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Vegfors, Magnus
Publications (10 of 12) Show all publications
Zdolsek, J., Vegfors, M., Lindahl, T., Tornquist, T., Bortnik, P. & Hahn, R. (2011). Hydroxyethyl starches and dextran during hip replacement surgery: effects on blood volume and coagulation. Acta Anaesthesiologica Scandinavica, 55(6), 677-685
Open this publication in new window or tab >>Hydroxyethyl starches and dextran during hip replacement surgery: effects on blood volume and coagulation
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2011 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 55, no 6, p. 677-685Article in journal (Refereed) Published
Abstract [en]

Background: Colloid fluids influence the coagulation system by diluting the plasma and, potentially, by exerting other effects that are unique for each fluid product. We hypothesised that changes in the coagulation measured at the end of surgery would be mainly governed by differences in half-life between the colloid fluids. Methods: Eighty-four patients were randomised to receive one of four colloids: HES 130/0.42/6 : 1 (Venofundin (R)), 130/0.4/9 : 1 (Voluven (R)), 200/0.5/5 : 1 (Haes-steril (R)) and 6% dextran 70 (Macrodex (R)). Blood samples were taken just before and after a preoperative 500ml bolus, and also after subsequent elective hip replacement surgery. Volume expansion was estimated from the blood dilution and coagulation assessed by ROTEM, activated partial thromboplastin time, prothrombin international normalised ratio (PT-INR), D-dimer and thrombin-antithrombin complex (TAT). Results: The blood volume expansion amounted to approximately 600 ml for all four colloids directly after infusion. Voluven (R) and Haes-steril (R) prolonged the aPT time and Venofundin (R) increased TAT. Although all colloids increased PT-INR and D-dimer, the ROTEM analyses showed that they consistently shortened the clotting time and weakened the clot strength. These effects were mainly unchanged after surgery, during which the haemorrhage averaged 500-600 ml. Macrodex (R) produced a stronger volume support at the end of the surgery (91% of infused volume; Pless than0.001) than the three starch solutions (42-60%). Conclusions: All tested colloid fluids induced a mild hypercoagulable state with faster clotting, but with weaker clot strength. The additive influence of surgery was relatively small, and postoperative changes in coagulation were mainly due to differences in the half-life of each colloid.

Place, publisher, year, edition, pages
Blackwell Publishing Ltd, 2011
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-69824 (URN)10.1111/j.1399-6576.2011.02434.x (DOI)000292100800009 ()
Available from: 2011-08-10 Created: 2011-08-08 Last updated: 2017-12-08
Nilsson, L., Lindberget, O., Gupta, A. & Vegfors, M. (2010). Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudes.. Acta Anaesthesiologica Scandinavica, 54(2), 176-82
Open this publication in new window or tab >>Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudes.
2010 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 54, no 2, p. 176-82Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The operating room is a complex work environment with a high potential for adverse events. Protocols for perioperative verification processes have increasingly been recommended by professional organizations during the last few years. We assessed personnel attitudes to a pre-operative checklist ('time out') immediately before start of the operative procedure. METHODS: 'Time out' was implemented in December 2007 as an additional safety barrier in two Swedish hospitals. One year later, in order to assess how the checklist was perceived, a questionnaire was sent by e-mail to 704 persons in the operating departments, including surgeons, anesthesiologists, operation and anesthetic nurses and nurse assistants. In order to identify differences in response between professions, each alternative in the questionnaire was assigned a numerical value. RESULTS: The questionnaire was answered by 331 (47%) persons and 93% responded that 'time out' contributes to increased patient safety. Eighty-six percent thought that 'time out' gave an opportunity to identify and solve problems. Confirmation of patient identity, correct procedure, correct side and checking of allergies or contagious diseases were considered 'very important' by 78-84% of the responders. Attitudes to checking of patient positioning, allergies and review of potential critical moments were positive but differed significantly between the professions. Attitudes to a similar checklist at the end of surgery were positive and 72-99% agreed to the different elements. CONCLUSION: Staff attitudes toward a surgical checklist were mostly positive 1 year after their introduction in two large hospitals in central Sweden.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-54483 (URN)10.1111/j.1399-6576.2009.02109.x (DOI)19719811 (PubMedID)
Available from: 2010-03-18 Created: 2010-03-18 Last updated: 2017-12-12
Laurent, C., Jönsson, B., Vegfors, M. & Lindberg, L.-G. (2005). Non-invasive measurement of systolic blood pressure on the arm utilising photoplethysmography: development of the methodology. Medical and Biological Engineering and Computing, 43(1), 131-135
Open this publication in new window or tab >>Non-invasive measurement of systolic blood pressure on the arm utilising photoplethysmography: development of the methodology
2005 (English)In: Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444, Vol. 43, no 1, p. 131-135Article in journal (Refereed) Published
Abstract [en]

