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- Bech-Hanssen, Odd, 1956, et al.
(författare)
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The relative contribution of prosthetic gradients, systemic arterial pressure, and pulse pressure to the left ventricular pressure in patients with aortic prosthetic valves.
- 2011
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Ingår i: European journal of echocardiography. - : Oxford University Press (OUP). - 1532-2114 .- 1525-2167. ; 12:1, s. 37-45
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Aortic valve replacement (AVR) in patients with aortic stenosis reduces the left ventricular (LV) pressure and the LV mass. However, residual LV hypertrophy at follow-up is a common finding with negative prognostic impact. In the present study, we investigate the contribution of the prosthesis (size, type, and gradients) and the load opposed by the arterial system to the mean LV pressure (MLVP). METHODS AND RESULTS: Twenty-five patients with a bileaflet mechanical (n = 12, size 19-27) or stented biological (size 21-25) valve were included. After weaning from bypass, continuous Doppler recordings (transoesophageal transducer) and simultaneous LV and aortic pressure measurements were performed (high-fidelity catheters). The mean prosthesis gradients with catheter or Doppler were moderately correlated to MLVP (R(2) = 0.40 and 0.34, P = 0.002 and <0.0001). In a multiple regression model, the relationship between MLVP and prosthesis gradient, mean blood pressure, and pulse pressure was strong for both mechanical and biological valves. Using catheter prosthesis gradients, we could explain 97% of the variability in MLVP and when using Doppler gradients 91%. CONCLUSION: In the present study of patients with aortic prosthetic valves, we demonstrate the importance of the load opposed by the arterial system for the LV pressure. Our findings suggest that the MLVP can be estimated from easily obtainable Doppler data and blood pressure measurements. In analysing predictors of LV mass regression, morbidity, and mortality following AVR, the equations might be of interest.
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| 2. |
- Kotyra, Mathias, 1972, et al.
(författare)
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Pulmonary haemodynamics and right ventricular function during cemented hemiarthroplasty for femoral neck fracture.
- 2010
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 54:10, s. 1210-6
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Tidskriftsartikel (refereegranskat)abstract
- Bone cement implantation syndrome (BCIS) is characterised by hypoxia, hypotension and loss of consciousness occurring early after bone cementation. The haemodynamic perturbations during BCIS have not been extensively studied, particularly not in patients with femoral neck fracture. We evaluated the effects of cemented hemiarthroplasty, in these patients, on pulmonary haemodynamics, right ventricular performance, intrapulmonary shunting and physiological dead space.
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| 3. |
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| 4. |
- Brattwall, Metha, 1952, et al.
(författare)
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Patient assessed health profile: a six-month quality of life questionnaire survey after day surgery.
- 2010
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Ingår i: Scand J Public Health. - : SAGE Publications. - 1651-1905 .- 1403-4948. ; 38:6, s. 574-579
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Patient assessed quality of life is one of the principal end-points after day surgery. The aim of the present study was to describe the natural course, differences and timing of final evaluation for three common day surgical procedures; inguinal hernia repair (IHR), arthroscopic procedures (AS); and cosmetic breast augmentation (CBA). Method: A total of 355 patients prospectively completed an extended eight-item EQ-5D questionnaire (pain, mobility, mood, self-care, activities, sleep, sex, need for analgesic), preoperatively and at one, three and six months postoperatively. RESULTS: Pain and mobility problems were frequently reported prior to surgery among IHR and AS patients, while CBA patients had less deviation from normal in the preoperative health profile. The proportions of patients reporting surgery-related deviations were 35%, 20% and 5% at one, three and six months respectively. After one month, 50% of AS patients still suffered subjective discomfort as compared to 13% and 20% of the IHR and CBA patients, respectively. Pain and ambulation problems were the most common symptoms in all groups. Six months after surgery, 94% of IHR, 89% of AS and 97% of CBA patients were fully recovered. CONCLUSIONS: No major morbidity or severe complications were observed and patients' satisfaction was high overall. We found procedure-specific changes in the postoperative health profile after day surgery. AS patients recovered more slowly compared with IHR and CBA patients. We conclude that time for final evaluation differs significantly between procedures.
