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Håkansson, Erik
Alternative names
Publications (10 of 39) Show all publications
Olsson, A., Alfredsson, J., Håkansson, E., Svedjeholm, R., Berglund, J. & Berg, S. (2016). Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass. Scandinavian Cardiovascular Journal, 50(1), 58-63
Open this publication in new window or tab >>Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass
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2016 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 50, no 1, p. 58-63Article in journal (Refereed) Published
Abstract [en]

Platelet dysfunction is an important cause of postoperative bleeding after cardiac surgery. Protamine is routinely used for reversal of heparin after cardiopulmonary bypass (CBP), but may affect platelet aggregation. We assessed changes in platelet function in relation to protamine administration. Design: Platelet aggregation was analyzed by impedance aggregometry before and after protamine administration in 25 adult cardiac surgery patients. Aggregation was also studied after in vitro addition of heparin and protamine. The activators adenosine diphosphate (ADP), thrombin receptor activating peptide-6 (TRAP), arachidonic acid (AA) and collagen (COL) were used.Results: Platelet aggregation was reduced by approximately 50% after in vivo protamine administration; ADP 640 +/- 230 (AU*min, mean +/- SD) to 250 +/- 160, TRAP 939 +/- 293 to 472 +/- 260, AA 307 +/- 238 to 159 +/- 143 and COL 1022 +/- 350 to 506 +/- 238 (all p<0.001). Aggregation was also reduced after in vitro addition of protamine alone with activators ADP from 518 +/- 173 to 384 +/- 157 AU*min p<0.001, and AA 449 +/- 311 to 340 +/- 285 (p<0.01) and protamine combined with heparin (1:1 ratio) with activators ADP to 349 +/- 160 and AA to 308 +/- 260 (both p<0.001); and COL from 586 +/- 180 to 455 +/- 172 (p<0.05). Conclusions: Protamine given after CPB markedly reduces platelet aggregation. Protamine added in vitro also reduces platelet aggregation, by itself or in combination with heparin.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2016
Keywords
Cardiopulmonary bypass; platelet aggregation; platelet function tests; protamine
National Category
Surgery
Identifiers
urn:nbn:se:liu:diva-124094 (URN)10.3109/14017431.2015.1099720 (DOI)000365693900009 ()26402229 (PubMedID)
Note

Funding Agencies|Blekinge Institute of Technology, Karlskrona; Department of Cardiothoracic Anaesthesiology and Intensive Care, County Council of Ostergotland [LIO-284621]

Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2018-04-03
Svedjeholm, R., Tajik, B., Vidlund, M., Friberg, Ö., Holm, J., Vanky, F. & Håkansson, E. (2014). Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?. In: : . Paper presented at 6th Joint Scandinavian conference in Cardiothoracic Surgery, Gothenburg, Sweden.
Open this publication in new window or tab >>Intravenous glutamatereduces the need for inotropes in patients with heart failure after CABG foracute coronary syndrome?
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2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-114365 (URN)
Conference
6th Joint Scandinavian conference in Cardiothoracic Surgery, Gothenburg, Sweden
Available from: 2015-02-19 Created: 2015-02-19 Last updated: 2015-03-31
Holm, J., Vidlund, M., Vanky, F., Friberg, Ö., Håkanson, E. & Svedjeholm, R. (2013). Does preoperative NT-proBNP provide additional prognostic information to EuroSCORE II in patients undfergoing CABG?. In: : . Paper presented at 28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013.
Open this publication in new window or tab >>Does preoperative NT-proBNP provide additional prognostic information to EuroSCORE II in patients undfergoing CABG?
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2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103348 (URN)
Conference
28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013
Available from: 2014-01-17 Created: 2014-01-17 Last updated: 2014-02-04
Svedjeholm, R., Vanhanen, I., Vanky, F. & Håkanson, E. (2013). Metabolic Intervention for weaning problems in patients with preoperative left ventricular dysfunction. In: : . Paper presented at 21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013.
Open this publication in new window or tab >>Metabolic Intervention for weaning problems in patients with preoperative left ventricular dysfunction
2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103217 (URN)
Conference
21st Annual meeting of the Asian Society for Cardiovascular and Thoracic Surgery, Kobe, Japan, April 4-7, 2013
Available from: 2014-01-15 Created: 2014-01-15 Last updated: 2014-01-29
Holm, J., Vidlund, M., Vanky, F., Friberg, Ö., Håkansson, E., Walther, S. & Svedjeholm, R. (2013). NT-proBNP provides additional prognostic information to Euroscoe II in patients undergoing CABG. In: : . Paper presented at Thoraxmöte, 16-18 oktober 2013, Linköping.
Open this publication in new window or tab >>NT-proBNP provides additional prognostic information to Euroscoe II in patients undergoing CABG
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2013 (Swedish)Conference paper, Oral presentation with published abstract (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100827 (URN)
Conference
Thoraxmöte, 16-18 oktober 2013, Linköping
Available from: 2013-11-13 Created: 2013-11-13 Last updated: 2015-05-04
Holm, J., Vidlund, M., Vánky, F., Friberg, O., Hakanson, E. & Svedjeholm, R. (2013). Preoperative NT-proBNP independently predicts outcome in patients with acute coronary syndrome undergoing CABG. Scandinavian Cardiovascular Journal, 47(1), 28-35
Open this publication in new window or tab >>Preoperative NT-proBNP independently predicts outcome in patients with acute coronary syndrome undergoing CABG
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2013 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 47, no 1, p. 28-35Article in journal (Refereed) Published
Abstract [en]

