Abstract:
BACKGROUND:Microvascular dysfunction is considered to play an important pathophysiological role in sepsis. We addressed the hypothesis that macrovascular and microvascular flow are uncoupled in early sepsis, using a rodent model with well-characterized haemodynamic and biochemical markers of severity and subsequent mortality. METHODS:Male Wistar rats received either an intraperitoneal injection of faecal slurry (sepsis, n=14) or sterile saline (sham, n=6). Identical i.v. fluid resuscitation regimens were administered 2 h later through tethered lines while conscious. At 6 h post-sepsis and in sham-operated controls, sidestream dark-field microvascular imaging of the left vastus lateralis muscle and transthoracic echocardiography were undertaken, again under anaesthesia. Non-operated rats (naive; n=5) served as negative controls. Mild and severe sepsis were defined a priori, based on the established predictive relationship between stroke volume and mortality in this model. RESULTS:Compared with sham-operated animals, there was a 19 (12-19)% and 62 (54-66)% decline in cardiac output in mild (n=8) and severe sepsis (n=6), respectively [median (inter-quartile range), P<0.0001]. Blinded assessment of microvascular imaging revealed that the microvascular flow index (MFI) was impaired in sepsis and in sham-operated controls (P<0.01), regardless of the degree of reduction in stroke volume and cardiac output. The MFI heterogeneity index revealed that only naive rats displayed a normal microvascular flow pattern. CONCLUSIONS:Microvascular flow is impaired during early sepsis and uncoupled from macrovascular function. The severity of macrovascular/cardiovascular compromise in early sepsis is not reflected by microvascular changes. Furthermore, surgery alone causes significant microvascular derangement, highlighting the importance of appropriate control subjects when using this technique.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Dyson A,Cone S,Singer M,Ackland GLdoi
10.1093/bja/aes093subject
Has Abstractpub_date
2012-06-01 00:00:00pages
973-8issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)32190-6journal_volume
108pub_type
杂志文章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::A double-blind trial was undertaken to compare the effects of trimeprazine tartrate (2 mg kg-1 or 4 mg kg-1) plus atropine 0.03 mg kg-1 for oral premedication of 192 children undergoing tonsillectomy. Demeanour before operation, side-effects after operation, recovery times and fluid balance were studied. Behaviour in ...
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/53.8.821
更新日期:1981-08-01 00:00:00
abstract::Although most local anaesthetic drugs are generally regarded as vasodilators at their site of injection, they produce systemic effects characterized by increases in peripheral resistance, cardiac output, arterial pressure heart rate. The direct depressive effects of the drugs are counterbalanced by increased sympathet...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:
更新日期:1975-02-01 00:00:00
abstract:Background:The influence of different head and neck positions on the effectiveness of ventilation with the air-Q® self-pressurizing airway remains unevaluated. This study aimed to evaluate the influence of different head and neck positions on ventilation with the air-Q® SP airway. Methods:In this prospective, randomiz...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aew448
更新日期:2017-03-01 00:00:00
abstract::A randomized, double-blind study of 40 women was performed to compare patient controlled anaesthesia (PCA) morphine requirements after spinal anaesthesia for elective Caesarean section. The women received 0.2 mg of either morphine or diamorphine mixed with 0.5% bupivacaine in 8% dextrose. There were no significant dif...
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/81.2.135
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Evidence-based international expert consensus regarding anaesthetic practice in hip/knee arthroplasty surgery is needed for improved healthcare outcomes. METHODS:The International Consensus on Anaesthesia-Related Outcomes after Surgery group (ICAROS) systematic review, including randomised controlled and ob...
journal_title:British journal of anaesthesia
pub_type: 共识发展会议,杂志文章,meta分析
doi:10.1016/j.bja.2019.05.042
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:This study evaluated the A-Line Autoregressive Index (AAI) response to surgical stimulation during lumbar arthrodesis, as an estimate of the anti-nociceptive component of a Bispectral Index (BIS) guided anaesthesia combined with epidural analgesia. METHODS:An epidural catheter was inserted in 23 patients al...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael004
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Ultrasound-guided internal jugular venous access increases the rate of successful cannulation and reduces the incidence of complications, compared with the landmark technique. Three transducer orientation approaches have been proposed for this procedure: short-axis (SAX), long-axis (LAX) and oblique-axis (OA...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev399
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:The Laryngeal Tube (LT) performs similarly to the classic laryngeal mask airway during controlled ventilation but with an improved airway seal. We compared the laryngeal tube with the ProSeal laryngeal mask airway (PLMA) throughout anaesthesia. METHODS:Thirty-two patients were studied using a randomized cro...
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/aeg239
更新日期:2003-11-01 00:00:00
abstract::Dysregulation of the immuno-inflammatory response, as seen in sepsis, may culminate in host cell and organ damage. Lipopolysaccharide from Gram-negative bacterial cell walls induces gene activation and subsequent inflammatory mediator expression. Gene activation is regulated by a number of transcription factors at the...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aeg034
更新日期:2003-02-01 00:00:00
abstract::Blood samples were obtained from a radial artery cannula in a 60-yr-old man during coronary artery surgery. Serum potassium concentrations of 9.3, 8.4, and 7.4 mmol litre(-1) were obtained. A simultaneous venous blood sample gave a serum potassium concentration of 4.4 mmol litre(-1). The ECG was unchanged. After the a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh199
更新日期:2004-09-01 00:00:00
abstract::In a prospective randomized multi-centre study, the mortality following internal fixation surgery for fracture of the upper femur was investigated in 538 elderly patients allocated to receive subarachnoid blockade or general (narcotic-relaxant) anaesthesia. The 28-day mortality was 6.6% with subarachnoid, and 5.9% wit...
