Abstract:
BACKGROUND:Goal-directed therapy has been proposed to improve outcome in high-risk surgery patients. The aim of this study was to investigate whether individualised goal-directed therapy targeting stroke volume and oxygen delivery could reduce the number of patients with post-operative complications and shorten hospital length of stay after open elective lower limb arterial surgery. METHODS:Forty patients scheduled for open elective lower limb arterial surgery were prospectively randomised. The LiDCO™plus system was used for haemodynamic monitoring. In the intervention group, stroke volume index was optimised by administering 250 ml aliquots of colloid intraoperatively and during the first 6 h post-operatively. Following surgery, fluid optimisation was supplemented with dobutamine, if necessary, targeting an oxygen delivery index level ≥ 600 ml/min(/) m(2) in the intervention group. Central haemodynamic data were blinded in control patients. Patients were followed up after 30 days. RESULTS:In the intervention group, stroke volume index, and cardiac index were higher throughout the treatment period (45 ± 10 vs. 41 ± 10 ml/m(2), P < 0.001, and 3.19 ± 0.73 vs. 2.77 ± 0.76 l/min(/) m(2), P < 0.001, respectively) as well as post-operative oxygen delivery index (527 ± 120 vs. 431 ± 130 ml/min(/) m(2), P < 0.001). In the same group, 5/20 patients had one or more complications vs. 11/20 in the control group (P = 0.05). After adjusting for pre-operative and intraoperative differences, the odds ratio for ≥ 1 complications was 0.18 (0.04-0.85) in the intervention group (P = 0.03). The median length of hospital stay did not differ between groups. CONCLUSION:Perioperative individualised goal-directed therapy may reduce post-operative complications in open elective lower limb arterial surgery.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Bisgaard J,Gilsaa T,Rønholm E,Toft Pdoi
10.1111/j.1399-6576.2012.02755.xsubject
Has Abstractpub_date
2013-02-01 00:00:00pages
189-98issue
2eissn
0001-5172issn
1399-6576journal_volume
57pub_type
杂志文章,随机对照试验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:BACKGROUND:In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport mission...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13071
更新日期:2018-05-01 00:00:00
abstract::The in vitro effects of flunarizine on indirectly- and directly-elicited contractions in rat phrenic-hemidiaphragm preparations were studied. The interactions of flunarizine with non-depolarizing and depolarizing neuromuscular blocking drugs (pancuronium and suxamethonium) and with an aminoglycoside antibiotic (neomyc...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1989.tb02971.x
更新日期:1989-10-01 00:00:00
abstract:BACKGROUND:Stroke volume variation (SVV)--as measured by the pulse contour cardiac output (PiCCO) system--predicts the cardiac output response to a fluid challenge in patients on controlled ventilation. Whether this applies to patients on pressure support ventilation is unknown. METHODS:Thirty consecutive patients wit...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.2006.01120.x
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:If intravenous access cannot be accomplished during cardiopulmonary resuscitation in children, tracheal administration of 100 micrograms/kg of adrenaline (ten times greater than the intravenous dose) is recommended. METHODS:In a randomized crossover study we recoreded the hemodynamic effect of a low dose of...
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.1399-6576.1996.tb04562.x
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:We examined the hypothesis that the minimum alveolar concentration of desflurane for maintaining bispectral index (BIS) below 50 (MACBIS 50 ) decreases with advance of age. METHODS:Sixty young (20-30 year), middle-aged (31-65 year) and elderly (66-80 year) patients were included (n = 20, each group). Five m...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12642
更新日期:2016-02-01 00:00:00
abstract::Consistent identification of peripheral nerves as well as placement of catheters for post-operative pain relief is possible with the aid of ultrasound. By blocking a single nerve rather than the entire extremity, pain can be eliminated without impairing motor function of the entire extremity, providing greater patient...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2008.01762.x
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Metohexital and propofol are short-acting induction agents, which have a tendency to prolong the QTc interval of the ECG. We studied whether this increase could be prevented by combining a beta-blocking agent, esmolol, with these drugs. Simultaneously, we studied the hemodynamic effects of these combinations...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2006.00911.x
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery. METHODS:Medline, the Cochrane Library and Google Scholar were searched for ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1399-6576.2011.02629.x
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:The quality of cardiopulmonary resuscitation (CPR) has an impact on survival. The quality may be impaired if the patient needs to be transported to the hospital with ongoing CPR. The aim of this study was to analyse whether the quality of CPR can be improved during transportation by using real-time audiovisu...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12245
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:We have previously proposed an equation derived from Fick's law and Lin's concept of effective blood concentration (EBC) to calculate the mixed venous blood concentration (MVBC) of isoflurane. Desflurane has a lower blood/air partition coefficient than isoflurane and, as such, promotes a faster induction and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.00887.x
更新日期:2006-05-01 00:00:00
abstract::The effect of changing the volume of cerebro-spinal fluid (CSF) before spinal anaesthesia with 3 ml of isobaric 0.5% bupivacaine was investigated in 60 elderly (58-77 years) orthopaedic or urological patients. The patients were randomly allocated to three groups. They received the spinal anaesthetic either with or wit...
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.1399-6576.1985.tb02260.x
更新日期:1985-08-01 00:00:00
abstract:BACKGROUND:Morphine decreases gut peristalsis, and ketamine decreases morphine use after surgery, and does not slow peristalsis. Thus, the combination should result in faster return of bowel function after surgery than morphine alone. METHOD:A double-blind randomized controlled trial of saline vs. ketamine with intrav...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1399-6576.2007.01436.x
更新日期:2007-10-01 00:00:00
abstract::Non-steroidal anti-inflammatory drugs (NSAID) effectively reduce the need for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surgery was compared in the present study. In a randomized and double-blind fashion, 90 ASA I-II patients (16-60 y...
