially prevent delirium by diminishing predisposing factors. The evidence regarding the use of dexmedetomidine in preventing delirium is conflicting. This protocol aims to identify the beneficial and harmful effects of dexmedetomidine in the prevention of delirium. ⋯ This systematic review can potentially aid clinicians in decision-making and benefit the many critically ill patients at risk of delirium.