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  • 1.
    Ekseth, K
    et al.
    Norge.
    Abildgaard, L
    Vegfors, Magnus
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Anaesthesiology. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, Anestesi.
    Berg-Johnsen, J
    Norge.
    Engdahl, O
    The in vitro effects of crystalloids and colloids on coagulation2002In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 57, no 11, p. 1102-1108Article in journal (Refereed)
    Abstract [en]

    Classically haemodilution is regarded as causing coagulopathy. However, haemodilution with saline seems to cause a hypercoagulable state both in vivo and in vitro. The aim of the present study was to measure the effect of mild to severe haemodilution using thrombelastography. Blood samples were taken in 12 healthy volunteers and divided into seven aliquots. One aliquot was undiluted and acted as control. The other six were diluted with normal saline, Ringer Acetate, 4% albumin, Dextran 70, 6% and 10% hydroxyethylstarch to 10%, 20%, 40%, 50% and 60% dilution. The dilution was checked by measuring the haemoglobin concentration. Each aliquot was placed in a temperature-controlled thrombelastography channel. Increased coagulation activity, as measured by thrombelastography changes, was detected at low and medium levels of dilution with all the tested solutions. At more than 40% dilution, coagulation returned to normal while in the case of dextran and hydroxyethylstarch coagulopathy developed. For crystalloids and albumin, dilution had to exceed 50% before coagulation was impaired. If these findings can be reproduced in vivo, they may have implications for transfusion practice and prophylaxis against thrombosis.

  • 2.
    Hahn, Robert
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping. Sodertalje Hospital, Sweden.
    Nyberg Isacson, M.
    Soder Sjukhuset, Sweden.
    Fagerstrom, T.
    Karolinska Institute, Sweden.
    Rosvall, J.
    Soder Sjukhuset, Sweden.
    Nyman, C. R.
    Soder Sjukhuset, Sweden.
    Isotonic saline in elderly men: an open-labelled controlled infusion study of electrolyte balance, urine flow and kidney function2016In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 71, no 2, p. 155-162Article in journal (Refereed)
    Abstract [en]

    Isotonic saline is a widely-used infusion fluid, although the associated chloride load may cause metabolic acidosis and impair kidney function in young, healthy volunteers. We wished to examine whether these effects also occurred in the elderly, and conducted a crossover study in 13 men with a mean age of 73 years (range 66-84), who each received intravenous infusions of 1.5 l of Ringers acetate and of isotonic saline. Isotonic saline induced mild changes in plasma sodium (mean +1.5 mmol.l(-1)), plasma chloride (+3 mmol.l(-1)) and standard bicarbonate (-2 mmol.l(-1)). Three hours after starting the infusions, 68% of the Ringers acetate and 30% of the infused saline had been excreted (p < 0.01). The glomerular filtration rate increased in response to both fluids, but more after the Ringers acetate (p < 0.03). Pre-infusion fluid retention, as evidenced by high urinary osmolality (> 700 mOsmol.kg(-1)) and/or creatinine (> 7 mmol.l(-1)), was a strong factor governing the responses to both fluid loads.

  • 3.
    Jensen, A. G.
    et al.
    Department of Radiology, Faculty of Health Sciences, Linköping University Hospital, Sweden.
    Kalman, S. H.
    Department of Radiology, Faculty of Health Sciences, Linköping University Hospital, Sweden.
    Eintrei, C.
    Department of Anaesthesiology, Department of Radiology, Faculty of Health Sciences, Linköping University Hospital, Sweden.
    Fransson, Sven-Göran
    Department of Radiology, Faculty of Health Sciences, Linköping University Hospital, Sweden.
    Morales, O.
    Department of Radiology, Faculty of Health Sciences, Linköping University Hospital, Sweden.
    Note: Atelectasis and oxygenation in major surgery with either propofol with or without nitrous oxide or isoflurane anaesthesia1993In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 48, no 12, p. 3p. 1094-1096Article in journal (Other academic)
    Abstract [en]

