Abstract:
BACKGROUND:Plasma-free volume replacement in haemorrhage often results in dilutional coagulopathy. Prothrombin time index (PTI) and activated partial thromboplastin time (aPTT) are used for monitoring haemostasis but have not yet been clinically evaluated. Our aim was to investigate the effects of haemodilution on the course of global coagulation tests and clotting factors (CFs). METHODS:Blood samples from each of 10 volunteers were diluted with sodium chloride 0.9% (saline) or 6% hydroxyethyl starch 130/0.4 (HAES) by 30-80%. PTI, aPTT, CF, and the thrombelastometric parameters (ROTEM(®)) coagulation time (CT) and maximum clot firmness (MCF) were determined. RESULTS:Dilution-dependent CF decreased in an almost linear manner and was not influenced by the diluent. Critically low activities for CF of ∼30% and a fibrinogen concentration <100 mg dl(-1) were measured at dilutions of between 60% and 75%. Critically low CF activities of about 30% were indicated by a PTI of 35-40%. PTI and MCF decreased continuously, demonstrating a good correlation with CF activities and fibrinogen. aPTT and CT showed a linear course up to a dilution of 65-75% corresponding to CF activities of 30-40%. Thereafter, values became pathological. PTI and aPTT were not influenced by the type of diluent, whereas the diluents had profound differences on results of thromboelastometry. CONCLUSIONS:PTI and MCF are useful for monitoring dilution and intervention points. aPTT and CT reflect intervention points when showing pathological values. The type of diluents does not seem to interfere with PTI and aPTT, but HAES impairs haemostasis in ROTEM(®) more profoundly than saline.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Weiss G,Lison S,Spannagl M,Heindl Bdoi
10.1093/bja/aeq199subject
Has Abstractpub_date
2010-10-01 00:00:00pages
429-36issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33468-2journal_volume
105pub_type
杂志文章abstract::Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev034
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectiv...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1093/bja/aeu401
更新日期:2015-04-01 00:00:00
abstract::We evaluated the use of an inexpensive trans-illuminating light wand for tracheal intubation. Expertise in its use was acquired quickly, thereby providing successful per-oral intubation in all patients who were able to open the mouth, irrespective of the view obtained of the epiglottis and larynx. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.5.494
更新日期:1989-05-01 00:00:00
abstract::Fentanyl or alfentanil, in doses approximating to those used in clinical practice, was added to the priming fluid of an extracorporeal circuit before the institution of cardiopulmonary bypass (CPB). The concentrations of both drugs in the priming fluid were measured over a 20-min period. The concentration of fentanyl ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/58.9.947
更新日期:1986-09-01 00:00:00
abstract::Percutaneous tracheostomy is being used increasingly in the intensive care unit and endoscopic control of this procedure affords an improved level of safety. Training in such new minimal access techniques can be a significant risk factor in patient outcome. Surgical simulation provides training which minimizes this ri...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/81.3.401
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/aep300
更新日期:2009-12-01 00:00:00
abstract::We gave either midazolam or propofol for induction of anaesthesia to 140 ASA I or II female patients (18-60 yr). ED50 values were obtained by probit analysis for three clinical end-points: loss of response to command; loss of eyelash reflex; failure to respond to application of an anaesthetic face mask delivering 1% i...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/69.3.240
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:The aim of this study was to test if intraoperative administration of N(2)O during propofol-remifentanil anaesthesia prevented the onset of postoperative opioid-induced hyperalgesia (OIH). METHODS:Fifty adult ASA I-II patients undergoing elective open septorhinoplasty under general anaesthesia were studied....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer323
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aeu001
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Single-lung ventilation in infants and small children is challenging because suitable sizes of double-lumen cuffed tracheal tubes are not available. A 6-yr-old child required pulmonary saline washout for primary alveolar proteinosis, and therefore needed sequential single-lung ventilation in order to achieve...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev305
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Psychological factors are thought to drive inter-patient variations in anaesthetic and analgesic requirements. This cross-sectional study investigated whether preoperative psychological factors can predict anaesthetic requirements and postoperative pain. METHODS:Before total thyroidectomy, 100 consecutive w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer305
更新日期:2012-01-01 00:00:00
abstract::We have compared the postoperative morphine requirements and analgesic efficacy of four doses of i.m. ketorolac 30 mg administered 6-hourly with placebo in a double-blind study of patients undergoing major or minor orthopaedic surgery. During the 24-h postoperative study period which began at the end of surgery, patie...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/69.1.19
更新日期:1992-07-01 00:00:00
abstract::We have compared the anaesthetic and analgesic efficacy of levobupivacaine with that of racemic bupivacaine in 66 male patients undergoing ambulatory primary inguinal herniorrhaphy. Patients were allocated randomly in a double-blind manner to local infiltration anaesthesia (0.25% w/v 50 ml) with either racemic bupivac...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/82.2.280
更新日期:1999-02-01 00:00:00