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/59.9.1080
更新日期:1987-09-01 00:00:00
abstract::A 4-year-old girl developed severe hepatitis following the fourth administration of halothane in a period of 5 months. She was shown to have a circulating antibody which acted specifically against rabbit hepatocyte previously sensitized to halothane. The patient made a full recovery from the hepatitis, but 5 months la...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/54.3.349
更新日期:1982-03-01 00:00:00
abstract::In the prone knee-chest position the spread of plain 0.5% bupivacaine in the cerebrospinal fluid and associated haemodynamic changes may be different compared with the horizontal position. A randomized comparison was performed in 40 ASA I-II patients, aged 24-61 yr, undergoing lumbar disc surgery. Subarachnoid injecti...
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/79.5.609
更新日期:1997-11-01 00:00:00
abstract::Sepsis is a constellation of clinical signs and symptoms resulting from excessive systemic host inflammatory response to infection. This inflammatory response is largely mediated by cytokines, which are released into the systemic circulation. Plasma concentrations of specific cytokines, TNF alpha, IL-1 beta, IL-6 and ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/77.1.110
更新日期:1996-07-01 00:00:00
abstract::Eight patients with a history of failed tracheal intubation during pregnancy were investigated by x-ray laryngoscopy after delivery. Partial elevation of the epiglottis with no view of glottic structures was found in five patients who were therefore considered to still present difficulty. In each of these five patient...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.6.813
更新日期:1990-12-01 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 present a new pattern of nerve stimulation--double burst stimulation (DBS)--to detect residual neuromuscular block manually. The DBS consists of two short lasting, 50-Hz tetanic stimuli or bursts separated by a 750-ms interval. The response to this pattern of stimulation is two single separated muscle contractions ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/62.3.274
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:Paravertebral regional anaesthesia is used to treat pain after several surgical procedures. This study aimed to improve on our first published ultrasound-guided approach to the paravertebral space (PVS) and to investigate a possible discrepancy between the needle, catheter, and contrast dye position. METHOD...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq309
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Cerebral state index (CSI) has recently been introduced as an intra-operative monitor of anaesthetic depth. We compared the performance of the CSI to the bispectral index (BIS) in measuring depth of anaesthesia during target-controlled infusion (TCI) of propofol. METHODS:Twenty Chinese patients undergoing g...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei253
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Axillary vein catheterization via a distal approach is an alternative to the proximal approach to axillary/subclavian vein catheterization under ultrasound (US) guidance. The aim of this trial was to compare the two approaches. METHODS:In a randomized single-centre study, all patients requiring central vein...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aev458
更新日期:2016-02-01 00:00:00
abstract::A blood-gas study of the respiratory effects of sodium nitroprusside during anaesthesia has shown a marked reduction in PaO2 when the drug was administered. After nitroprusside PaO2 returned to the previous values. It is suggested that the reduction in PaO2 is a result of an increased scatter of ventilation/perfusion ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.11.1205
更新日期:1975-11-01 00:00:00
abstract::We have investigated 60 patients in a prospective double-blind, placebo-controlled study to assess the efficacy of EMLA (Eutectic Mixture of Local Anaesthetics) cream to provide analgesia during extracorporeal shock wave lithotripsy (ESWL) with a second generation lithotriptor. Before operation, EMLA or placebo cream ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/69.4.399
更新日期:1992-10-01 00:00:00
abstract::We have estimated the effect of omitting antagonism of neuromuscular block on postoperative nausea and vomiting. A systematic search (MEDLINE, EMBASE, Biological Abstracts, Cochrane library, reference lists and hand searching; no language restriction, up to March 1998) was performed for relevant randomized controlled ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/82.3.379
更新日期:1999-03-01 00:00:00
abstract::In order to clarify the relative contribution of hepatic metabolism to the short term disposition of methohexitone, we have measured hepatic blood flow during induction of anaesthesia with a 1.5-mg kg-1 i.v. bolus dose of methohexitone. Median hepatic clearance was 1.01 litre min-1 and hepatic extraction 87%. As a con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.5.478
更新日期:1992-11-01 00:00:00
abstract::The effects of i.m. dexmedetomidine 1.0 micrograms kg-1, a new alpha 2-adrenoceptor agonist, were compared with those of i.m. midazolam 0.08 mg kg-1 and placebo on vigilance, anaesthetic requirements, haemodynamic state and plasma catecholamine concentrations in a double-blind placebo-controlled study in 107 healthy (...
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/67.4.402
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:The effect of anaesthetic drugs on long-term oncological outcomes after cancer surgery is an area of current interest. Dexamethasone is widely used in anaesthetic practice; however, its effect on long-term survival and cancer outcomes is not known. This study presents the results of a 5-yr follow-up of patie...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aet577
更新日期:2014-07-01 00:00:00
abstract::We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injec...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem178
更新日期:2007-09-01 00:00:00
abstract::The results of the ventilatory management of babies, obtained in the first 3 years of a neonatal surgical intensive care unit, are assessed. Overall mortality figures and detailed examination of the cause of death in individual diagnostic groups support a selective approach to intermittent positive pressure ventilatio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.3.273
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Tobacco use interventions in surgical patients who smoke could benefit both their short-term outcome and long-term health. Anaesthesiologists and surgeons can play key roles in delivering these interventions. This study determined the practices, attitudes, and beliefs of these physicians regarding tobacco us...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aem400
更新日期:2008-03-01 00:00:00