    Forty-two patients undergoing major colonic surgery were assigned at random to receive isoflurane-fentanyl anaesthesia with nitrous oxide in oxygen, propofol-fentanyl anaesthesia with air in oxygen or propofol-fentanyl anaesthesia with nitrous oxide in oxygen. The groups were comparable in demographic data. Atelectases were identified, and the area measured by computerised tomography of the chest 203±69 min after extubation. and oxygenation was determined by arterial blood gas samples taken during operation at 30, 60, 90 and 120 min after extubation and on postoperative days 1, 2 and 3. Atelectases were seen in all three groups with no differences in the mean area between groups. After operation, the effect of 4 l.min−1 of oxygen by nasal catheter on Pao2 was similar in all groups. A significant decrease in PaO2 was found during the first 3 days after surgery, and was also the same in all groups. There was no correlation between area of atelectasis and postoperative PaO2. We conclude there is no difference in the incidence of postoperative atelectasis or oxygenation when using propofol, with or without nitrous oxide or isoflurane.

  • 4.
    Nilsson, Ulrica K
    et al.
    Department of Anaesthesiology and Intensive Care and Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
    Rawal, Narinder
    Department of Clinical Medicine, Division of Anaesthesiology, Örebro University Hospital, Sweden.
    Unosson, Mitra
    Department of Anaesthesiology and Intensive Care, Örebro University Hospital, Sweden.
    A comparison of intra-operative or postoperative exposure to music: a controlled trial of the effects on postoperative pain2003In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 58, no 7, p. 699-703Article in journal (Refereed)
    Abstract [en]

    The effect of intra-operative compared to postoperative music on postoperative pain was evaluated in a controlled trial. In all, 151 patients undergoing day case surgery for inguinal hernia repair or varicose vein surgery under general anaesthesia were randomly allocated to three groups: group 1 listened to music intra-operatively, group 2 listened to music postoperatively and group 3, the control group, listened to ‘white noise’. The anaesthetic and postoperative analgesic techniques were standardised. Pain was assessed using a numeric rating scale (0–10) and patients requirements for postoperative morphine, paracetamol and ibuprofen was recorded. The effect of music on nausea, fatigue and anxiety was also investigated. The results showed that patients exposed to music intra-operatively or postoperatively reported significantly lower pain intensity at 1 and 2 h postoperatively and patients in the postoperative music group required less morphine at 1 h compared to the control group. No differences were noted in the other variables. This study demonstrates that there is a short-term pain-reducing effect of music therapy however, the beneficial effects do not differ if the patient is exposed to music intra-operatively or postoperatively.

  • 5.
    Steins, Krisjanis
    et al.
    Linköping University, Department of Science and Technology, Communications and Transport Systems. Linköping University, The Institute of Technology.
    Walther, Sten
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery. Linköping University, Faculty of Health Sciences.
    A generic simulation model for planning critical care resource requirements2013In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 68, no 11, p. 1148-1155Article in journal (Refereed)
    Abstract [en]

    Intensive care capacity planning based on factual or forecasted mean admission numbers and mean length of stay without taking non-linearity and variability into account is fraught with error. Simulation modelling may allow for a more accurate assessment of capacity needs. We developed a generic intensive care simulation model using data generated from anonymised patient records of all admissions to four different hospital intensive care units. The model was modified and calibrated stepwise to identify important parameters and their values to obtain a match between model predictions and actual data. The most important characteristic of the final model was the dependency of admission rate on actual occupancy. Occupancy, coverage and transfers of the final model were found to be within 2% of the actual data for all four simulated intensive care units. We have shown that this model could provide accurate decision support for planning critical care resource requirements.

  • 6.
    Szabó, Zoltán
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
    Letter: New forceps for videolaryngoscopic intubation2015In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 70, no 8, p. 1004-1005Article in journal (Other academic)
    Abstract [en]

    n/a

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