Photoplethysmography (PPG) can be used to measure systolic blood pressure at the brachial artery. With a specially designed probe, positioned in the most distal position beneath a pressure cuff on the upper arm, this is possible. The distance between the light source (880 nm) and the photodetector was 20 mm. A test was performed on neuro-intensive care patients by determining blood pressure from the PPG curves, and, when it was compared with systolic blood pressure obtained from inserted indwelling arterial catheters, a correlation factor of r=0.95 was achieved. The difference between blood pressure obtained using PPG and invasive blood pressure measurement was 3.9±9.1 mmHg (mean±SD), n=19. The depth to the brachial artery was 13.9±4.1 mm (mean±SD), n=18. A digital PPG system utilising pulsating light was also developed.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-29570 (URN)10.1007/BF02345134 (DOI)000226938000020 ()14945 (Local ID)14945 (Archive number)14945 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2017-12-13
Kimme, P., Fridriksson, S., Engdahl, O., Hillman, J., Vegfors, M. & Sjöberg, F. (2004). Moderate hypothermia for 359 operations to clip cerebral aneurysms. British Journal of Anaesthesia, 93(3), 343-347
Open this publication in new window or tab >>Moderate hypothermia for 359 operations to clip cerebral aneurysms
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2004 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 93, no 3, p. 343-347Article in journal (Refereed) Published
Abstract [en]

Background. Experimental data have suggested that hypothermia (32–34°C) may improve outcome after cerebral ischaemia, but its efficacy has not yet been established conclusively in humans. In this study we examined the feasibility and safety of deliberate moderate perioperative hypothermia during operations for subarachnoid aneurysms.

Methods. A total of 359 operations for intracranial cerebral aneurysms were included in this prospective study. By using cold intravenous infusions (4°C) and convective cooling our aim was to reduce the patient's core temperature to more than 34°C within 1 h before operation. The protocol assessed postoperative complications such as infections, prolonged mechanical ventilation, pulmonary complications and coagulopathies.

Results. During surgery, the body temperature was reduced to a mean of 32.5 (sd 0.4) °C. Cooling was accomplished at a rate of 4.0 (sd 0.4) °C h−1. All patients were normothermic at 5 (sd 2) h postoperatively. Peri/postoperative complications included circulatory instability (n=36, 10%), arrhythmias (n=17, 5%) coagulation abnormalities and blood transfusion (n=169, 47%), infections (n=29, 8%) and pulmonary complications (infiltrate or oedema while on ventilatory support) (n=97, 27%). Eighteen patients died within 30 days (5%). There was no significant correlation between the extent of hypothermia and any of the complications. However, there was a strong correlation between the occurrence of complications and the severity of the underlying neurological disease as assessed by the Hunt and Hess score.

