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ALM Fluid Therapy Shifts Sympathetic Hyperactivity to Parasympathetic Dominance in the Rat Model of Non-Compressible Hemorrhagic Shock
Excessive sympathetic outflow following trauma can lead to cardiac dysfunction, inflammation, coagulopathy, and poor outcomes. We previously reported that buprenorphine analgesia decreased survival after hemorrhagic trauma. Our aim is to examine the underlying mechanisms of mortality in a non-compressible hemorrhage rat model resuscitated with saline or adenosine, lidocaine, magnesium (ALM). Anesthetized adult male Sprague-Dawley rats were randomly assigned to Saline control group or ALM therapy group (both n = 10). Hemorrhage was induced by 50% liver resection. After 15 min, 0.7 mL/kg 3% NaCl ± ALM intravenou...
Source: Shock - January 21, 2022 Category: Emergency Medicine Tags: Basic Science Aspects Source Type: research

Orally Administered Crocin Protects Against Cerebral Ischemia/Reperfusion Injury Through the Metabolic Transformation of Crocetin by Gut Microbiota
Conclusion Collectively, pharmacokinetic and pharmacodynamic association studies provide evidence that the gut microbiota plays a vital role in the fate of crocin and crocetin in the gastrointestinal tract. In addition, the cross-interaction between gut microbiota and crocin might mediate the activation of the cerebral-protective effect of orally administered crocin. Ethics Statement This study was carried out in accordance with the recommendations of ‘Institutional Animal Research Committee guidelines, Animal Ethics Committee of China Pharmaceutical University.’ The protocol was approved by the ‘An...
Source: Frontiers in Pharmacology - April 29, 2019 Category: Drugs & Pharmacology Source Type: research

Pharmacokinetics of Magnesium in Cardiac Surgery: Implications for Prophylaxis Against Atrial Fibrillation
Postoperative atrial fibrillation (POAF) is the most common cardiovascular complication in patients undergoing cardiac surgery. The risk of POAF depends on the type of procedure, and ranges from 30% in patients undergoing coronary artery bypass surgery to 50% in those undergoing combined procedures. Patients who develop POAF have an increased risk of a number of other complications, including stroke and a prolonged hospital stay, and have a higher risk of death during long-term follow-up.1 The precise mechanism of POAF is unknown, but it is obvious that numerous preoperative, intraoperative, and postoperative factors might...
Source: Journal of Cardiothoracic and Vascular Anesthesia - December 4, 2017 Category: Anesthesiology Authors: Vladimir V. Lomivorotov, Sergey M. Efremov, Alexander M. Karaskov Tags: Editorial Source Type: research

Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed stud...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Ray A, Ray S Tags: Cochrane Database Syst Rev Source Type: research

Subarachnoid Hemorrhage
Publication date: September 2016 Source:Anesthesiology Clinics, Volume 34, Issue 3 Author(s): Jeremy S. Dority, Jeffrey S. OldhamTeaser Subarachnoid hemorrhage (SAH) is a debilitating, although uncommon, type of stroke with high morbidity, mortality, and economic impact. Modern 30-day mortality is as high as 40%, and about 50% of survivors have permanent disability. Care at high-volume centers with dedicated neurointensive care units is recommended. Euvolemia, not hypervolemia, should be targeted, and the aneurysm should be secured early. Neither statin therapy nor magnesium infusions should be initiated for delayed cereb...
Source: Anesthesiology Clinics - August 9, 2016 Category: Anesthesiology Source Type: research

Myocardial function after polarizing versus depolarizing cardiac arrest with blood cardioplegia in a porcine model of cardiopulmonary bypass EXPERIMENTAL
CONCLUSIONS Polarizing oxygenated blood cardioplegia with esmolol/adenosine/magnesium offers comparable myocardial protection and improves contractility compared with the standard potassium-based depolarizing blood cardioplegia.
Source: European Journal of Cardio-Thoracic Surgery - June 19, 2016 Category: Cardiovascular & Thoracic Surgery Authors: Aass, T., Stangeland, L., Moen, C. A., Salminen, P.-R., Dahle, G. O., Chambers, D. J., Markou, T., Eliassen, F., Urban, M., Haaverstad, R., Matre, K., Grong, K. Tags: History, Myocardial protection EXPERIMENTAL Source Type: research

Cerebral protection during neurosurgery and stroke
This article reviews the recent evidence on perioperative neuroprotection in patients undergoing brain surgery and in patients with acute stroke. Recent findings: With varying degrees of success, numerous pharmacological and nonpharmacological therapies have been employed to provide neuroprotection for patients during the perioperative period and after acute ischemic stroke (IAS). Recent studies have failed to demonstrate neuroprotective effects of intraoperative remifentanil or propofol use, although hypertonic saline may provide better brain relaxation than mannitol during elective intracranial surgery for tumor. Magnesi...
Source: Current Opinion in Anaesthesiology - September 3, 2015 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Keith J. Ruskin Source Type: research

Update on anesthetic neuroprotection
Purpose of review: Perioperative cerebral injury can result in a wide range of clinical consequences from subtle cognitive changes to devastating or fatal strokes. Although the overall incidence of perioperative stroke is low, the large and growing number of aging patients undergoing surgery and anesthesia is placing an increasing number of vulnerable patients at risk. The purpose of this review is to evaluate recent evidence concerning the use of pharmacological and nonpharmacological strategies to protect against perioperative cerebral injury. Recent findings: Although a growing body of preclinical literature suggests th...
Source: Current Opinion in Anaesthesiology - July 3, 2015 Category: Anesthesiology Tags: DRUGS IN ANESTHESIA: Edited by Tong J. Gan Source Type: research

Postoperative ICU management of patients after subarachnoid hemorrhage
This article reviews recent advances in the postoperative ICU management of patients after subarachnoid hemorrhage (SAH), especially with regards to hemodynamic management, methods of improving neurological outcomes, and management of cardiac and pulmonary complications. Recent findingsSeveral hemodynamic monitors and parameters may be useful for guiding volume therapy, including cardiac output, stroke volume variation monitoring, and global end-diastolic volume index. Early goal-directed hemodynamic therapy after SAH has recently been shown to improve clinical outcomes in patients with a poor clinical grade or coexisting ...
Source: Current Opinion in Anaesthesiology - October 1, 2014 Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Kristin Engelhard Source Type: research