Minerva anestesiologica
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Minerva anestesiologica · Dec 2011
Randomized Controlled Trial Comparative StudyGlucose response during craniotomy: propofol-remifentanil versus isoflurane-remifentanil.
Major surgery is associated with a stress response. The aim of this study was to compare the effects of isoflurane or propofol, both supplemented with remifentanil, on the glucose, cortisol and insulin-based stress responses prospectively. ⋯ Isoflurane and propofol, both combined with remifentanil, provided clinically comparable cortisol and insulin responses to surgery in craniotomy operations, whereas propofol attenuated the increase in plasma blood glucose.
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Minerva anestesiologica · Dec 2011
ReviewUse of synthetic colloids in sepsis: a critical review on efficacy, safety and patient benefits.
In this narrative review, the studies and analyses are discussed that pertain to benefits and detriments of synthetic colloids versus natural colloids or crystalloids used for fluid resuscitation in sepsis and septic shock. The relative amount of fluid infusions used to reach clinical or hemodynamic end-points are reviewed, as well as potential toxicity of starch solutions on the kidney. Hence, it cannot be excluded that adverse effects partly offset beneficial hemodynamic effects that are similar to that of natural colloids, so that in most analyses a mortality benefit of synthetic colloid fluid resuscitation in sepsis and septic shock cannot be demonstrated.