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- Hedner, Jan A, 1953, et al.
(author)
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Effects of TRH and TRH analogues on the central regulation of breathing in the rat.
- 1983
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In: Acta physiologica Scandinavica. - : Wiley. - 0001-6772 .- 1365-201X. ; 117:3, s. 427-37
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Journal article (peer-reviewed)abstract
- Respiratory activity was studied in rats during light halothane anesthesia. Thyrotropin releasing hormone (TRH) and two TRH analogues: the desamidated form (TRH-OH) and gamma-butyrolactone-gamma-carbonyl-L-histidyl-L-prolinamide citrate (DN 1417) were administered intracerebroventricularly. TRH 0.5-5 micrograms induced a marked tachypnoea with a rapid onset and a duration of at least 20 min. DN 1417, a potent analogue of TRH with a very low TSH (thyroid stimulating hormone) releasing activity was more effective in stimulating respiratory frequency, while TRH-OH, regarded to have neither TSH releasing nor extra hypothalamic effects, at equimolar doses was unable to induce any changes in the respiratory pattern. When TRH was given into the fourth ventricle the dose response curve was slightly shifted to the left. In experiments employing the occluded breath technique, P0.1 was increased in the same magnitude as the mean inspiratory flow (VT/T1). The results also indicated an increase in the gain of the inflation reflex loop whereas the central bulbopontine setting for T1 and TTOT were not significantly changed. Local injection of TRH into the nucleus tractus solitarii induced a stimulation of respiratory frequency which was slower in onset compared to the response seen after injection into the lateral or fourth ventricles. Concomitantly to the respiratory changes, i.c.v. TRH injection induced a hypocarbia and an alkalosis. No changes in blood pressure or heart rate were seen. The respiratory stimulant effect of TRH could be potentiated by pretreatment with naloxone, methylatropine or a low dose of GABA. Haloperidol or propranolol did not significantly change the respiratory effects of TRH, while reserpine pretreatment seemed to blunt some of the ventilatory effects of TRH. It seems likely that TRH has few direct effects on brain stem neurones involved in the central regulation of respiration, but the main effects seem to be elicited in areas rostral to the brain stem. The respiratory stimulating effect of TRH is unrelated to TSH. Furthermore, other neurotransmitter systems might also be involved in modulation of the respiratory stimulation evoked by TRH.
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- Ringdal, Mona, 1955, et al.
(author)
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Delusional memories from the intensive care unit - experienced by patients with physical trauma
- 2006
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In: Intensive and Critical Care Nursing. - 0964-3397. ; 22:6, s. 346-354
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Journal article (peer-reviewed)abstract
- During and after intensive care unit (ICU) stays some patients report unreal experiences or so called delusional memories, which can be a source of distress. The aims of this study were: to describe trauma patients' memories of their stay in the ICU, factors that may influence delusional memories, problems experienced after discharge from the ICU and the patients' return to work. In this multi-centre study, 239 trauma patients filled in a self-administered questionnaire (ICUM tool) 6-18 months after their ICU stay. Clinical data were obtained from patient records. Fifteen percent of the respondents had no memory whatsoever of the ICU. Factual memories such as visits by family members were recalled by 83%. Delusional memories were reported by 26%, nightmares being the most common. These patients' also had more memories of pain, fear and panic. Significant factors associated with delusional memories were age <50 year, ICU stay >/=3 days, temperature >/=38 degrees C, S-Haemaglobin
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- Ringdal, Mona, 1955, et al.
(author)
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Outcome After Injury: Memories, Health-Related Quality of Life, Anxiety, and Symptoms of Depression After Intensive Care
- 2009
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In: Journal of Trauma-Injury Infection & Critical Care. - 0022-5282. ; 66:4, s. 1226-1233
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Journal article (peer-reviewed)abstract
- Background: To examine the relationship between delusional memories from the Intensive Care Unit (ICU) stay, health related quality of life (HRQoL), anxiety, and symptoms of depression in patients with physical trauma, 6 months to 18 months after their ICU stay. Methods: Multicenter study in five combined medical and surgical ICUs (n = 239). A questionnaire comprising the Medical outcome Short Form 36, the Hospital Anxiety and Depression scale, and the Intensive Care Unit Memory tool was sent to the patients with trauma 6 months to 18 months after their discharge from the ICU. Clinical data were drawn from patient records in retrospect. A matched reference sample (n = 159) was randomly drawn from the Swedish Short Form 36 norm database (n = 8,930). Results: Patients with trauma had significantly lower HRQoL than the reference sample. One or more delusional memories such as hallucinations, nightmares, dreams, or sensations of people trying to hurt them in the ICU were experienced by 26%. These patients were significantly younger, had a longer ICU stay, relied more on mechanical ventilation, and had higher Injury Severity Score and Sequential Organ Failure Assessment scores. They also reported a significantly poorer HRQoL and a higher probability of experiencing anxiety (51% vs. 29%) and symptoms of depression (48% vs. 26%) compared with patients without such memories. Conclusions: Our results highlight the importance of treating the delusional memories experienced by ICU patients with a trauma diagnosis as a postinjury factor with a potential to create anxiety and symptoms of depression and which may affect HRQoL after discharge.
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