Abstract:
BACKGROUND:We determined whether whole blood impedance aggregometry using the Multiplate detects the effects of antiplatelet drugs as reliably as does classical light transmission aggregometry (LTA) or the platelet function analyzer PFA-100(R). METHODS:Multiplate (M) assays, measuring changes in electrical resistance as aggregation units over time (AU*min), and LTA assays induced by collagen (COL), adenosine diphosphate (ADP) or arachidonic acid (AA) and PFA-100 testing, using epinephrine (PFA100-EPI) or ADP (PFA100-ADP) cartridges, were performed simultaneously using arterial blood samples obtained before induction of anesthesia in 70 consecutive patients scheduled for elective coronary artery bypass grafting. Patients in group A (n = 48) served as controls, patients in group B (n = 11) received aspirin 100 mg/d and those in group C (n = 11) aspirin 100 mg/d and clopidogrel 75 mg/d until the day before surgery. RESULTS:In controls the median (1st, 3rd quartiles) change in impedance AU*min for M-COL (374 [231-469]) was significantly greater than in patients receiving aspirin (164 [86-211], P = 0.0009) or receiving aspirin and clopidogrel (118 [101-244], P = 0.004). M-ADP values in controls were 258 (158-389), in patients receiving aspirin 261 (159-393), and in patients receiving aspirin and clopidogrel 88 (48-231, P = 0.054). M-AA values were significantly lower in patients receiving aspirin alone (45 [28-60], P = 0.0004) or aspirin and clopidogrel (44 [26-221], P = 0.008) than in controls (200 [86-345]). The areas under the receiver operating characteristic curves indicating the ability to discriminate patients taking aspirin from those not taking aspirin were comparable for COL and AA assays using whole blood impedance aggregometry or classical LTA (M-COL 0.84 [P = 0.001], LTA-COL 0.85 [P = < .001], M-AA 0.84 [P = < .001] and LTA-AA 0.87 [P = < .001]), but only 0.74 for PFA-100-EPI (P = 0.03). Similarly, for discrimination of patients not taking antiplatelet drugs from patients taking clopidogrel and aspirin the areas under the receiver operating characteristic curve were also comparable for both aggregometry methods M-COL 0.77 (P = 0.006), LTA-COL 0.78 (P = 0.004), M-ADP 0.74 (P = 0.015), LTA-ADP 0.73 (P = 0.018). CONCLUSION:Results achieved with the bedside Multiplate assays were not different than those obtained with classical aggregometry for detecting the effects of aspirin and clopidogrel in preoperative patients scheduled for elective cardiac surgery.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Velik-Salchner C,Maier S,Innerhofer P,Streif W,Klingler A,Kolbitsch C,Fries Ddoi
10.1213/ane.0b013e31818524c1subject
Has Abstractpub_date
2008-12-01 00:00:00pages
1798-806issue
6eissn
0003-2999issn
1526-7598pii
107/6/1798journal_volume
107pub_type
杂志文章abstract:UNLABELLED:Selective pulmonary vasodilation is an advantageous therapeutic strategy for cardiac surgical patients with increased pulmonary vascular resistance (PVR) and right ventricular failure. We hypothesized that milrinone, an adenosine-3',5'-cyclic monophosphate (cAMP)-selective phosphodiesterase enzyme (PDE) inhi...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200112000-00018
更新日期:2001-12-01 00:00:00
abstract:UNLABELLED:We selected bis [N-(3,4-diacetoxybenzyl) tropanium-3alpha-yl] glutarate dibromide (TAAC3) from many new tropinyl diester derivatives to evaluate its neuromuscular blocking (NMB) and autonomic side effects on anesthetized rats, rabbits, guinea pigs, cats, pigs, dogs, and monkeys. NMB potency, onset, recovery ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200204000-00020
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Acute renal failure is a frequent complication of sepsis. Hydroxyethyl starch (HES) is widely used in the treatment of such patients. However, the effect of HES on renal function during sepsis remains controversial. We established an in vitro model of tumor necrosis factor-alpha (TNF-alpha)-stimulated human ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181c03c97
更新日期:2010-02-01 00:00:00
abstract::A double-blind comparison of 1.1% lidocaine carbonate and 1.0% lidocaine hydrochloride was carried out in 30 healthy adult patients undergoing upper-extremity surgery under interscalene brachial plexus block. Epinephrine (1:200,000) was added to both solutions just before injection. As compared to lidocaine hydrochlor...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract::Rapid sequence induction and intubation (RSII) and awake tracheal intubation are commonly used anesthetic techniques in patients at risk of pulmonary aspiration of gastric or esophageal contents. Some of these patients may have a gastric tube (GT) placed preoperatively. Currently, there are no guidelines regarding whi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ANE.0b013e3182917f11
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Currently, the monitoring of cardiac output (CO) and stroke volume (SV) is mainly performed using invasive techniques. Therefore, performing CO monitoring noninvasively by means of electrical impedance tomography (EIT) would be advantageous for intensive care. Our hypothesis was that, by means of EIT, it is ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000000241
更新日期:2014-07-01 00:00:00
abstract::To evaluate the effects of succinylcholine on cardiac arrhythmias and serum levels of potassium and catecholamines, dogs with hypoxia alone and with hypoxia and hypercarbia were studied during anesthesia with halothane or enflurane. After the injection of succinylcholine (0.3 mg/kg), cardiac arrhythmias occurred in al...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1987-12-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine, an α(2)-receptor agonist, prolongs analgesia when used in neuraxial and IV blocks. We evaluated the effect of dexmedetomidine added to ropivacaine for tibial nerve block on the duration of the sensory blockade. METHODS:For this prospective, randomized, controlled, double-blind, crossover tr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e318265bab7
更新日期:2012-10-01 00:00:00
abstract::The effects of gestational age (GA) and plasma protein concentrations on the plasma protein binding of fentanyl and alfentanil were studied in preterm and term neonates. Binding experiments were performed using split-cell equilibrium dialysis. Fentanyl and alfentanil concentrations were measured using specific radioim...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199702000-00013