Objectives. The predictive value of preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) was evaluated in patients with acute coronary syndrome undergoing coronary artery bypass grafting (CABG). Design. As a substudy to a clinical trial 383 patients with acute coronary syndrome undergoing CABG were studied. 17 patients had a concomitant procedure. NT-proBNP was measured immediately preoperatively and evaluated with regard to in-hospital mortality, and severe circulatory failure postoperatively according to prespecified criteria. Follow-up was 3.2 +/- 0.9 years. Results. In patients with isolated CABG, receiver operating characteristics (ROC) analysis showed an area under the curve (AUC) of 0.82 for in-hospital mortality and 0.87 for severe circulatory failure respectively with a best cut-off for preoperative NT-proBNP of 1028 ng/L. This cut-off level independently predicted severe circulatory failure. Patients with NT-proBNP andlt; 1028 ng/L had significantly better long-term survival (p = 0.004). Preoperative NT-proBNP was higher in patients with concomitant procedure than isolated CABG (2146 +/- 1858 v 887 +/- 1635 ng/L; p = 0.0005). In patients with concomitant procedure ROC analysis showed an AUC of 0.93 for severe circulatory failure with a best cut-off for preoperative NT-proBNP of 3145 ng/L. Conclusions. Preoperative NT-proBNP predicted in-hospital mortality, severe circulatory failure postoperatively and long-term survival in patients undergoing surgery for acute coronary syndrome but a higher threshold was found in patients having concomitant procedures.

Place, publisher, year, edition, pages
Informa Healthcare, 2013
Keywords
acute coronary syndrome, coronary artery bypass grafting, natriuretic peptides
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-88661 (URN)10.3109/14017431.2012.731518 (DOI)000313678500004 ()
Note

Funding Agencies|Swedish Heart-Lung Foundation|20030595|Capio Research Foundation|2005-10212006-1203|Linkoping University||Ostergotlands Lans Landsting||

Available from: 2013-02-14 Created: 2013-02-14 Last updated: 2017-12-06Bibliographically approved
Olsson, A., Håkansson, E., Svedjeholm, R., Alfredsson, J. & Berg, S. (2013). Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass. In: : . Paper presented at Fifth Joint Scandinavian Conference in Cardiothoracic Surgery, 22-24 August 2013, Aarhus, Denmark.
Open this publication in new window or tab >>Protamine reduces whole blood platelet aggregation after cardiopulmonary bypass
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2013 (English)Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-102321 (URN)
Conference
Fifth Joint Scandinavian Conference in Cardiothoracic Surgery, 22-24 August 2013, Aarhus, Denmark
Available from: 2013-12-05 Created: 2013-12-05 Last updated: 2014-01-08
Vidlund, M., Håkanson, E., Friberg, Ö., Holm, J., Vanky, F., Sunnermalm, L. & Svedjeholm, R. (2013). The influence of inotropic drugs on the outcome of the GLUTAMICS trial. In: : . Paper presented at 28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013.
Open this publication in new window or tab >>The influence of inotropic drugs on the outcome of the GLUTAMICS trial
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2013 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103220 (URN)
Conference
28th Annual meeting of the European Association of Cardiothoracic Anesthesiologists, Barcelona, Spain, June 6-8, 2013
Available from: 2014-01-15 Created: 2014-01-15 Last updated: 2014-01-30
Vidlund, M., Håkansson, E., Friberg, O., Juhl-Andersen, S., Holm, J., Vánky, F., . . . Svedjeholm, R. (2012). GLUTAMICS-a randomized clinical trial on glutamate infusion in 861 patients undergoing surgery for acute coronary syndrome. Journal of Thoracic and Cardiovascular Surgery, 144(4), 922
Open this publication in new window or tab >>GLUTAMICS-a randomized clinical trial on glutamate infusion in 861 patients undergoing surgery for acute coronary syndrome
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2012 (English)In: Journal of Thoracic and Cardiovascular Surgery, ISSN 0022-5223, E-ISSN 1097-685X, Vol. 144, no 4, p. 922-Article in journal (Refereed) Published
Abstract [en]