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.1399-6576.1995.tb05599.x
更新日期:1995-01-01 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 effectiveness of an anaesthetic technique employing diclofenac sodium as an analgesic given preoperatively by intramuscular injection was compared against one employing intravenous fentanyl in patients undergoing laparoscopic sterilization. Postoperative pain was marked and both drugs provided partial relief only....
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1994.tb03904.x
更新日期:1994-05-01 00:00:00
abstract::Twenty patients, 36-78 years old, with a history of chronic obstructive lung disease, and immediately after operation mostly for cardiac disease, were treated with ipratropium bromide (IB, 15 cases) or placebo (5 cases). A metered dose inhaler with a new adapter was used during postoperative ventilator treatment. In t...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.1987.tb02638.x
更新日期:1987-10-01 00:00:00
abstract::The haemodynamic response to endotracheal intubation and changes in the QT interval of ECG during anaesthetic induction were studied in 68 healthy children (5.5 years). The children were pretreated double-blindly with either alfentanil 10 micrograms/kg (A10), 25 micrograms/kg (A25), 50 micrograms/kg (A50) or saline (c...
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.tb03305.x
更新日期:1991-05-01 00:00:00
abstract::Two cases of venous air embolism are described. One case occurred in a 12-year-old girl operated for ureteroileo-cutaneostomy; the other case occurred in a 44-year-old patient who underwent a hemihepatectomy. The haemodynamic and pulmonary consequences were successfully treated with intravenous papaverine. ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1989.tb02902.x
更新日期:1989-04-01 00:00:00
abstract::An oxygen consuming an carbon dioxide producing model lung was used for evaluation of anaesthetic circle systems. Two different circles, the AGA metal circle and the AGA Monosorb circle ventilated by an AGA UV-705 were tested with reference to inspired oxygen concentrations and end-tidal CO2 levels. Carbon dioxide is ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1982.tb01731.x
更新日期:1982-02-01 00:00:00
abstract::Fifty patients with chronic resistant cervicobrachialgia were randomly divided into two groups. Twenty-five patients (group A) were treated with cervical epidural steroid/lidocaine injections and 17 patients (group B) were treated with steroid/lidocaine injections into the posterior neck muscles. Another eight patient...
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.1399-6576.1993.tb03765.x
更新日期:1993-08-01 00:00:00
abstract::Adenosine, an endogenous compound with a known antinociceptive effect when administered into the CNS, was applied in nine patients (21-65 years) by the peripheral intravenous route (70-130 micrograms.kg-1.min-1) as a replacement for peroperative opioids during inhalation anaesthesia for surgical procedures not requiri...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1992.tb03526.x
更新日期:1992-08-01 00:00:00
abstract::We present the case of a parturient with moyamoya disease admitted to the hospital for elective cesarean section. Combined spinal and epidural technique was chosen because it allows better analgesia than epidural anesthesia and more hemodynamic stability than either general or spinal anesthesia. Ropivacaine was the lo...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1998.tb05388.x
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Previous studies have shown that ventilation-perfusion matching is improved in the prone as compared with that in the supine position. Regional differences in the regulation of vascular tone may explain this. We have recently demonstrated higher production of nitric oxide in dorsal compared with ventral huma...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2009.02018.x
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Pre-hospital tracheal intubation (TI) is an important but difficult procedure with the potential to produce hypoxaemia. The aim of this study was to determine the incidence of desaturation episodes during out-of-hospital rapid sequence induction (RSI) and TI by the medical team of a German Helicopter Emergen...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12032
更新日期:2013-02-01 00:00:00
abstract::The effects of enflurane anaesthesia on central circulation, total oxygen uptake, splanchnic circulation and splanchnic oxygen uptake were studied in 10 artifically ventilated dogs, basally anaesthetized with thiopental and nitrous oxide. Hepatic arterial, superior mesenteric arterial and portal venous blood flows wer...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1979.tb01416.x
更新日期:1979-02-01 00:00:00
abstract::A previously healthy woman (20 years old) was admitted to our hospital with several fractures after a car accident. She was sedated with propofol, etc. in doses ranging from 1.4 to 5.1 mg/kg/h for 88 h. She developed multiple organ failure with rhabdomyolysis and died. This case fulfils (except acidosis) the criteria ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2006.00904.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:ST changes related to ischemia at different heart rates (HRs) have not been well described. We aimed to analyze ST dynamic changes by vectorcardiography (VCG) during pacing-induced HR changes for subjects with proven coronary artery disease (CAD) and without (non-CAD). METHODS:Symptomatic CAD patients sched...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2007.01507.x
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Assessment of preload independent left ventricular function with conductance volumetry is traditionally accomplished by inflating a balloon in the inferior caval vein. Our aim was to investigate if a similar change in preload could be achieved by positive pressure ventilation with large tidal volume. METHOD...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2003.00084.x
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:This study describes the design of a hypnosis closed-loop control system with propofol. The controller used a proportional-integral (PI) algorithm with the bispectral index (BIS) as the feedback signal. Our hypothesis was that a PI closed-loop control could be applied in clinical practice safely keeping the ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2012.02738.x
更新日期:2012-09-01 00:00:00