abstract::This study tests the hypothesis that naloxone, but not its quarternary salt, naloxone methiodide (which does not enter the central nervous system), improves recovery from myocardial stunning in conscious dogs. Twenty dogs were chronically instrumented for measurement of heart rate, left atrial, aortic and left ventric...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.4.545
更新日期:2001-04-01 00:00:00
abstract::We have compared the viability criteria of muscle bundles used in the in vitro contracture test for susceptibility to malignant hyperthermia (MH) in a group of 28 patients with various neuromuscular diseases (NMD) and 93 MH-related family patients. In the patients with NMD, this standard test gave one positive, six eq...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/72.1.93
更新日期:1994-01-01 00:00:00
abstract::We report two patients who developed skin necrosis following an intramuscular injection of non-steroidal anti-inflammatory drug into the anteriolateral area of their thigh. Both patients required further multiple operations and one developed life threatening septicaemia. They were left with disfiguring scars. Skin nec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/88.1.139
更新日期:2002-01-01 00:00:00
abstract::We prospectively studied spontaneous recovery from cisatracurium-induced neuromuscular block in 18 patients scheduled for cardiac surgery, and its suitability for fast-track cardiac surgery. Neuromuscular block was induced by an i.v. bolus (range 0.15-0.3 mg kg(-1)) and maintained by a continuous infusion (range 1.1-3...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/86.1.130
更新日期:2001-01-01 00:00:00
abstract::Blood loss and the frequency of vomiting were assessed at 88 spontaneous vertex deliveries. An i.v. injection of oxytocin 10 u was as effective as ergometrine 0.5 mg in controlling bleeding from the uterus after delivery. The continuous infusion of a dilute solution of oxytocin in the first stage of labour was not fol...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/51.2.113
更新日期:1979-02-01 00:00:00
abstract::As constant hypoxaemia itself may trigger development of apnoea and periodic breathing, we have studied the effect of oxygen therapy on the occurrence of late postoperative episodic hypoxaemia. Thirty-five patients without cardiopulmonary disease and undergoing elective total hip replacement were monitored with a puls...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1992-01-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/68.5.527
更新日期:1992-05-01 00:00:00
abstract::Patients receiving opioids report feeling sleepy, but opioids actually inhibit the rapid eye movement phase of sleep (REM). Inhibition of REM sleep is followed by a rebound increase in REM sleep associated with cardiopulmonary complications. The medial pontine reticular formation (mPRF) is a brain region from which mo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/74.2.188
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:With the increasing prevalence of children who are overweight and with obesity, anaesthesiologists must determine the optimal dosing of medications given the altered pharmacokinetics and pharmacodynamics in this population. We therefore determined the single dose of dexmedetomidine that provided sufficient s...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.11.037
更新日期:2021-01-22 00:00:00
abstract::The majority of patients with acute respiratory distress syndrome (ARDS) require mechanical ventilation. This support provides time for the lungs to heal, but the adverse effects of mechanical ventilation significantly influence patient outcome. Traditionally, these were ascribed to mechanical effects, such as haemody...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeh031
更新日期:2004-02-01 00:00:00
abstract::Seven patients are described in whom a prophylactic blood patch was instituted within 15 min of accidental dural puncture. Five of the patients received extradural anaesthesia before the blood patch, and one after the blood patch had been performed. In three of these patients further "top-up" doses of local anaestheti...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.5.538
更新日期:1985-05-01 00:00:00
abstract::Arterial blood and expired gas samples were taken from 20 patients before operation and on the first day after upper abdominal surgery. After operation the patients were studied breathing air and also breathing 35% oxygen from a venturi-type mask. Preoperative Pao2 with age was exaggerated by operation. Pao2 after ope...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.4.491
更新日期:1975-04-01 00:00:00
abstract::General anaesthesia for emergency surgery in a pressurized habitat is likely to involve the use of i.v. agents. The anaesthetic property of such agents is known to be antagonized by pressure, but the effect on their duration of action is not easily predicted. The recovery of mice from a single i.v. dose of Althesin, k...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.5.455
更新日期:1981-05-01 00:00:00
abstract::Twenty consecutive patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) were allocated at random to group 1 (n = 10, high inspired oxygen fraction (FIO2) after CPB), or group 2 (n = 10, moderate FIO2 after CPB). The effects of each FIO2 on arterial and mixed venous concentrations of endothelin-1 (ET-1...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2000-05-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/65.3.415
更新日期:1990-09-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.99
更新日期:1996-01-01 00:00:00
abstract::The relative analgesic efficacy and side-effect profile of peripheral nerve blockade (PNB) techniques compared with lumbar epidural analgesia for major knee surgery is unclear. We undertook a systematic review and meta-analysis of all randomized trials comparing epidural analgesia with PNB for major knee surgery. Eigh...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1093/bja/aem373
更新日期:2008-02-01 00:00:00