Abstract:
BACKGROUND:Clinical studies have raised concerns about the safety of 6% hydroxyethylstarch (HES) 130/0.42, but the pathomechanisms of this renal impairment remain unknown. To evaluate the effects of different HES concentrations, molar substitutions and molecular weights in HES-induced renal impairment, we used a porcine two-hit model that combined haemorrhagic and septic shock. METHODS:We conducted a prospective, randomised, double-blinded, controlled study in a university animal laboratory. Thirty anaesthetised and ventilated pigs were randomised to receive volume replacement therapy using 6% HES130/0.42, 6% HES200/0.5, 10% HES130/0.42 or 10% HES200/0.5, all dissolved in 0.9% NaCl rather than 0.9% NaCl alone. First, we bled the animals until they reached half of their baseline mean arterial pressure (MAP) for 45 minutes followed by fluid resuscitation. As a second hit, sepsis was induced using an Escherichia coli-laden clot 6 hours after haemorrhagic shock. Volume resuscitation started with a delay of two hours and a central venous pressure goal of 12 mmHg. RESULTS:At the end of the study, the groups showed no difference in cardiac output or MAP, but the volume balance (mL/kg BW) was significantly higher in the 0.9% NaCl group (346±90; P≤0.05) than in the other groups (6% HES130, 125±26; 6% HES200, 105±15; 10% HES130, 114±17; 10% HES200, 96±23). Creatinine clearance (mL/min) was significantly lower in the 6% HES200 (26±33) and 10% HES200 (15±18) groups compared to the 0.9% NaCl group (104±46; P≤0.05) but not in the HES 130 formulations (6% HES130: 64±51; 10% HES130: 58±38) at the end of the study. CONCLUSION:In this porcine two-hit shock model, treatment with 0.9% NaCl, HES 130/0.42 or HES 200/0.5 led to a similar maintenance of haemodynamic values. Despite this similar maintenance of the haemodynamic values, volume replacement with 6% and 10% HES 200/0.5 led to an accumulation of HES, higher colloid osmotic pressure and significantly reduced renal function after haemorrhagic and septic shock. These facts support the presumption that not the concentration but the degree of substitution and the molecular weight play a decisive role in HES-induced renal impairment.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Simon TP,Thiele C,Schuerholz T,Fries M,Stadermann F,Haase G,Amann KU,Marx Gsubject
Has Abstractpub_date
2015-06-01 00:00:00pages
608-18issue
6eissn
0375-9393issn
1827-1596pii
R02Y9999N00A140946journal_volume
81pub_type
杂志文章abstract::The importance of Ketamine in continuous perfusion is described on the basis of a studied carried out in 30 patients. The clinical data are compared with results predicted by the mathematical model. Special study was made of the behaviour of the cardiocirculatory apparatus, particularly in reference to myocardial cont...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-08-01 00:00:00
abstract::A case of high spinal anesthesia complicating an interscalene brachial plexus block is described. After an apparently straightforward location of the plexus with good paresthesias, the injection of 10 ml of local anesthetic caused a high spinal block whose main feature was apnea. The patient retained his consciousness...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Intranasal dexmedetomidine, although still off-label, recently boasted an increasing consensus for different uses, namely, in diagnostic non-painful procedures, in painful procedures and in surgical premedication. However, at present, there is no consensus regarding indications, dosage and timing for administration. T...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.19.13820-5
更新日期:2019-12-01 00:00:00
abstract::The overall use of allogeneic blood transfusions in clinical practice remains relatively high and still varies widely among centres and practitioners. Moreover, allogeneic blood transfusions have historically been linked with risks and complications: some of them (e.g. transfusion reactions and transmission of pathoge...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. The aim of this study was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anesthesia. METHODS:A prospective...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12720-9
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:The aim was to ascertain the prognostic value of mid-regional pro-adrenomedullin (MR-proADM), measured within 24 hours from the onset of septic shock (SS). METHODS:We performed a prospective, observational study on all patients admitted to our hospital's Intensive Care Unit with SS over a one year period fr...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract::The anesthetic management of a 58 year-old-male suffering from idiopathic pulmonary fibrosis associated with a previous experience of altered dose-response relationship to muscle relaxants is reported. He underwent a gastroendoscopic surgical procedure. After intravenous atropine, remifentanil 3.0 microg kg(-1) was in...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2002-11-01 00:00:00
abstract::A multimodal, rehabilitative, fast discharge approach to abdominal aortic surgery is analyzed. The approach was developed in two phases during the years 1997-2000: in the first phase (1997) patients had thoracic epidural anesthesia plus TIVA and analgesia. They had improvement of the classical surrogate outcomes and a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Patient safety is a top priority in healthcare. Little is known about the visual behavior of professionals during high-risk procedures. The aim of this study was to assess feasibility, usability and safety of eye-tracking to analyze gaze patterns during the extubation process in the intensive care unit. MET...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14468-7
更新日期:2020-11-01 00:00:00
abstract::109 patients who suffered from an episode of acute respiratory failure, necessitated mechanical ventilation (MV) in a general Intensive Care Unit (ICU) and admitted to our Respiratory Intermediate Intensive Unit (RIIU), were retrospectively evaluated for outcome and weaning success. The patients, 69 +/- 9 years old, p...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:The majority of authors and the literature recommend sugammadex dose to be calculated according to RBW without taking fat content into consideration. Our aim was to compare the efficacy and safety of sugammadex at doses of 1.5, 2, and 4 mg/kg, calculated according to ideal body weight basis, for the reversal...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:10.23736/S0375-9393.16.11349-5
更新日期:2017-02-01 00:00:00