更新日期:1997-02-01 00:00:00
abstract::Tracheal injuries, independent of their origin, may be life-threatening. Surgical repair is regarded as the treatment of choice but has not been compared with other approaches. We hypothesized that defects bridgeable by an artificial airway may enable conservative treatment. We report on five patients with tracheal in...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000140780.14175.5A
更新日期:2005-01-01 00:00:00
abstract::Organ transplantation is a multidisciplinary specialty that has seen remarkable advances in the past two decades, in the tireless pursuit of providing life-saving therapy for patients suffering from end-stage organ failure. As the scientific basis and clinical practice of organ transplantation continues to evolve, it ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199005000-00014
更新日期:1990-05-01 00:00:00
abstract:UNLABELLED:In this randomized, controlled study in dogs, we examined the short-term effects of blood pressure targeted fluid resuscitation with colloids or crystalloids solutions on systemic oxygen delivery, and lactate blood concentration. Fluid resuscitation using hydroxyethyl starch (HES) 6% to a mean arterial blood...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200301000-00009
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Multiple interventions have been tested in models of cardiopulmonary resuscitation (CPR) to optimize drug use, chest compressions, and ventilation. None has studied the effects of positive end-expiratory pressure (PEEP) on outcome. We hypothesized that because PEEP can reverse pulmonary atelectasis, lower pu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181b278a3
更新日期:2009-10-01 00:00:00
abstract::Apnea and airway obstruction are common during monitored anesthesia care (MAC). Because their early detection is essential, we sought to measure the efficacy of capnography as an indicator of apnea during MAC at a variety of oxygen flow rates compared with thoracic impedance. Anesthesia care providers using standard A...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ANE.0000131964.67524.E7
更新日期:2004-08-01 00:00:00
abstract:UNLABELLED:The objective of this study was to evaluate prognostic models for quality assurance purposes in predicting automatically detected intraoperative cardiovascular events (CVE) in 58458 patients undergoing noncardiac surgery. To this end, we assessed the performance of two established models for risk assessment ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000103262.26387.9c
更新日期:2004-03-01 00:00:00
abstract:UNLABELLED:To evaluate the possible effects of outpatient preoperative evaluation (OPE) for new surgical patients who will be inpatients, we conducted an observational study at a university hospital in The Netherlands. Various outcomes before and after the introduction of an OPE clinic were compared. The study populati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200203000-00030
更新日期:2002-03-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,meta分析,评审
doi:10.1213/ANE.0b013e3181cdb081
更新日期:2010-09-01 00:00:00
abstract::A study was undertaken in 15 patients to compare measured and assumed arteriovenous oxygen (A-V O2) content differences and their effects on resultant shunt calculations. All patients were on volume ventilators and demonstrated a stable cardiovascular state. Simultaneous measurements of the O2 content of a pulmonary a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197503000-00008
更新日期:1975-03-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197605000-00005
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199009000-00009
更新日期:1990-09-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181f0c2da
更新日期:2010-10-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/00000539-199377020-00027
更新日期:1993-08-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199706000-00003
更新日期:1997-06-01 00:00:00
abstract::Sevoflurane, 3% and 4% in oxygen was administered to four dogs for 3 hours. Sevoflurane was metabolized to inorganic fluoride and hexafluoroisopropanol. Serum fluoride concentrations reached peak values during 2 to 3 hours into anesthesia and averaged 18.5 micrometer/L (n = 2) and 20.0 +/- 4.8 (mean +/- SD) micrometer...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:Anesthesia induction in children is frequently achieved by inhalation of nitrous oxide and sevoflurane. Pediatric anesthesiologists commonly use distraction techniques such as humor or nonprocedural talk to reduce anxiety and facilitate a smooth transition at this critical phase. There is a large body of suc...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31824d5224
更新日期:2012-11-01 00:00:00
abstract::A newly developed transtracheal Doppler (TTD) computer for cardiac output determination was studied in nine patients after open heart surgery (coronary artery bypass grafting, n = 4; mitral valve replacement, n = 5). The measurements were compared with those simultaneously obtained by thermodilation. Doppler signals w...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199206000-00004
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND:Blood conservation strategies and transfusion guidelines remain a heavily debated clinical topic. Previous investigational trials have shown that acute isovolemic hemodilution does not limit adequate oxygen delivery; however, a true critical hemoglobin level has never been investigated or defined due to safe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002430
更新日期:2018-01-01 00:00:00
abstract::We tested the hypothesis that middle ear pressure (MEP) is influenced by the choice of airway device during anesthesia with or without nitrous oxide (N2O) in the gas mixture. Eighty consecutive anesthetized, paralyzed ventilated patients (ASA physical status I-II, 18-65 yr) were randomly allocated for airway managemen...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ANE.0000180768.81020.C4
更新日期:2006-01-01 00:00:00
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journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/ANE.0000000000000595
更新日期:2015-05-01 00:00:00
abstract::The effects of midazolam on atrial rate and contractile force in the isolated canine atrium perfused with donor blood were investigated. When midazolam in a dose range of 100-1000 micrograms was injected directly into the sinus node artery of the isolated atrium, biphasic (negative followed by positive) chronotropic a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00