Abstract:
BACKGROUND:ROTEM(®)/TEG(®) (rotational thromboelastometry) assays appear to be useful for the treatment of bleeding trauma patients. However, data on the prevalence and impact of abnormal ROTEM(®) assays are scarce. METHODS:This is a prospective cohort study of blunt trauma patients (Injury Severity Score ≥15 or Glasgow Coma Score ≤14) admitted to Innsbruck Medical University Hospital between July 2005 and July 2008. Standard coagulation tests, antithrombin (AT), prothrombin fragments (F1+2), thrombin-antithrombin complex (TAT), and ROTEM(®) assays were measured after admission. Data on 334 patients remained for final analysis. RESULTS:ROTEM(®) parameters correlated with standard coagulation tests (all Spearman r>0.5), and significant differences in mortality were detected for defined ROTEM(®) thresholds [FIBTEM 7 mm (21% vs 9%, P=0.006), EXTEM MCF (maximum clot firmness) 45 mm (25.4% vs 9.4%, P=0.001)]. EXTEM MCF was independently associated with early mortality [odds ratio (OR) 0.94, 95% confidence interval (CI) 0.9-0.99] and MCF FIBTEM with need for red blood cell transfusion (OR 0.92, 95% CI 0.87-0.98). In polytrauma patients with or without head injury (n=274), the prevalence of low fibrinogen concentrations, impaired fibrin polymerization, and reduced clot firmness was 26%, 30%, and 22%, respectively, and thus higher than the prolonged international normalized ratio (14%). Hyperfibrinolysis increased fatality rates and occurred as frequently in isolated brain injury (n=60) as in polytrauma (n=274) (5%, 95% CI 1.04-13.92 vs 7.3%, 95% CI 4.52-11.05). All patients showed elevated F1+2 and TAT and low AT levels, indicating increased thrombin formation. CONCLUSIONS:Our data enlarge the body of evidence showing that ROTEM(®) assays are useful in trauma patients. Treatment concepts should focus on maintaining fibrin polymerization and treating hyperfibrinolysis.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Tauber H,Innerhofer P,Breitkopf R,Westermann I,Beer R,El Attal R,Strasak A,Mittermayr Mdoi
10.1093/bja/aer158subject
Has Abstractpub_date
2011-09-01 00:00:00pages
378-87issue
3eissn
0007-0912issn
1471-6771pii
S0007-0912(17)33077-5journal_volume
107pub_type
杂志文章abstract:BACKGROUND:A significantly increased risk of acute kidney injury (AKI) with the prophylactic use of aprotinin has been reported in adults undergoing cardiac surgery, but not in children. Blood product transfusions have also been shown to carry an independent risk of AKI. The present study assessed associations between ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes002
更新日期:2012-05-01 00:00:00
abstract::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 00:00:00
abstract::Development targets in anaesthetic pharmacology have evolved from minimizing harm caused by unwanted effects through an era in which rapid onset and offset of drug effect were prioritised. Today's anaesthetists have access to a library of effective drugs whose characteristics offer controllable hypnosis, analgesia and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aex328
更新日期:2017-12-01 00:00:00
abstract::As the physiology of deliberate hypotension has been unravelled, and as each new pharmacological agent has become available which either depresses or blocks peripheral vascular tone, depresses myocardial performance, or interferes with the conducting tissues within the myocardium, its possible incorporation into the a...
journal_title:British journal of anaesthesia
pub_type: 历史文章,杂志文章
doi:10.1093/bja/47.7.745
更新日期:1975-07-01 00:00:00
abstract::We have studied in eight rabbits the cardiovascular effects of midazolam, propofol and alfentanil with graded hypoxia. Central blood volume was reduced progressively by gradual inflation of a thoracic vena cava cuff so that cardiac index (CI) decreased at a constant rate. Under control conditions the haemodynamic resp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/75.5.610
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnoea (OSA) affects ~9-24% of the general population, and 90% remain undiagnosed. Those patients with undiagnosed moderate-to-severe OSA may be associated with an increased risk of perioperative complications. Our objective was to evaluate the proportion of surgical patients with undiagnos...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes465
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:High-dose glucocorticoid may reduce postsurgical pain and improve recovery. We hypothesized that 125 mg methylprednisolone (MP) would reduce time to meet functional discharge criteria after total hip arthroplasty (THA). METHODS:Forty-eight patients undergoing unilateral THA under spinal anaesthesia were con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes345
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:We investigated the effects of spinal and general anaesthesia and surgical tourniquet on acute pain and early recovery after total knee arthroplasty (TKA). METHODS:Patients (n=413) were randomised to four parallel groups: spinal anaesthesia with or without tourniquet, and general anaesthesia with or without...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.bja.2020.03.036
更新日期:2020-11-01 00:00:00
abstract::We present a case of fatal cardiac tamponade that occurred in association with a peripherally inserted central catheter (PICC) inserted from the right antecubital fossa. Migration of the catheter from the right atrium within 24 h of insertion lead to the administration of a potassium-enriched sodium chloride solution ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem181
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:We developed a new neuromuscular transmission monitor, the compressomyograph (CMG, European patent number: EP 06018557.6, US patent number: US 60/824.541). This is the first preliminary report comparing neuromuscular block monitored by CMG and the Relaxometer mechanomyograph (MMG). METHODS:The two monitors ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aem379
更新日期:2008-03-01 00:00:00
abstract::The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking...