Conclusion. Moderate hypothermia accomplished within 1 h of induction of anaesthesia and maintained during surgery for subarachnoid aneurysms appears to be a safe method as far as the risks of peri/postoperative complications such as circulatory instability, coagulation abnormalities and infections are concerned.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-24033 (URN)10.1093/bja/aeh206 (DOI)3589 (Local ID)3589 (Archive number)3589 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
Laurent, C., Jönsson, B., Vegfors, M., Eneling, M. & Lindberg, L.-G. (2004). Noninvasive monitoring of systolic blood pressure on the arm utilizing photoplethysmography (PPG): clinical report. In: Gerald E. Cohn; Warren S. Grundfest; David A. Benaron; Tuan Vo-Dinh (Ed.), Proc. SPIE 5318, Advanced Biomedical and Clinical Diagnostic Systems II: (pp. 99). Bellingham WA, USA: SPIE
Open this publication in new window or tab >>Noninvasive monitoring of systolic blood pressure on the arm utilizing photoplethysmography (PPG): clinical report
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2004 (English)In: Proc. SPIE 5318, Advanced Biomedical and Clinical Diagnostic Systems II / [ed] Gerald E. Cohn; Warren S. Grundfest; David A. Benaron; Tuan Vo-Dinh, Bellingham WA, USA: SPIE , 2004, p. 99-Conference paper, Published paper (Refereed)
Abstract [en]

A soft (silicone) probe, containing six light emitting diodes (880 nm) and three photo detectors, utilizes photoplethysmography (PPG) to monitor pulsations from the brachialis artery under an occluding cuff during deflation. When the arterial pulse returns, measured by PPG, the corresponding pressure in the cuff is determined. This pressure is assumed to equal the systolic pressure. An assessment trial was performed on 21 patients (9 women and 12 men, aged 27-69) at the Neuro-Intensive care unit. Since the patients were already provided with arterial needles, invasive blood pressure could be used as the reference. By choosing a threshold, for detecting pulses, as a fraction (4%) of the maximum amplitude, the systolic blood pressure was underestimated (-0.57 mmHg, SD 12.1). The range of systolic pressure for the patients was 95.5 - 199.0 mmHg, n=14. The method is promising, but improvements still have to be made in order to improve the technique.

Place, publisher, year, edition, pages
Bellingham WA, USA: SPIE, 2004
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-22175 (URN)10.1117/12.529092 (DOI)1305 (Local ID)1305 (Archive number)1305 (OAI)
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2013-11-13
Laurent, C., Jönsson, B., Vegfors, M., Eneling, M. & Lindberg, L.-G. (2004). Nonivasive monitoring of systolic blood pressuire on the arm utilizing photoplethysmpgraphy (PPG). Proceedings of SPIE jfr 1998-2000 SPIE proceedings ISSN 1017-2653, 99-107
Open this publication in new window or tab >>Nonivasive monitoring of systolic blood pressuire on the arm utilizing photoplethysmpgraphy (PPG)
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2004 (English)In: Proceedings of SPIE jfr 1998-2000 SPIE proceedings ISSN 1017-2653, ISSN 1605-7422, p. 99-107Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28707 (URN)13874 (Local ID)13874 (Archive number)13874 (OAI)
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2011-01-12
Naredi, S., Koskinen, L.-O., Grande, P.-O., Nordstrom, C.-H., Nellgard, B., Rydenhag, B. & Vegfors, M. (2003). Treatment of Traumatic Head Injury - U.S./European Guidelines or the Lund Concept [1]. Critical Care Medicine, 31(11)
Open this publication in new window or tab >>Treatment of Traumatic Head Injury - U.S./European Guidelines or the Lund Concept [1]
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2003 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 31, no 11, p. 2713-2714Other (Other academic)
Abstract [en]

[No abstract available]

Publisher
p. 2713-2714
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-46453 (URN)10.1097/01.CCM.0000095462.89651.9C (DOI)
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13
Kimme, P., Jannsen, B., Ledin, T., Gupta, A. & Vegfors, M. (2001). High incidence of pruritus after large doses of hydroxyethyl starch (HES) infusions. Acta Anaesthesiologica Scandinavica, 45(6), 686-689
Open this publication in new window or tab >>High incidence of pruritus after large doses of hydroxyethyl starch (HES) infusions
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2001 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 45, no 6, p. 686-689Article in journal (Refereed) Published
Abstract [en]

Background: There are several studies indicating a correlation between treatment with hydroxyethyl starch (HES) and pruritus. In order to see whether there is a possible dose–response relationship between HES and pruritus, we retrospectively studied 50 patients who had received HES in varying doses (cumulative dose 500–19500 ml) as hemodilution therapy after subarachnoid hemorrhage.

