Glomerular filtration rate is increased in burn patients.

Urinary output, a key parameter guiding fluid resuscitation in burn trauma, is an inadequate measure of renal function. In this study, the clearance of iohexol (CL) was used to follow the glomerular filtration rate during the first week after burn. Nineteen adults with major burns received an intravenous bolus injection of iohexol every other day.

Effects of celecoxib on blood loss, pain, and recovery of function after total knee replacement: a randomized placebo-controlled trial.

Background: Pain management after surgery has been used as a sales argument for the use of COX-2 inhibitors, but their potential positive and negative effects have not been fully investigated. We thus conducted a controlled evaluation of the effect of celecoxib on perioperative blood loss, pain relief and consumption of analgesics, range of motion, and subjective outcome in conjunction with total knee replacement (TKR).

Method: 50 patients were randomized to either placebo or celecoxib (200 mg) preoperatively and then twice daily.

Blood loss after total hip replacement: a prospective randomized study between wound compression and drainage.

A randomized, controlled study compared the effects of wound compression with drainage after primary total hip arthroplasty. In 51 patients, an inflatable cuff was placed over the wound underneath a girdle (System Calmed, Calmed AB, Askim, Sweden). Control patients had wound drainage (n = 54).

Measuring the size of the extracellular fluid space using bromide, iohexol, and sodium dilution.

There is a need to find methods to assess the size of the extracellular fluid (ECF) volume without involving radioactive tracers. For this purpose, we applied 3 methods for measuring the ECF volume in 10 male volunteers (mean age, 34 yr). Steady-state plasma bromide concentration (control) was compared to the results of kinetic analysis of plasma iohexol and to kinetic analysis of the dilution of serum sodium after IV infusion of 1 L of isotonic mannitol.

Tranexamic acid in total hip arthroplasty saves blood and money: a randomized, double-blind study in 100 patients.

Background: A blood transfusion is a costly transplantation of tissue that may endanger the health for the recipient. Blood transfusions are common after total hip arthroplasty. The total saving potential is substantial if the blood loss could be reduced.

Enhanced rate of ethanol elimination from blood after intravenous administration of amino acids compared with equicaloric glucose.

Aims: To investigate the effect of an amino acid mixture given intravenously (i.v.) on the rate of ethanol elimination from blood compared with equicaloric glucose and Ringer's acetate as control treatments.

Nitric oxide does not cause extravasation in endotoxemic rats.

Background: Nitric oxide (NO) formed from inducible NO synthase (iNOS) is assumed to promote vascular permeability in sepsis and endotoxemia.

Methods: Thirty-seven anesthetized rats were examined for the effects of endotoxin. After randomization, 17 animals had lipopolysaccharide (LPS) administered and 20 rats served as controls and were given the corresponding volume of saline.

Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement.

Background: Total knee arthroplasty (TKA) is often carried out using a tourniquet and shed blood is collected in drains. Tranexamic acid decreases the external blood loss. Some blood loss may be concealed, and the overall effect of tranexamic acid on the haemoglobin (Hb) balance is not known.

Albumin extravasation and tissue washout of hyaluronan after plasma volume expansion with crystalloid or hypooncotic colloid solutions.

Background: Intravascular volume expansion is followed by loss of fluid from the circulation. The extravasation of albumin in this readjustment is insufficiently known.

Methods: Twelve male volunteers participated, each in three separate sessions, in a controlled, randomised, open fashion.

Effective inhibition of nitric oxide production by aminoguanidine does not reverse hypotension in endotoxaemic rats.

Background: Excess production of nitric oxide (NO) by the inducible NO synthase (iNOS) has been implicated in the pathophysiology of septic shock. Using methaemoglobin (metHb) and the stable NO metabolite nitrate as markers of NO formation, we assessed the effect of iNOS blockade by aminoguanidine (AG) on hypotension and NO formation in endotoxaemic rats.

Methods: In 32 male Wistar rats under chloralose anaesthesia, MetHb (at 15 and 330 min, respectively) and plasma nitrate (at 330 min) were determined.

Blood loss in prosthetic hip replacement is not influenced by the AB0 blood group.

Objective: To find out if there is a correlation between AB0 type and the amount of blood lost at operation.

Design: Retrospective study.

Setting: One county and one university hospital, Sweden.

Limited effectiveness of intraoperative autotransfusion in major back surgery.

Background And Objective: The efficiency of intraoperative autotransfusion in scoliosis surgery is poorly known but needs to be evaluated, not least because of the large blood losses in these patients. This is a retrospective analysis of transfusion requirements of 43 such patients.