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/79.1.122
更新日期:1997-07-01 00:00:00
abstract:BACKGROUND:We studied the potential neuroprotective effects of halothane and desflurane, compared with the awake state, on infarct size following 2 h of intraluminal middle cerebral artery occlusion (MCAo) and 22 h of reperfusion. METHODS:Male Sprague-Dawley rats were anaesthetized with desflurane or halothane, intuba...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeg186
更新日期:2003-09-01 00:00:00
abstract::Plain bupivacaine 0.5% or 0.75% was injected intrathecally in four groups of 10 patients. Group A received 0.75% bupivacaine 2.7 ml at L3/4, group B 0.5% bupivacaine 4 ml at L3/4, group C 0.75% bupivacaine 2.7 ml at L2/3 and group D 0.75% bupivacaine 2 ml at L3/4. A very wide range of height of block was found in each...
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/58.3.292
更新日期:1986-03-01 00:00:00
abstract::The possibility of an interaction between diazepam and pancuronium bromide was investigated in six patients undergoing general anaesthesia maintained with fentanyl, droperidol and nitrous oxide. Neuromuscular blockade was controlled using a feedback mechanism which automatically adjusted the rate of injection of pancu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.8.859
更新日期:1981-08-01 00:00:00
abstract::We have studied post-tetanic count (PTC) and single twitch height at the onset of reflex movement to carinal stimulation after administration of vecuronium with five different types of anaesthesia. Seventy-five adult patients were allocated randomly to five groups of 15 patients each, to receive one of the following a...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1093/bja/72.6.688
更新日期:1994-06-01 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::In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/65.2.220
更新日期:1990-08-01 00:00:00
abstract::Bupivacaine is used widely as a local anaesthetic but has potential for severe cardiovascular and central nervous system (CNS) toxicity. It has an asymmetric carbon atom giving it a chiral centre, and the commercial preparation is a racemic mixture of its two enantiomers: dextro or R(+)-bupivacaine and levo or S(-)-bu...
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/80.5.594
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Weaning from mechanical ventilation is a challenging step during recovery from critical illness. Weaning failure or early reintubation are associated with increased morbidity and mortality, exposing patients to life-threatening complications. Cardiac dysfunction represents the most common cause of weaning fa...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1016/j.bja.2020.07.059
更新日期:2021-01-01 00:00:00
abstract::Before the induction of labour in 34 pregnant women 1.5% lignocaine 10 ml was injected into the lumbar extradural space at constant rates between 0.143 and 0.333 ml s-1. Injection pressures and residual pressures were recorded and the extent of analgesia to pinprick was assessed. No significant correlation was found b...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.1.55
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:After cardiac surgery adequate postoperative analgesia is necessary. We assessed analgesia using intrathecal morphine and clonidine. METHODS:In a double-blind randomized study, 45 patients having coronary artery bypass graft surgery were allocated randomly to receive i.v. patient-controlled analgesia (PCA) ...
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/aeg070
更新日期:2003-03-01 00:00:00
abstract::The effect of ketamine analgesia on gastric emptying was assessed in five healthy volunteers. Gastric emptying, estimated indirectly by the absorption of orally administered paracetamol, was not significantly delayed following administration of i.m. ketamine when compared with placebo. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.12.1321
更新日期:1981-12-01 00:00:00
abstract::Fast inactivation of sodium channel function is modified by anaesthetics. Its quantitative contribution to the overall anaesthetic effect is assessed by removing the fast inactivation mechanism enzymatically. Sodium channels from human brain cortex were incorporated into planar lipid bilayers. After incorporation, cha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/82.1.74
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:It was hypothesized that xenon would stabilize mean arterial pressure (MAP) in haemorrhagic shock, recovery, and volume resuscitation, because a higher MAP has been observed with xenon, when compared with isoflurane anaesthesia. The responses to haemorrhage and subsequent volume replacement were therefore co...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei127
更新日期:2005-06-01 00:00:00
abstract::Sickle cell disease is a congenital haemoglobinopathy with a high incidence of perioperative complications. Traditional anaesthetic management, based largely on extrapolation from biochemical models, has emphasized avoidance of red cell sickling to prevent exacerbations of the disease. This historical review outlines ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei129
更新日期:2005-09-01 00:00:00
abstract::We have compared the effects of sevoflurane and halothane on the discharge frequencies of 19 slowly adapting and four rapidly adapting lung receptors in the rabbit by recording from single vagal fibres. Both agents reduced the discharge frequency of slowly adapting receptors during expiration (P < 0.0005), halothane h...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.2.257
更新日期:1998-02-01 00:00:00
abstract::We have investigated the effect of dopamine and dopexamine on the isolated perfused rat kidney. After an equilibration period of 20 min and two control periods of 10 min, dopexamine 1.0, 2.5 or 4.0 micrograms kg-1 min-1 or dopamine 2.0 micrograms kg-1 min-1 were perfused for a further 40 min in random order. Renal blo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.6.898
更新日期:1999-12-01 00:00:00
abstract::Protein kinase C (PKC) is a key regulatory enzyme that has been implicated as a molecular target for the action of general anaesthetics. We have determined the effects of halothane on the translocation and down-regulation of conventional PKC (cPKC) by analysing the subcellular distribution of PKC activity, [3H]phorbol...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.2.189
更新日期:1997-02-01 00:00:00
abstract::Raised intracranial pressure (ICP) and low cerebral blood flow (CBF) are associated with ischaemia and poor outcome after brain injury. Therefore, many management protocols target these parameters. This overview summarizes the technical aspects of ICP and CBF monitoring, and their role in the clinical management of br...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael110
更新日期:2006-07-01 00:00:00
abstract::We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA...
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/80.6.742
更新日期:1998-06-01 00:00:00