Abstract:
:In the developed world, an increasing number of patients receive therapy with vitamin K antagonists (VKA). This group of patients poses an additional challenge in the perioperative management of emergency surgery and trauma. The present review offers a detailed description of some treatment options for reversal of VKA therapy. Optimal treatment of the anticoagulated patient requires a well-balanced intervention securing a reduced risk of haemorrhagic surgical complications as well as optimal anticoagulation post-operatively without exposing the patient to an increased risk of thromboembolic complications. The following factors must be considered in VKA-treated patients scheduled for emergency surgery: (1) the indication for VKA therapy, including the risk of thromboembolic events when the International normalized ratio (INR) is reduced, (2) type of surgery, including the risk of haemorrhagic complications and (3) the pharmacodynamic/-kinetic profile of the therapy used to revert the VKA therapy. Therapeutic options for acute reversal of VKA therapy include: vitamin K, fresh frozen plasma (FFP), prothrombin complex concentrate (PCC) and perhaps activated recombinant factor VII. PCC is a relatively new drug in some European countries and clinical experience is limited compared with the use of FFP. Reversal of VKA anticoagulation with PCC is faster and more efficient compared with FFP, but there are currently no randomized studies demonstrating an improved clinical outcome.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Vang ML,Hvas AM,Ravn HBdoi
10.1111/j.1399-6576.2011.02414.xsubject
Has Abstractpub_date
2011-05-01 00:00:00pages
507-16issue
5eissn
0001-5172issn
1399-6576journal_volume
55pub_type
杂志文章,评审abstract:BACKGROUND:A propofol target-controlled infusion (TCI) is often proposed for the management of difficult airway intubation and fibreoptic intubation under anaesthesia and spontaneous ventilation. No data are available about sevoflurane. The aim of the present study was to compare propofol and sevoflurane as hypnotics d...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2006.01186.x
更新日期:2007-01-01 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:Anaphylactoid reactions in anaesthesia are rare and should ideally be investigated in specialist centres. At Gentofte University Hospital, we established such a centre in 1998 as a joint venture between the Departments of Anaesthesiology and Dermatology. We present the methodology, diagnostic algorithm and p...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2001.451005.x
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:To give prophylactics or timely treatment for post-operative nausea and vomiting (PONV) is the question. We compared the intensity and number of disturbing post-operative symptoms (i.e. pain, PONV, headache, fatigue, etc.) after prophylactic antiemetic treatment in a group of patients with >30% risk for post...
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:10.1111/j.0001-5172.2004.00403.x
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Short-term infusion of NG-monomethyl-L-arginine (L-NMMA) reversibly inhibits endogenous nitric oxide (NO) production in humans. We studied responses to more long-lasting (60 min) infusions, at doses high enough to cause effective inhibition of endogenous NO. METHODS:Eight healthy volunteers had catheters (p...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04852.x
更新日期:1997-10-01 00:00:00
abstract::The haemodynamic effects of vecuronium and pancuronium were studied in 20 healthy patients during diazepam/ketamine anaesthesia. Anaesthesia was induced with glycopyrrolate 3 micrograms/kg, diazepam 0.3 mg/kg and ketamine 1.0 mg/kg as a bolus and 1.0 mg/kg over 10 min. After induction, anaesthesia was maintained with ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1984.tb02095.x
更新日期:1984-08-01 00:00:00
abstract:BACKGROUND:The clinical use of epidural analgesia has changed over past decades. Minimally invasive surgery and emergence of alternative analgesic techniques have led to an overall decline in its use. In addition, there is increasing awareness of the patient-specific risks for complications such as spinal haematoma and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13219
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Morbid obesity is associated with important differences in pharmacokinetics and pharmacodynamics. The aim of this study was to determine minimum alveolar concentration of sevoflurane for maintaining bispectral index (BIS) below 50 (MACBIS50 ) in morbidly obese patients undergoing bariatric surgery using the ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12038
更新日期:2013-04-01 00:00:00
abstract::Including a venturi injector in a Magill breathing attachment reduces the requirement of compressed gases to 40% of that normally used: 100-120 ml x kg-1 x min-1. The entrainment of ambient air through the venturi injector enables the supply of an adequate flow of gas mixture to the patient. In 10 awake volunteers and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1989.tb02937.x
更新日期:1989-07-01 00:00:00
abstract::The influence of an intravenous infusion of naloxone 1 microgram kg-1 h-1, in combination with intrathecal diamorphine, on analgesia and hormonal stress responses after laminectomy was assessed in a blinded, randomized, placebo-controlled study. Twenty-seven patients undergoing laminectomy with postoperative analgesia...
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.1399-6576.1992.tb03455.x
更新日期:1992-04-01 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:Intramuscular scopolamine plus morphine premedication is traditionally used when prominent sedative or antisialogogue effect is needed. Knowledge of the pharmacokinetics of scopolamine is limited due to low plasma concentrations found after therapeutic doses. This investigation compares the pharmacokinetics ...
