Abstract:
Background:Blood lactate is a strong predictor of mortality, and repeated blood lactate assays are recommended during surgery in high-risk patients. We hypothesized that the use of intravascular microdialysis incorporated in a central venous catheter would be interchangeable with the reference blood gas technique to monitor changes in blood lactate. Methods:Microdialysis and central venous blood lactate measurements were recorded simultaneously in high-risk cardiac surgical patients. The correlation between absolute values was determined by linear regression, and the Bland-Altman test for repeated measurements was used to compare bias, precision, and limits of agreement. Changes in lactate measurements were evaluated with a four-quadrant plot and trend interchangeability method (TIM). Results:In the 23 patients analysed, the central venous catheter was used as part of standard care, with no complications. The correlation coefficient for absolute values ( n =104) was 0.96 ( P <0.0001). The bias, precision, and limits of agreement were -0.19, 0.51, and -1.20 to 0.82 mmol litre -1 , respectively. The concordance rate for changes in blood lactate measurements ( n =80) was 94% with the four-quadrant plot. In contrast, the TIM showed that 23 (29) changes in lactate measurements were not interpretable, and among the remaining 57 (71) interpretable changes, 18 (32) were interchangeable, 8 (14) were in the grey zone, and 31 (54) were not interchangeable. Conclusions:Microdialysis with a central venous catheter appears to provide reliable absolute blood lactate values. Although changes in blood lactate measurements showed an excellent concordance rate, changes between the two methods were poorly interchangeable with the TIM. Clinical trial registration:NCT02296593.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Gouëzel C,Lorne E,Bonnet V,Fradin S,Saplacan V,Gérard JL,Hanouz JL,Fellahi JL,Fischer MO,FHT (French Hemodynamic Team).doi
10.1093/bja/aex338subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1110-1117issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)54138-0journal_volume
119pub_type
杂志文章abstract:BACKGROUND:Several medications have proved to be useful in preventing postoperative nausea and vomiting (PONV). However, routine antiemetic prophylaxis is not cost-effective. We evaluated the accuracy and discriminating power of an artificial neural network (ANN) to predict PONV. METHODS:We analysed data from 1086 in-...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael282
更新日期:2007-01-01 00:00:00
abstract::Chlorhexidine allergy has been described in the literature, mainly in Japanese individuals. Most reactions have been limited to the skin, mild in severity and a result of chlorhexidine containing solutions such as 'Savlon' (Novartis Consumer Health, Horesham, UK). We describe what we believe is the first reported case...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.2.306
更新日期:2001-08-01 00:00:00
abstract::This study was designed to observe the effects of i.v. fluid infusion on uterine activity during normal labour in women receiving an extradural block. Thirty-four women in spontaneous labour at term gestation were allocated randomly and prospectively to one of three i.v. pre-extradural fluid load groups: group A, no f...
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/77.5.632
更新日期:1996-11-01 00:00:00
abstract::We have studied the effect of analgesia on maternal temperature (oral and tympanic membrane) progression in 53 women during normal spontaneous labour. Three groups were studied: two received extradural analgesia with a continuous infusion of 0.25% bupivacaine with or without the addition of fentanyl; the third group r...
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/67.5.565
更新日期:1991-11-01 00:00:00
abstract::We have investigated the effects of propofol on beat-to-beat fluctuations in heart rate, arterial pressure (continuous arterial tonometry) and infrared finger plethysmography in 10 healthy male patients undergoing elective surgery. Administration of Diprivan (propofol 10 mg ml-1) 0.2 ml kg-1, followed by an infusion o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/73.2.167
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:Dynamic arterial elastance (Eadyn) has been proposed as an indicator of vascular tone that predicts the decrease in arterial pressure in response to changes in norepinephrine (NE). The purpose of this study was to determine whether Eadyn measured by uncalibrated pulse contour analysis (UPCA) can predict a de...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.01.032
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Acute pulmonary embolism (APE) is an important clinical problem in patients after major surgery and often remains a difficult diagnosis because of unspecific clinical symptoms. Therefore, we investigated the role of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) for the detection of APE. MET...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes315
更新日期:2012-12-01 00:00:00
abstract::A new design of tracheal tube cuff was compared with two types of high-volume, low-pressure (HVLP) cuffed tracheal tube for leakage of fluid from the subglottic space into the trachea. Spontaneous and positive-pressure ventilation were simulated using a mechanical lung, an intubated model trachea and a ventilator. Exc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.6.796
更新日期:1998-06-01 00:00:00
abstract::Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitate...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/49.4.363
更新日期:1977-04-01 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:BACKGROUND:Investigators planning dose-response studies of neuromuscular blockers have rarely used a priori power analysis to determine the minimal sample size their protocols require. Institutional Review Boards and peer-reviewed journals now generally ask for this information. This study outlines a proposed method fo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq310
更新日期:2011-02-01 00:00:00
abstract::We have examined the effects of bupivacaine and lignocaine on myocardial metabolism in the rat isolated heart-lung preparation. Bupivacaine 1, 5 or 25 micrograms ml-1 or lignocaine 4, 20 or 100 micrograms ml-1 was administered 5 min after the start of perfusion. Both bupivacaine 25 micrograms ml-1 and lignocaine 100 m...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/65.4.521
更新日期:1990-10-01 00:00:00
abstract::Logistical and ethical reasons make conducting clinical research in paediatric practice difficult, and therefore safe and efficacious advances are dependent on good preclinical research. For example, notable advances have been made in preclinical studies of pain processing that correlate well with patient data. Other ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aen263
更新日期:2008-11-01 00:00:00
abstract::We have compared, in a double-blind study, the efficacy of flumazenil with that of aminophylline in antagonizing the effects of midazolam in 60 patients (ASA I-II, mean age 66 yr) undergoing transurethral resection of prostate under spinal anaesthesia. All patients received midazolam 0.075 mg kg-1 i.v. and the test dr...
