Publications by authors named "T B Lunen"
Background: Septic shock is associated with high morbidity and mortality, the endothelium plays an important role. Crystalloids is standard of care to maintain intravascular volume. Plasma is associated with improved endothelial integrity and restoration of the glycocalyx layer.
View Article and Find Full Text PDFPurpose: Enhanced recovery after surgery programs is widely implemented in elective settings, however, until recently, rarely in emergency surgery. The purpose of this study was to present detailed contents and data on implementation of an emergency abdominal perioperative protocol on the basis of compliance.
Methods: A multidisciplinary perioperative bundle for major emergency abdominal surgery was developed and implemented in March 2017 covering surgical, emergency, anesthesiological, radiological, physiotherapy, and nutritional support.
Several scoring systems exist for assessing the risk of post-operative organ-specific complications. An accurate estimation can help to identify the high-risk surgical patients, thus providing opportunities for an individualised and improved patient care. Such estimates can guide the pre- and perioperative management, allow shared decision-making with the patient, and target post-operative care.
View Article and Find Full Text PDFArticle Synopsis
- This study investigated how adrenaline affects blood clotting using thrombelastography (TEG) and Multiplate analyses in both splenectomized individuals and healthy controls.
- Healthy subjects showed significant improvements in clot formation and platelet activity after adrenaline infusion, while splenectomized subjects only experienced a reduction in time to initial fibrin formation.
- In liver transplant patients, adrenaline also enhanced clot formation during a critical surgical phase, reinforcing the idea that the spleen plays a major role in adrenaline's boost to hemostatic competence.
Background: In patients undergoing open surgery for a ruptured abdominal aortic aneurysm (rAAA), survivors demonstrate a high platelet count, and proactive administration of platelets (and fresh frozen plasma) appears to influence mortality.
Objectives: This trial investigated the effect of platelets administered before transport to surgery.
Methods: In a prospective study design, patients were randomised to receive platelets (intervention; n = 61) or no platelets (control; n = 61) before transport to vascular surgery from 11 local hospitals.