Methods: Records from 43 patients were studied.

Albumin supplementation during the first week after a burn does not mobilise tissue oedema in humans.

Objective: To measure water balance and changes in distribution, and the effect of giving supplementary albumin, early after a burn injury.

Design: Consecutive patients (matched groups) and healthy controls.

Setting: National burn unit in a Swedish university hospital.

Aminoguanidine does not influence tissue extravasation of albumin in endotoxaemic rats.

Background: It is generally maintained that protein and fluid are lost from the circulation under septic conditions. The role played by an increased production of nitric oxide, by the inducible nitric oxide synthase (iNOS), in this process is unclear.

Methods: Chloralose anaesthetised male Wistar rats received E.

Transesophageal echocardiographic hemodynamic monitoring during preoperative acute normovolemic hemodilution.

Background: Preoperative acute normovolemic hemodilution may compromise oxygen transport. The aims of our study were to describe the hemodynamic effects of normovolemic hemodilution and to determine its effect on systolic and diastolic cardiac function by multiplane transesophageal echocardiography.

Methods: In eight anesthetized patients (aged 13-51 yr) without heart disease, hemoglobin was reduced in steps from 123 +/- 8 (mean +/- SD) to 98 +/- 3 and to 79 +/- 5 g/l.

Effects of non-invasive stimulation of acupoints on the cardiovascular system.

Objective: To study the effect of two non-invasive methods to stimulate acupoints on the cardiovascular system.

Design: Blind randomized-controlled trial.

Setting: An experimental setting in a university-affiliated hospital.

The effect of hypermetabolism induced by burn trauma on the ethanol-oxidizing capacity of the liver.

Objective: To study the rate of elimination of ethanol after a major burn trauma.

Design: Prospective, controlled study.

Setting: National burns unit in a Swedish university hospital.

Mild hypothermia does not increase blood loss during total hip arthroplasty.

Background: The effects of mild hypothermia on blood loss are little known.

Methods: Patients, undergoing primary prosthetic hip surgery under spinal anaesthesia, were randomised to the operative procedure, with (n=25) or without (n=25) forced air warming. Core temperature was repeatedly measured from the tympanic membrane.

Quantitative sensory changes in humans after intravenous regional block with mepivacaine.

Background And Objectives: In previous studies we have demonstrated that after intravenous regional block (IVRA) with dilute mepivacaine, there is a decrease in neurogenic inflammation as well as in post-ischemic hyperemia and steady-state flow, the latter for at least 60 minutes. It is unclear whether these vascular reactions reflect a uniform depression of nerve function in the treated arms. Because the various afferents convey impulses from different types of sensory receptors, we used quantitative sensory testing (QST) to define these effects of IVRA with mepivacaine.

Intravenous endotoxin does not increase tissue extravasation of albumin in rats.

Background: It is unclear whether activation of the inducible nitric oxide synthase (iNOS) increases or decreases the extravasation of plasma.

Methods: Chloralose anaesthetised male Wistar rats received E. coli lipopolysaccharide (LPS), 3 mg kg-1 i.

Differential effect on vasodilatation and pain after intradermal capsaicin in humans during decay of intravenous regional anesthesia with mepivacaine.

Background And Objectives: When given intracutaneously, capsaicin can cause burning pain by central propagation in thin afferents, as well as neurogenic vasodilatation, reflecting antidromic conduction in the same fibers. We wanted to test the hypothesis that an intravenous regional block (IVRA) inhibits these two phenomena to a similar degree.

Methods: Sixteen healthy volunteers participated.

Intraoperative autotransfusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery.

Background: The efficacy of intraoperative salvage and washing of wound blood and the predictors of allogeneic red cell transfusions in prosthetic hip surgery are insufficiently known.

Methods: In 96 patients, undergoing primary or revision surgery, salvaged and washed red cells and, if necessary, allogeneic blood were used to keep haematocrit not lower than 33%. The bleeding of red cells during hospital stay was calculated from the red cell balance.

Combined overdose with verapamil and atenolol: treatment with high doses of adrenergic agonists.

A 55-year-old man was admitted following an overdose of sustained-release verapamil (calcium channel blocker) and ordinary-release atenolol (beta-1 blocker). At admission, there was extreme bradycardia (20-25 beats min-1) and hypotension (systolic arterial pressure 40-50 mm Hg). To counteract the cardiovascular depression, prenalterol, dopamine, dobutamine, isoprenaline, adrenaline and noradrenaline were used.