Abstract:
BACKGROUND:Microcirculatory dysfunction has been hypothesized to play a key role in the pathophysiology of multiple organ failure and, consequently, patient outcome. The objective of this study was to investigate the differences in reactive hyperemia response and oscillation frequency in surviving and non-surviving patients with multiple organ dysfunction syndrome. METHODS:Twenty-nine patients (15 survivors; 14 non-survivors) with two or more organ failures were eligible for study entry. All patients were hemodynamically stabilized, and demographic and clinical data were recorded. A laser Doppler flowmeter was used to measure the cutaneous microcirculatory response. Reactive hyperemia and oscillatory changes in the Doppler signal were measured during 3 min before and after a 5-min period of forearm ischemia. RESULTS:Non-survivors demonstrated a significantly higher multiple organ dysfunction score when compared with survivors (P= 0.004). Norepinephrine administration was higher in non-survivors (P= 0.018). Non-survivors had higher arterial lactate levels (P= 0.046), decreased arterial pH levels (P= 0.001) and decreased arterial Po(2) values (P= 0.013) when compared with survivors. A higher oscillation frequency of the skin microvasculature at rest (P= 0.033) and after an ischemic stimulus (P= 0.009) was observed in non-survivors. The flow motion frequency observed in reactive hyperemia was associated with the severity of multiple organ dysfunction (P= 0.009) and, although not statistically significant, with the arterial lactate concentration (P= 0.052). CONCLUSION:Increased skin microvascular oscillation frequency at rest and in the hyperemic state after an ischemic stimulus is associated with increased mortality in patients suffering from multiple organ dysfunction. The underlying mechanism could be a response of the skin microvasculature to an impaired oxygen utilization of the skin tissue.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Knotzer H,Maier S,Dünser M,Stadlbauer KH,Ulmer H,Pajk W,Hasibeder WRdoi
10.1111/j.1399-6576.2007.01336.xsubject
Has Abstractpub_date
2007-07-01 00:00:00pages
701-7issue
6eissn
0001-5172issn
1399-6576pii
AAS1336journal_volume
51pub_type
杂志文章abstract::Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bup...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1985.tb02175.x
更新日期:1985-01-01 00:00:00
abstract::In 20 healthy children undergoing elective surgery, mobility of neutrophils, both unstimulated and stimulated by endotoxin, was studied using a millipore filter system with microscopic determination of leading front migration. Paired samples were incubated with 10(-2) mol l-1 calcium ascorbate and ten children also re...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1987.tb02580.x
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Hypothermia, commonly used for organ protection during cardiopulmonary bypass (CPB), has been associated with changes in plasma volume, hemoconcentration and microvascular fluid shifts. Fluid pathophysiology secondary to hypothermia and the mechanisms behind these changes are still largely unknown. In a rece...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2001.045006720.x
更新日期:2001-07-01 00:00:00
abstract::35S-thiopental 15 mg/kg and 14C-diazepam 5 mg/kg were injected intravenously in separate groups of rats (n = 6) at 1 ATA air and at 71 ATA air-He. Total radioactivity was measured in the brain, liver, kidney, muscle and fat after 1, 3, 5 and 15 min. The thiopental content was significantly reduced at pressure in the b...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1983.tb01982.x
更新日期:1983-12-01 00:00:00
abstract::Venous air embolism during surgery is a rare but important complication and can be rapidly fatal. We present two cases of fatal air embolism in the prone position occurring in small children undergoing surgery for progressive scoliosis. Venous air embolism is a rare complication in the prone position. This is thought ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04839.x
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:propofol is an excellent sedative agent for use in patients undergoing bronchoscopy. The addition of an opioid to propofol can be advantageous because of the antitussive effect of the opioid and the possible improvement in sedation quality. However, it may increase the risk of hypoxaemia. To investigate the ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2010.02336.x
更新日期:2011-01-01 00:00:00
abstract::A large and important group of acid-base disturbances are the metabolic acidoses. In general, every type of metabolic acidosis can be treated with infusion of base when the underlying cause of the disturbances is removed. In our medical centers, the use of tris and bicarbonate is common. For a long time they were comp...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1982.tb01752.x
更新日期:1982-06-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication after cardiac and major non-cardiac surgery with general anaesthesia in the elderly. We hypothesized that the incidence of POCD would be less with regional anaesthesia rather than general. METHODS:We included patients aged over 60 years und...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1034/j.1399-6576.2003.00057.x
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Anaesthesia induction and deep anaesthesia may be accompanied by a considerable haemodynamic depression, especially in patients suffering from cardiovascular diseases. A decrease in cardiac index (CI) leads to a concomitant decrease in oxygen transport (DO2I). We examined whether these changes in haemodynami...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1996.tb04552.x
更新日期:1996-09-01 00:00:00
abstract::N-methyl-D-aspartate (NMDA) receptors are involved in the development of neuropathic pain. Ketamine, a non-competitive NMDA receptor antagonist, has in several case reports given pain relief but efficacy in dosages tolerated in long-term ketamine treatment is unknown. Another substance with an antagonist action at NMD...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04709.x
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Sevoflurane, a potent inhalational anaesthetic agent that is structurally similar to halothane, has some favourable characteristics, but may also be able to trigger malignant hyperthermia (MH) in susceptible patients. The diagnosis of malignant hyperthermia susceptibility relies on the in vitro contracture t...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2000.440320.x
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Laparoscopic hysterectomy (LH) is expected to provide fast and comfortable recovery, plus an early return to normal daily activities. This study was carried out to compare the outcome after LH in patients anesthetized with isoflurane or propofol. METHODS:Sixty-two patients undergoing LH were randomized to r...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1399-6576.1997.tb04699.x
更新日期:1997-03-01 00:00:00