abstract::The introduction of use of propofol in the anesthetists' pharmacopoeia has reinvigorated the research for a totally intravenous anaesthesia, for which the Authors propose a diagram. However, in experience related to the supplementary use of N2O, in virtue of its analgesic power, demonstrates yet another utility, permi...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:In an acute care setting, diuretics are often prescribed to maintain or increase urine output in patients presenting with acute kidney injury (AKI). The rationale behind giving diuretics is that they may protect the kidney from ischemic injury by maintaining a nonoliguric state. There have been many studies ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-05-01 00:00:00
abstract::Intraoperative hemodynamic and respiratory data from one-year experience of orthotopic liver transplantation with veno-venous bypass (10 cases) were collected. Seven different phases of OLT was submitted to one way analysis of variance. Variability is due to degree and duration of liver disease. Basal conditions inclu...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Pulse-oximeter is described as the most important technological proceeding for monitoring the patients' safety during anesthesia, after surgery and in emergency. This opinion was widely confirmed in the 1990s when pulse-oximeter has been definitively introduced in the standard for base monitoring in the OR and has bee...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-05-01 00:00:00
abstract::The performance of a precise and safe peripheral nerve blockade (PNB) can currently rely on the aid of the ultrasounds and nerve stimulators. The injection pressure monitoring may be beneficial to perform a safer procedure. This review focuses on the pressures measured during PNB among studies conducted on animal, and...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.19.13518-3
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys agains...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The ideal tidal volume (TV) during one-lung ventilation (OLV) remains controversial. High TVs may increase the incidence of postoperative lung injury after thoracic surgery. There is nonetheless little evidence that the use of low TV during OLV will fail to provide adequate arterial oxygenation. We evaluated...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of two cardiac output measurement methods based on a modified Fick equation, that calculate the O2 consumption (VO2) dividing the CO2 production (VCO2) by a fixed respiratory quotient (RQ). DESIGN:Comparative study. SETTING:One 5 beds general intensive care unit in a 500 beds g...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1995-05-01 00:00:00
abstract::Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuro...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.18.12287-5
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Evidences supporting the use of ICP monitoring after aneurysmal subarachnoid hemorrhage (aSAH) are limited. The aim of our paper is to examine whether elevated intracranial pressure (ICP) and ICP-derived variables predict mortality and functional outcomes after aSAH. METHODS:A systematic review of the liter...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2016-04-05 00:00:00
abstract:BACKGROUND:The analysis of the arterial pulse contour obtained by means of a non-invasive device (Finapres) seems to be an ideal method to measure cardiac output (CO). An individual calibration factor (Z) dimensionally equal to aortic impedence is the necessary pre-requisite to calculate CO by pulse contour analysis. T...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of the modified Harris-Benedict formula predicting Energy Expenditure (EE) in pressure support ventilated, critically ill patient. SETTING:The intensive care unit (ICU) of a teaching hospital. PATIENTS:Fiftyfive patients admitted to ICU for acute respiratory failure, requiring mec...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Although blood gas analysis (BGA) is important for supplemental oxygen titration, it is invasive, intermittent, costly, and burdensome for staff. We assessed whether the Oxygen Reserve Index (ORi™), a novel pulse oximeter-based index that reflects the partial pressure of oxygen (PaO2), could determine the am...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14895-8
更新日期:2020-12-15 00:00:00
abstract:OBJECTIVE:To investigate the relationship between Therapeutic Intervention Scoring System (TISS), length of ICU stay and severity of illness. DESIGN:Prospective study lasting 1 year. SETTING:Two 4-bed surgical-medical ICU. PATIENTS:All consecutively ICU admitted patients. METHODS:Every day TISS of each patient duri...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1997-10-01 00:00:00
abstract:AIM:Microdialysis allows the biochemical analysis of interstitial fluids as a bedside procedure. This technique is of interest to evaluate the glucose dependent metabolism in hypoglycaemic patients. It was the aim to perform subcutaneous and blood microdialysis during hypoglycaemic clamp experiments in 12 healthy young...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract::In 1947 John Bonica as new Chief of Anesthesiology at Tacoma General Hospital organized one of the first around-the-clock labor anesthesia services and when became the first chairman of the new Department of Anesthesiology at the University of Washington (1960), caudal anesthesia was the primary technique used for pro...
journal_title:Minerva anestesiologica
pub_type: 传,历史文章,杂志文章
doi:
更新日期:2005-09-01 00:00:00
abstract::Ahead of Print article withdrawn by publisher Blood brain barrier disruption (BBBD) is a novel technique for treating central nervous system lymphoma. This technique depends on the disruption of the tight junctions between endothelial cells (which represent the blood brain barrier) by intra-arterial injection of manni...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-10-21 00:00:00
abstract:BACKGROUND:The partial pressure of carbon dioxide (pCO2) gap is the difference between pCO2 values in the arterial and mixed venous blood; values higher than six mmHg may be predictive of tissue hypoperfusion. It is still doubtful if central venous blood can be used to assess the gap. This study was aimed to compare th...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.19.13554-7
更新日期:2019-12-01 00:00:00
abstract::Excessive adrenergic stimulation may be associated with several adverse events and contribute to increase mortality in critically ill septic patients. Few clinical data exist on the effects of adrenergic blockade in this setting. The objective of this study was to investigate the effect of a short acting b-blocker (es...
journal_title:Minerva anestesiologica
pub_type: 评论,杂志文章
doi:
更新日期:2014-02-01 00:00:00