Abstract：
BACKGROUND:The perioperative period may be associated with a marked neurohumoral stress response, significant fluid losses, and varied fluid replacement regimes. Acute changes in serum sodium concentration are therefore common, but predictors and outcomes of these changes have not been investigated in a large surgical population. METHODS:We carried out a retrospective cohort analysis of 27 068 in-patient non-cardiac surgical procedures in a tertiary teaching hospital setting. Data on preoperative conditions, perioperative events, hospital length of stay, and mortality were collected, along with preoperative and postoperative serum sodium measurements up to 7 days after surgery. Logistic regression was used to investigate the association between sodium changes and mortality, and to identify clinical characteristics associated with a deviation from baseline sodium >5 mmol litre(-1). RESULTS:Changes in sodium concentration >5 mmol litre(-1) were associated with increased mortality risk (adjusted odds ratio 1.49 for a decrease, 3.02 for an increase). Factors independently associated with a perioperative decrease in serum sodium concentration >5 mmol litre(-1) included age >60, diabetes mellitus, and the use of patient-controlled opioid analgesia. Factors associated with a similar increase were preoperative oxygen dependency, mechanical ventilation, central nervous system depression, non-elective surgery, and major operative haemorrhage. CONCLUSIONS:Maximum deviation from preoperative serum sodium value is associated with increased hospital mortality in patients undergoing in-patient non-cardiac surgery. Specific preoperative and perioperative factors are associated with significant serum sodium changes.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Klinck J,McNeill L,Di Angelantonio E,Menon DKdoi
10.1093/bja/aeu409subject
Has Abstractpub_date
2015-04-01 00:00:00pages
615-22issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)31674-4journal_volume
114pub_type
杂志文章abstract：:Transoesophageal echocardiography (TOE) is valuable for perioperative monitoring in patients at risk from haemodynamic disturbance. However, its use is not practicable in patients undergoing surgical procedures under regional anaesthesia. We describe two cases showing that transthoracic echocardiography (TTE) has the ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/oxfordjournals.bja.a013596
更新日期：2000-06-01 00:00:00
abstract：:We have studied the effect of P6 acupuncture on postoperative vomiting in 45 children undergoing tonsillectomy. After induction of anaesthesia and before the start of surgery, 50% of the patients received P6 acupuncture (in the middle of the ventral surface of the wrist) for 5 min. There was no difference in the incid...
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/67.6.779
更新日期：1991-12-01 00:00:00
abstract：:One hundred and eighty-five patients were allocated at random to receive pethidine with diazepam (in an emulsion), or pethidine with midazolam i.v. as sedation for upper gastrointestinal endoscopy. Sedation and conditions for examination were comparable and satisfactory in both groups. Midazolam produced more amnesia ...
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/55.11.1095
更新日期：1983-11-01 00:00:00
abstract：BACKGROUND:Desflurane (DES)-induced preconditioning is mediated by large-conductance calcium-activated potassium channels (BK(Ca)). Whether BK(Ca) are involved in anaesthetic-induced post-conditioning is unknown. We tested the hypothesis that DES-induced post-conditioning is mediated by BK(Ca) upstream of the mitochond...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aer496
更新日期：2012-04-01 00:00:00
abstract：:The effects of laudanosine, a metabolite of atracurium, on the behaviour of conscious mice, rats and dogs, and on cardiovascular function in conscious and anaesthetized dogs have been evaluated: EEG studies were performed in anaesthetized dogs. In mice and rats, i.v. bolus doses of laudanosine 10-20 mg kg-1, caused co...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/59.2.218
更新日期：1987-02-01 00:00:00
abstract：:We describe three histaminoid reactions occurring on induction of anaesthesia. The patients were all resuscitated successfully and subsequent skin testing suggested sensitivity to rocuronium. In this hospital, the incidence of such reactions is of the order of 1 in 3000. This may be coincidental but suggests that ther...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/oxfordjournals.bja.a013365
更新日期：2000-01-01 00:00:00
abstract：BACKGROUND:Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to aware...
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/aeh289
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:Endothelial dysfunction might be involved in the development of cerebral vasospasm after aneurysmal subarachnoid haemorrhage (SAH). METHODS:This prospective observational study of 48 SAH subjects and 23 control subjects examined associations between reactive hyperaemia index (RHI) measured by peripheral art...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet331
更新日期：2014-02-01 00:00:00
abstract：BACKGROUND:Lidocaine is frequently used as an agent to treat ventricular arrhythmias associated with acute myocardial ischaemia. Lidocaine is a potent blocker not only of sodium channels, but also of ATP-sensitive potassium channels. The opening of these channels is a key mechanism of ischaemic preconditioning. We inve...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeh262
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND:Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS:Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeu440
更新日期：2015-03-01 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:Dexmedetomidine is an α-2-receptor agonist which might be used as an additive to local anaesthetics for various regional anaesthetic techniques. We therefore designed this prospective, double-blinded, controlled volunteer study to investigate the effects of dexmedetomidine as an adjuvant to ropivacaine on pe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aes400
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Emotional information has the ability to alter the formation and strength of a memory ('memory modulation'). Memory modulation by negative emotion is mediated by the amygdala. It is not known how gamma aminobutyric acid (GABA)ergic drugs affect the processes involved in memory modulation. This study investig...