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.1399-6576.1998.tb04924.x
更新日期:1998-03-01 00:00:00
abstract::Aspiration pneumonitis is a severe complication of anesthesia. The objectives of this study were to determine if preoperative famotidine, a new histamine2-receptor antagonist, given by mouth either the evening before or the morning of elective surgery, reduced gastric residual volume and increased gastric pH in pediat...
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.1399-6576.1991.tb03328.x
更新日期:1991-07-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive dysfunction (POCD) is a common complication, especially in the elderly. The aim of this study was to describe how variability in neuropsychological testing could lead to the detection of cognitive improvement and poor consistency of POCD between postoperative test sessions. METHODS:I...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.2004.00502.x
更新日期:2004-10-01 00:00:00
abstract::The duration of action of mivacurium was evaluated during a modified neurolept anaesthesia in 17 patients heterozygous for the usual and the atypical plasma cholinesterase (pChe) gene (E1uE1a) and in five patients homozygous for the atypical gene (E1aE1a). The response to train-of-four nerve stimulation was recorded u...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1993.tb03721.x
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. METHODS:Eleven pati...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13045
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Involutional changes of peripheral nervous system occur with aging. The aim of the study was to determine the minimum effective volume of local anesthetic required to offer an effective ultrasound-guided supraclavicular brachial plexus block in 50% of middle-aged (< 50 years) and elderly (> 65 years) patient...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/aas.12109
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Total knee arthroplasty (TKA) is often associated with a considerable amount of post-operative blood loss, necessitating the transfusion of allogeneic blood, which can add to the complications. Optimization of strategies to reduce the need for blood transfusion is desired. This study was designed to evaluate...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.2006.001005.x
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Dexamethasone has analgesic properties when given intravenously before surgery, but the optimal dose has not been determined. We hypothesised that a dose of 40 mg dexamethasone would improve analgesia after outpatient shoulder surgery compared with 8 mg. METHODS:A randomised, double-blind, placebo-controlle...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aas.12333
更新日期:2014-07-01 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::ASA II-III patients, scheduled for peripheral vascular surgery, were included in a study designed to assess the effect of spinal epinephrine and clonidine on plasma concentrations of spinally administered 0.5% glucose-free bupivacaine. Patients were allocated randomly to three groups to receive via a spinal catheter 2...
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.1399-6576.1992.tb03544.x
更新日期:1992-10-01 00:00:00
abstract:UNLABELLED:In this prospective, consecutive study, 191 patients were interviewed before and after surgery (orthopaedic, gynaecological, abdominal and urological operations) about their attitude to and the quality of received pain relief, respectively. In addition, nurses working in the surgical units involved in the st...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1993.tb03737.x
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:One of the problems encountered in assessment of the hypnotic level during anesthesia is the extraction of a consistent and reliable measure online and close to real time. Hemodynamic parameters such as heart rate and blood pressure are not, at least with the traditional single parameter versus time presenta...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1034/j.1399-6576.2000.440614.x
更新日期:2000-07-01 00:00:00
abstract::Fluctuating PEEP (F-PEEP) is a newly developed PEEP in which end-expiratory pressure (EEP) is periodically changed within a certain range. In a dog model with unilateral lung injury induced by the introduction of hydrochloric acid, F-PEEP in which the EEP was periodically changed from 0.5 to 1.5 kPa at periods of 6 mi...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1988.tb02748.x
更新日期:1988-07-01 00:00:00
abstract:BACKGROUND:We conducted a prospective observational survey of pregnant women with cardiac disease. The aim was to analyse and present the mode of delivery, outcome, and haemodynamic changes during a caesarean section under regional anaesthesia in women with cardiac disease. METHODS:All pregnant women with a cardiovasc...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2009.02080.x
更新日期:2010-01-01 00:00:00
abstract::A new system for continuous measurement of oxygen uptake was tested. The tidal volumes delivered by the system, the accuracy of the oxygen sensor cell, measurement of the oxygen uptake at different inspired oxygen concentrations, and comparative tests of oxygen uptake using the Fick principle were studied. Judging fro...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1987.tb02511.x
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND:Genetic variability contributes to variable clinical response to opioids. This study emerged from the observation of three Norwegian patients who showed no or extraordinary poor response to very high doses of opioids. We suspected a genetic defect and applied a 'most likely candidate gene' approach to invest...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12739
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The prognostic value of blood lactate as a predictor of adverse outcome in the acutely ill patient is unclear. The aim of this study was to investigate if a peripheral venous lactate measurement, taken at admission, is associated with in-hospital mortality in acutely ill patients with all diagnosis. Furtherm...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12503
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The number of very elderly ICU patients (abbreviated to VOPs; ≥80 years) with sepsis increases. Sepsis was redefined in 2016 (sepsis 3.0) using the quick SOFA (qSOFA) score. Since then, multiple studies have validated qSOFA for prognostication in different patient categories, but the prognostic value in VOPs...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13536
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Some experimental and retrospective clinical studies signal an association between certain anaesthetic techniques and tumour metastasis following breast cancer surgery. Neutrophil Extracellular Trapping (NETosis) is an immunological process, whereby neutrophils engulf tumour antigen then degranulate, leaving...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13745
更新日期:2020-11-13 00:00:00