Methods: Of 50 consecutive patients, 6 were excluded due to severe neurological sequelae. A questionnaire was sent to the remaining 44 patients at 6 months (5–12 months) median (range) after the end of HES treatment.

Results: We received answers from 37 patients, of whom 54% reported pruritus. On average pruritus lasted for 15 weeks. There was significantly more pruritus in patients who received more than 5000 ml of HES versus those who received less than 5000 ml (P=0.023). Pruritus had a delayed onset and appeared as pruritic crises lasting for 2–30 min. It had a patchy distribution in most patients and no predilected locations. In 4 patients (20%) the pruritus lasted longer than 21 weeks.

Conclusion: Our study indicates that there is a dose-dependency for the incidence of HES-induced pruritus, and that in some cases the pruritus may be severe and long-lasting.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26975 (URN)10.1034/j.1399-6576.2001.045006686.x (DOI)11609 (Local ID)11609 (Archive number)11609 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
Laurent, C., Jönsson, B., Vegfors, M. & Lindberg, L.-G. (2000). Non-invasive monitoring of systolic blood preassure on arm utilizing photoplethysmography (PPG). In: World Congress of Medical Physics and Biomedical Engineering,2000: . Paper presented at World Congress of Medical Physics and Biomedical Engineering, July 2000, Chicago, USA (pp. 131-135). Springer-Verlag
Open this publication in new window or tab >>Non-invasive monitoring of systolic blood preassure on arm utilizing photoplethysmography (PPG)
2000 (English)In: World Congress of Medical Physics and Biomedical Engineering,2000, Springer-Verlag , 2000, p. 131-135Conference paper, Published paper (Refereed)
Abstract [en]

Photoplethysmography (PPG) can be used to measure systolic blood pressure at the brachial artery. With a specially designed probe, positioned in the most distal position beneath a pressure cuff on the upper arm, this is possible. The distance between the light source (880 nm) and the photodetector was 20 mm. A test was performed on neuro-intensive care patients by determining blood pressure from the PPG curves, and, when it was compared with systolic blood pressure obtained from inserted indwelling arterial catheters, a correlation factor of r=0.95 was achieved. The difference between blood pressure obtained using PPG and invasive blood pressure measurement was 3.9±9.1 mmHg (mean±SD), n=19. The depth to the brachial artery was 13.9±4.1 mm (mean±SD), n=18. A digital PPG system utilising pulsating light was also developed.

Place, publisher, year, edition, pages
Springer-Verlag, 2000
Series
Medical and Biological Engineering and Computing, ISSN 0140-0118, E-ISSN 1741-0444 ; Volume 43, Issue 1
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-32638 (URN)10.1007/BF02345134 (DOI)18555 (Local ID)18555 (Archive number)18555 (OAI)
Conference
World Congress of Medical Physics and Biomedical Engineering, July 2000, Chicago, USA
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2018-02-20
Enlund, G., Johansson, M., Vegfors, M. & Lindberg, L.-G. (1997). Photoplethysmography (PPG) reflexts changes in blood flow at different vascular levels. In: World Congress on Medical Physics and Biomedical Engineering,1997.
Open this publication in new window or tab >>Photoplethysmography (PPG) reflexts changes in blood flow at different vascular levels
1997 (English)In: World Congress on Medical Physics and Biomedical Engineering,1997, 1997Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-32898 (URN)18845 (Local ID)18845 (Archive number)18845 (OAI)
Available from: 2009-10-09 Created: 2009-10-09
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