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/66.5.591
更新日期:1991-05-01 00:00:00
abstract::Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of ...
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/61.2.180
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Anaesthetic drugs act at sites within the brain that undergo profound changes during typical ageing. We postulated that anaesthesia-induced brain dynamics observed in the EEG change with age. METHODS:We analysed the EEG in 155 patients aged 18-90 yr who received propofol (n=60) or sevoflurane (n=95) as the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aev213
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Pressures (Pe) exerted by bronchial blockers on the inner wall of the bronchi may cause mucosal ischaemia. Our aims were as follows: (i) to compare the intracuff pressure (Pi) and Pe exerted by commercially available bronchial blockers in an in vitro and an ex vivo model; (ii) to investigate the influence of...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew120
更新日期:2016-09-01 00:00:00
abstract::The in vitro halothane and caffeine contracture tests have been performed on muscle tissue from six survivors of the neuroleptic malignant syndrome. The results, which are expressed in accordance with the criteria of the European MH Group, defined five of the subjects as MHN and one patient as MHE. It is concluded tha...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/59.12.1554
更新日期:1987-12-01 00:00:00
abstract::We have examined the effects of the highly selective alpha 2-adrenoceptor agonist, dexmedetomidine, on noradrenaline release and cell firing in isolated, superfused slices of rat locus coeruleus. Dexmedetomidine decreased both noradrenaline release and cell firing rate in a concentration-dependent fashion, with an EC5...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.3.447
更新日期:1993-09-01 00:00:00
abstract::We describe the anaesthetic management of a patient undergoing lobectomy for cavitating lung abscess complicated by haemoptysis. Surgery for lung abscess is one of the absolute indications for the use of a double-lumen tube (DLT). Because pus or blood could impede fibreoptic-assisted DLT placement, a traditional, blin...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.5.791
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:The aim of this retrospective study was to compare the failure rates and the frequency of anaesthesia-related complications of two different methods of regional anaesthesia used for carotid endarterectomy--cervical epidural (CE) anaesthesia and cervical plexus block (CPB). METHODS:The study included 1828 ca...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1093/bja/aem171
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims ...
journal_title:British journal of anaesthesia
pub_type: 评论,信件
doi:10.1093/bja/aew336
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:During normothermic cardiopulmonary bypass (CPB), the effect on propofol pharmacokinetics of changes in its binding to plasma proteins is consistent with the predictions of the well-stirred model of hepatic elimination for nonrestrictively cleared drug. However, whether changes in binding lead to clinically ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aei293
更新日期:2006-02-01 00:00:00
abstract::A randomized, double-blind study of 38 patients undergoing total knee replacement was undertaken to compare the efficacy and respiratory effects of low-dose spinal morphine and patient-controlled i.v. morphine against patient-controlled i.v. morphine alone. Patients received either morphine 0.3 mg or saline 0.3 ml 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/85.2.233
更新日期:2000-08-01 00:00:00
abstract::Respiratory mass spectrometry and on-line computation were used to estimate lung volume in normal subjects by a rebreathing technique, using oxygen, nitrogen and argon as indicators. The computation had previously been tested in a numerical model. In real normal lungs, it performed well enough for practical purposes, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.5.509
更新日期:1984-05-01 00:00:00
abstract::We have developed a simple, reliable method for rapid analysis of the partial pressure of volatile anaesthetic agents, based on a two-stage, head-space analysis. It is designed to solve the problems associated with reduced solubility of modern anaesthetics. After equilibration and analysis of a 2-ml sample of blood at...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.4.449
更新日期:1997-04-01 00:00:00
abstract::The circulating blood volume (CBV) of critically ill patients may be difficult to estimate on the basis of history and physical examination. The aim of this study was to evaluate the ability of seven clinical signs and central venous pressure (CVP) to predict CBV in critically ill patients; CBV was evaluated with the ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/86.6.754
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:The usefulness of the PFA-100 in assessing the risk of bleeding in non-cardiac surgery is not clear. This study aims to examine this by correlating preoperative PFA-100 measurement with perioperative bleeding in patients receiving cyclooxygenase (COX) inhibitors. METHODS:PFA-100 with adenosine-5'-diphosphat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep091
更新日期:2009-06-01 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::Delirium commonly manifests in the postoperative period as a clinical syndrome resulting from acute brain dysfunction or encephalopathy. Delirium is characterized by acute and often fluctuating changes in attention and cognition. Emergence delirium typically presents and resolves within minutes to hours after terminat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew475
更新日期:2017-08-01 00:00:00