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| 5. |
- Brattwall, Metha, 1952, et al.
(författare)
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Patients' assessment of 4-week recovery after ambulatory surgery
- 2011
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Ingår i: Acta Anaesthesiologica Scandinavica. - : The Acta Anaesthesiologica Scandinavica Foundation. - 0001-5172 .- 1399-6576. ; 55:1, s. 92-98
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients’ own assessment of recovery after ambulatory surgery has not been well studied. The aim was to study patients’ self-assessed recovery, the occurrence and time course of post-operative problems in relation to the type of ambulatory surgery.Methods: A questionnaire was filled in by 355 patients at five time points: pre-operative, first day at home, 1, 2 and 4 weeks post-operatively. Consecutive patients who underwent either inguinal hernia repair (IHR), arthroscopic procedures (AS) or cosmetic breast augmentation (CBA) were included.Results: Unplanned return to hospital was rare (3/355). Health care contacts were noted for 9% of the patients during the first week; a total of 70 contacts occurred during the entire period. Pain was the most frequently reported symptom; 40% of the patients reported pain or mobility problems at 1 week, 28% after 2 weeks and 20% after 4 weeks. Pre-operative pain was associated with an increased level of pain during the early post-operative course, in the recovery room and at 1 week post-operatively. IHR was associated with an overall rapid recovery, while AS patients experienced a slower restitution. All AS patients who reported pain after 4 weeks had reported pain problems already pre-operatively. Pain was not present pre-operatively in the CBA group, but was common at 1 and 2 post-operative weeks and was still reported by 11% at 4 weeks.Conclusion: Self-assessed recovery was found to cover several weeks with procedure-specific recovery patterns. Pain and mobility impairment were still frequently reported 4 weeks post-operatively.
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| 6. |
- Brattwall, Metha, 1952, et al.
(författare)
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Postoperative impact of regular tobacco use, smoking or snuffing, a prospective multi-center study.
- 2010
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Ingår i: Acta Anaesthesiol Scand. - : Wiley. - 1399-6576 .- 0001-5172. ; 54:3, s. 321-7
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim was to study the effects of different tobacco administration routes on pain and post-operative nausea and vomiting (PONV), following three common day surgical procedures: cosmetic breast augmentation (CBA), inguinal hernia repair (IHR) and arthroscopic procedures (AS). We have prospectively investigated the effects of regular tobacco use in ambulatory surgery. Methods: The 355 allocated patients were followed during recovery and the first day at home. Results: Thirty-two percent of the patients used tobacco regularly, 33% of CBA, 27% of IHR and 34% of AS. Pain was well controlled in the post-anesthesia care unit at rest; during ambulation, 37% of all patients reported VAS>3. Tobacco use had no impact on early post-operative pain. Post-operative nausea was experienced by 30% of patients during recovery while in hospital. On day 1, 14% experienced nausea. We found a significant reduction of PONV among tobacco users (smoking and/or snuffing). Smoking or snuffing reduced the risk of PONV by nearly 50% in both genders on the day of surgery and at the first day at home. The reduction of PONV was equal, regardless of tobacco administration routes. Conclusion: We found that regular use of tobacco, both by smoking and snuffing, had a significant effect on PONV during the early post-operative period. Non-tobacco users undergoing breast surgery were found to have the highest risk for PONV. We could not see any influence of nicotine use on post-operative pain. Thus, it seems of value to identify regular tobacco use, not only smoking, as a part of the pre-operative risk assessment.
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| 7. |
- Sand, Lena, et al.
(författare)
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Effect of patient position and PEEP on hepatic, portal and central venous pressures during liver resection.
- 2011
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 1399-6576 .- 0001-5172. ; 55:9, s. 1106-12
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that blood loss during liver resection may be reduced if central venous pressure (CVP) is kept at a low level. This can be achieved by changing patient position but it is not known how position changes affect portal (PVP) and hepatic (HVP) venous pressures. The aim of the study was to assess if changes in body position result in clinically significant changes in these pressures.
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