Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2020
Randomized Controlled Trial Multicenter StudyHypothermic to ischaemic ratio and mortality in post cardiac arrest patients.
We studied the associations between ischemia and hypothermia duration, that is, the hypothermic to ischemic ratio (H/I ratio), with mortality in patients included in a trial on two durations of targeted temperature management (TTM) at 33°C. ⋯ We did not find any consistent evidence of a modification of the effect of TTM based on ischemia duration.
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Acta Anaesthesiol Scand · Apr 2020
Randomized Controlled TrialFlow-controlled ventilation improves gas exchange in lung-healthy patients - a randomised interventional cross-over study.
Flow-controlled ventilation (FCV) is a new ventilation mode that provides constant inspiratory and expiratory flow. FCV was shown to improve gas exchange and lung recruitment in porcine models of healthy and injured ventilated lungs. The primary aim of our study was to verify the influences of FCV on gas exchange, respiratory mechanics and haemodynamic variables in mechanically ventilated lung-healthy patients. ⋯ Flow-controlled ventilation improves oxygenation and carbon dioxide elimination within a short time, compared to VCV with identical tidal volume, inspiratory plateau pressure and end-expiratory pressure.
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Acta Anaesthesiol Scand · Apr 2020
Randomized Controlled TrialHypervolemia does not cause degradation of the endothelial glycocalyx layer during open hysterectomy performed under sevoflurane or propofol anesthesia.
Fluid-induced hypervolemia may stimulate the release of natriuretic peptides and cause degradation (shedding) of the endothelial glycocalyx layer. Sevoflurane is believed to protect the glycocalyx, but the importance of using sevoflurane to prevent shedding during routine surgery is unclear. ⋯ No relevant elevations of brain natriuretic peptide or degradation products of the glycocalyx layer were observed when hypervolemia was induced during open abdominal hysterectomy performed with sevoflurane or propofol anesthesia. Plasma volume expansion from Ringer´s lactate was pronounced.
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Acta Anaesthesiol Scand · Mar 2020
Randomized Controlled Trial Multicenter StudyHyperoxia and antioxidants during major non-cardiac surgery and risk of cardiovascular events: Protocol for a 2x2 factorial randomised clinical trial.
Myocardial injury after non-cardiac surgery occurs in a high number of patients, resulting in increased mortality in the post-operative period. The use of high inspiratory oxygen concentrations may cause hyperoxia, which is associated with impairment of coronary blood flow. Furthermore, the surgical stress response increases reactive oxygen species, which is involved in several perioperative complications including myocardial injury and death. Avoidance of hyperoxia and substitution of reactive oxygen species scavengers may be beneficial. Our primary objective is to examine the effect of oxygen and added antioxidants for prevention of myocardial injury assessed by area under the curve for troponin measurements during the first three post-operative days. ⋯ The current trial will provide further evidence for clinicians on optimal administration of perioperative oxygen in surgical patients with cardiovascular risks and the clinical effects of two common antioxidants.
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Acta Anaesthesiol Scand · Mar 2020
Randomized Controlled TrialIntra- and inter-Individual variability in nerve block duration: A randomised cross-over trial in the common peroneal nerve of healthy volunteers.
The reported variation in nerve block duration is considerable. To individualize nerve block therapy, knowledge of the intra- vs inter-individual variability is essential. We investigated the relative contribution of these 2 parameters to the overall nerve block duration variability. ⋯ The intra-individual variability is a substantially minor contributor to the overall variability in sensory nerve block duration compared with the inter-individual variability.