abstract:BACKGROUND:Severe postoperative pain is a well-known problem following shoulder surgery. This study evaluates the clinical efficacy of continuous interscalene brachial plexus block, patient-controlled analgesia, and morphine (i.v. and i.m.) for postoperative analgesia in this setting. METHODS:Thirty patients, schedule...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.1999.430304.x
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:The goal of this study was to explore the ability of professional judgment to predict the need for tracheotomy early among intensive care unit (ICU) patients. METHODS:Prospective study using daily questionnaires among ICU physicians in a mixed medical-surgical ICU. The prediction of tracheotomy was by a vis...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2010.02290.x
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:A controversy exists whether beneficial analgesic effects of epidural analgesia over intravenous analgesia influence the rate of post-operative complications and the length of hospital stay. There is some evidence that favours epidural analgesia following major surgery in high-risk patients. However, there i...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2008.01734.x
更新日期:2008-11-01 00:00:00
abstract::The effects of i.v. infusion of 5% albumin and balanced salt solutions were investigated in a prospective study on 18 patients subjected to reconstruction of the abdominal aorta. The same schedules for blood replacement and intraoperative fluid therapy were followed for all patients. Postoperatively, the amounts of fl...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1981.tb01623.x
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:Ropivacaine is a long-acting local anesthetic with low cardiac toxicity that induces vasoconstriction in vitro and in vivo. Vascular smooth muscle tone is regulated by changes in both intracellular Ca(2+) concentration ([Ca(2+)](i)) and myofilament Ca(2+) sensitivity. Therefore, the aim of this study was to ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2007.01390.x
更新日期:2007-10-01 00:00:00
abstract::The effects of hydralazine, clonidine, propranolol and methyldopa medications on the cardiovascular response to ketamine anaesthesia were studied in spontaneously hypertensive (SH) rats. Except in propranolol- and methyldopa-treated animals, blood pressure was increased by ketamine in all groups. The heart rate was in...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1978.tb01320.x
更新日期:1978-01-01 00:00:00
abstract:BACKGROUND:An intact basement membrane at the dermal-epidermal junction is essential to the viability of the skin. The effect of sepsis on the basement membrane is unknown. METHODS:Skin biopsies were used to study basement membrane structure in severe sepsis (Day 1). Subsequent biopsies were taken on Day 8 and at 3 mo...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12539
更新日期:2015-09-01 00:00:00
abstract::The effects of propofol on right ventricular function were studied in 11 ICU patients who needed sedation for acute respiratory failure or neurological diseases. Right ventricular function was studied using a thermodilution method at patients' bedside. Right ventricular ejection fraction (RVEF), cardiac output (CO), r...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1994.tb03878.x
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Wound infiltration with local anesthetics does not reliably produce satisfactory postoperative analgesia, and the dose of local anesthetic which may be safely administered is limited by the potential for systemic toxicity. This study evaluated the efficacy of a slow-release liposomal bupivacaine formulation ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04666.x
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Our objective was to compare the recovery characteristics of sevoflurane and halothane for short day-case anaesthesia in a specifically limited age group of children 1-3 yr. METHODS:Eighty unpremedicated children undergoing day-case adenoidectomy were randomly assigned to receive inhalational induction with...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1034/j.1399-6576.2000.440118.x
更新日期:2000-01-01 00:00:00
abstract::The effect of nitrous oxide on blood flow in the cerebral cortex, the cerebellum and the brain stem was evaluated in a rat model. Catheters were surgically implanted in advance to avoid influence from other anaesthetics. The animals were housed in a plastic tube where they were allowed to breathe spontaneously. Blood ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1991.tb03389.x
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Impairment of surfactant is involved in development of acute respiratory distress syndrome. To develop artificial surfactant substitute for clinical use, we prepared synthetically reconstituted surfactant (SRS) by adding porcine surfactant-associated protein B and C (SP-B and SP-C) to synthetic phospholipids...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.1999.430807.x
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The Patient Injury Act has been in effect in Finland since 1 May 1987. This legislation is a no-fault compensation scheme and implies that if a patient during the course of medical treatment suffers any injury as a result of that treatment he or she may file a claim to the Patient Insurance Association (PIA)...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04722.x
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:The use of opioids in non-cancer-related pain following skeletal trauma is controversial due to the presumed risk of dose escalation and dependence. We therefore examined the pattern of opioid prescriptions, that is, those actually dispensed, in patients with femoral shaft fractures. METHODS:We analysed dat...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12666
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:In comparison with bupivacaine, ropivacaine exhibits comparable anaesthetic effects but with less motor impairment and systemic toxicity. However, the analgesic potency may differ. For example, ropivacaine during obstetric epidural analgesia provides an approximately 40% lower analgesic potency than bupivaca...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2006.01259.x
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The mortality of patients suffering from acute decompensated liver disease treated in the intensive care unit (ICU) varies between 50% and 100%. Previously published data suggest that liver-specific score systems are less accurate compared with the ICU-specific scoring systems acute physiology and chronic he...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2012.02692.x
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Trauma systems have improved outcomes for injured patients, but might be challenging to implement. We assessed the implementation of a trauma system in Norway after recommendations for a national trauma system were published in 2007, with a focus on elements in acute care hospitals. METHODS:All hospitals in...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12467
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentration...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12897
更新日期:2017-07-01 00:00:00