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/aeh211
更新日期：2004-09-01 00:00:00
abstract：:We have evaluated the effect of delivering nitric oxide using a continuous flow system (CFS) or two commercially available proportional gas injection systems (PGIS), Nodomo (Dräger, Lübeck, Germany) and Pulmonox-Mini (Messer Griesheim Austria, Gumpoldskirchen, Austria) on measured and simulated concentrations of nitri...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/81.4.544
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Blood flow patterns are important modifiers of platelet interactions with plasma coagulation factors. However, it is not feasible to evaluate rheological effects of haemodilution on coagulation using conventional coagulation testing. METHODS:We evaluated thrombus formation with a microchip-based flow-chambe...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet229
更新日期：2013-12-01 00:00:00
abstract：:The sedation of 50 children aged 6 months to 9 years who had undergone open heart surgery was studied. During artificial ventilation a midazolam infusion was used in conjunction with the administration of morphine (and tubocurarine). Sedation for patients breathing spontaneously with positive airway pressure was conti...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.10.1104
更新日期：1986-10-01 00:00:00
abstract：BACKGROUND:The second gas effect (SGE) is considered to be significant only during periods of large volume N(2)O uptake (VN(2)O); however, the SGE of small VN(2)O has not been studied. We hypothesized that the SGE of N(2)O on sevoflurane would become less pronounced when sevoflurane administration is started 60 min aft...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/ael008
更新日期：2006-03-01 00:00:00
abstract：:Twelve hydrocephalic patients undergoing hydrodynamic studies and shunt procedures during general anaesthesia were subjected to short term observations of the cerebrovascular effects of isoflurane. Intraventricular pressure (IVP), arterial pressure (AP); cerebral perfusion pressure (CPP = AP-IVP), end-tidal PCO2, Cere...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/59.10.1208
更新日期：1987-10-01 00:00:00
abstract：:A 72-yr-old patient was to undergo a left lumbar plexus block by the posterior approach to achieve postoperative analgesia after hip replacement. The block failed after three unsuccessful attempts to identify nerve structures and a fascia iliaca compartment block was performed. Postoperatively the patient received eno...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeh242
更新日期：2004-10-01 00:00:00
abstract：:The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. Extradural ana...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/52.9.919
更新日期：1980-09-01 00:00:00
abstract：:We have compared the effects of progressive (30% and 60%) in vitro haemodilution with hydroxyethyl starch (HES), gelatin (GEL) and albumin (ALB) with haemodilution using 0.9% saline in 96 patients by thrombelastography. Haemodilution with HES, GEL and ALB significantly (P < 0.05) compromised coagulation time (k), angl...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/78.6.684
更新日期：1997-06-01 00:00:00
abstract：BACKGROUND:Tapentadol is an analgesic agent for treatment of acute and chronic pain that activates the µ-opioid receptor combined with inhibition of neuronal norepinephrine reuptake. Both mechanisms are implicated in activation of descending inhibitory pain pathways. In this study, we investigated the influence of tape...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aeu056
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Current guidelines for perioperative management of coronavirus disease 19 (COVID-19) are mainly based on extrapolated evidence or expert opinion. We aimed to systematically investigate how COVID-19 affects perioperative management and clinical outcomes, to develop evidence-based guidelines. METHODS:First, w...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1016/j.bja.2020.08.049
更新日期：2020-12-01 00:00:00
abstract：:Neurological deterioration from intraspinal haematoma following insertion of a spinal needle is extremely rare. We present the case of a 28-yr-old female, who presented with complete paraplegia following attempted spinal anaesthesia for delivery of her third child. Space-occupying iatrogenic spinal haemorrhage from a ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/88.3.438
更新日期：2002-03-01 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：: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：:In our daily anaesthetic practice, we are confronted with an increasing number of patients treated with either antiplatelet or anticoagulant agents. During the last decade, changes have occurred that make the handling of antithrombotic medication a challenging part of anaesthetic perioperative management. In this revi...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aew214
更新日期：2016-09-01 00:00:00
abstract：:We have investigated the incidence of regurgitation of gastric contents during general anaesthesia administered via a laryngeal mask airway (LMA) or face mask and Guedel airway in 56 patients with no risk factors for regurgitation. Patients swallowed a gelatin capsule containing methylene blue 10 min before induction ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/69.3.314
更新日期：1992-09-01 00:00:00
abstract：:The cardiorespiratory effects of increasing respiratory frequency were investigated in two groups of dogs ventilated mechanically with a system which minimized apparatus and anatomical deadspace. In one group minute volume was constant whilst frequency was increased; in the second group minute volume was increased to ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/52.5.475
更新日期：1980-05-01 00:00:00
abstract：:The trachea of a man who had cut his own throat was successfully intubated using a fibreoptic laryngoscope after attempts at conventional oral intubation had failed. The advantages of the fibreoptic instrument and the method of use in such an injury are discussed. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/50.5.511
更新日期：1978-05-01 00:00:00