Objective: Glutamate has been claimed to protect the heart from ischemia and to facilitate metabolic and hemodynamic recovery after ischemia. The GLUTAmate for Metabolic Intervention in Coronary Surgery trial investigated whether an intravenous glutamate infusion given in association with surgery for acute coronary syndrome could reduce mortality and prevent or mitigate myocardial injury and postoperative heart failure. less thanbrgreater than less thanbrgreater thanMethods: In the present prospective, triple-center, double-blind study, 861 patients undergoing surgery for acute coronary syndrome were randomly assigned to an intravenous infusion of glutamate (n=428) or saline (n=433) perioperatively. less thanbrgreater than less thanbrgreater thanResults: The incidence of the primary endpoint-a composite of 30-day mortality, perioperative myocardial infarction, and left ventricular heart failure at weaning from cardiopulmonary bypass-was 7.3% versus 5.8% (P=.41) in the glutamate and control groups, respectively. Patients with left ventricular failure at weaning from cardiopulmonary bypass had a shorter median intensive care unit stay (25 vs 92 hours; P=.02) if they were treated with glutamate. In patients with unstable angina (Canadian Cardiovascular Society class IV) undergoing isolated coronary artery bypass grafting (n=458), the incidence of severe circulatory failure according to the prespecified criteria was significantly lower in the glutamate group (1.3% vs 6.9%; P=.004). On multivariate analysis, glutamate infusion was associated with a reduced risk of developing severe circulatory failure (odds ratio, 0.17; 95% confidence interval, 0.04-0.72; P=.02). A relative risk reduction exceeding 50% for developing severe circulatory failure was seen in most risk groups undergoing isolated coronary artery bypass grafting, with those with diabetes a notable exception. less thanbrgreater than less thanbrgreater thanConclusions: The primary endpoint did not differ significantly between the groups. The secondary outcomes and post hoc analyses warrant additional studies with regard to the potential beneficial effect of glutamate on postischemic myocardial recovery.

Place, publisher, year, edition, pages
Elsevier, 2012
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84881 (URN)10.1016/j.jtcvs.2012.05.066 (DOI)000309111600028 ()
Note

Funding Agencies|Swedish Heart-Lung Foundation|20030595|Capio Research Foundation|2005-10212006-1203|Linkoping University||Ostergotlands Lans Landsting||Orebro Lans Landsting||

Available from: 2012-11-01 Created: 2012-10-26 Last updated: 2017-12-07Bibliographically approved
Holm, J., Håkanson, E., Vánky, F. & Svedjeholm, R. (2011). Mixed venous oxygen saturation predicts short- and long-term outcome after coronary artery bypass grafting surgery: a retrospective cohort analysis. British Journal of Anaesthesia, 107(3), 344-350
Open this publication in new window or tab >>Mixed venous oxygen saturation predicts short- and long-term outcome after coronary artery bypass grafting surgery: a retrospective cohort analysis
2011 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 107, no 3, p. 344-350Article in journal (Refereed) Published
Abstract [en]

Background. Complications of an inadequate haemodynamic state are a leading cause of morbidity and mortality after cardiac surgery. Unfortunately, commonly used methods to assess haemodynamic status are not well documented with respect to outcome. The aim of this study was to investigate SV(O2) as a prognostic marker for short-and long-term outcome in a large unselected coronary artery bypass grafting (CABG) cohort and in subgroups with or without treatment for intraoperative heart failure. less thanbrgreater than less thanbrgreater thanMethods. Two thousand seven hundred and fifty-five consecutive CABG patients and subgroups comprising 344 patients with and 2411 patients without intraoperative heart failure, respectively, were investigated. SV(O2) was routinely measured on admission to the intensive care unit (ICU). The mean (SD) follow-up was 10.2 (1.5) yr. less thanbrgreater than less thanbrgreater thanResults. The best cut-off for 30 day mortality related to heart failure based on receiver-operating characteristic analysis was SV(O2) 60.1%. Patients with SV(O2) andlt;60% had higher 30 day mortality (5.4% vs 1.0%; P andlt; 0.0001) and lower 5 yr survival (81.4% vs 90.5%; P andlt; 0.0001). The incidences of perioperative myocardial infarction, renal failure, and stroke were also significantly higher, leading to a longer ICU stay. Similar prognostic information was obtained in the subgroups that were admitted to ICU with or without treatment for intraoperative heart failure. In patients admitted to ICU without treatment for intraoperative heart failure and SV(O2) andgt;= 60%, 30 day mortality was 0.5% and 5 yr survival 92.1%. less thanbrgreater than less thanbrgreater thanConclusions. SV(O2) andlt;60% on admission to ICU was related to worse short- and long-term outcome after CABG, regardless of whether the patients were admitted to ICU with or without treatment for intraoperative heart failure.

Place, publisher, year, edition, pages
Oxford University Press (OUP), 2011
Keywords
assessment, patient outcomes, coronary artery bypass grafting, patient monitoring, postoperative complications, survival rates
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-70321 (URN)10.1093/bja/aer166 (DOI)000293910400008 ()
Note
Funding Agencies|Östergotlands Läns Landsting||Linköping University Hospital||Available from: 2011-09-02 Created: 2011-09-02 Last updated: 2017-12-08
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