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Nilsson, Kristofer F.ORCID iD iconorcid.org/0000-0002-8461-5074
Publications (10 of 18) Show all publications
Duchesne, J., Tatum, D., Hörer, T. M., Nilsson, K. F., McGreevy, D., DuBose, J. & Brenner, M. (2019). IMPACT OF DELTA SYSTOLIC BLOOD PRESSURE AFTER REBOA PLACEMENT IN NON-COMPRESSIBLE TORSO HEMORRHAGE PATIENTS: AN ABOTRAUMA REGISTRY ANALYSIS. Paper presented at 42nd Annual Conference on Shock, Coronado, CA, USA, June 8-11, 2019,. Shock, 51(6), 159-159
Open this publication in new window or tab >>IMPACT OF DELTA SYSTOLIC BLOOD PRESSURE AFTER REBOA PLACEMENT IN NON-COMPRESSIBLE TORSO HEMORRHAGE PATIENTS: AN ABOTRAUMA REGISTRY ANALYSIS
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2019 (English)In: Shock, ISSN 1073-2322, E-ISSN 1540-0514, Vol. 51, no 6, p. 159-159Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-75966 (URN)000480793600343 ()
Conference
42nd Annual Conference on Shock, Coronado, CA, USA, June 8-11, 2019,
Available from: 2019-08-29 Created: 2019-08-29 Last updated: 2019-08-29Bibliographically approved
Seilitz, J., Vidlund, M., Axelsson, B., Nilsson, K. F., Norgren, L., Friberg, Ö. & Jansson, K. (2019). Perioperative intraperitoneal metabolic markers in patients undergoing cardiac surgery with cardiopulmonary bypass: an exploratory pilot study. Perfusion, 34(7), 552-560
Open this publication in new window or tab >>Perioperative intraperitoneal metabolic markers in patients undergoing cardiac surgery with cardiopulmonary bypass: an exploratory pilot study
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2019 (English)In: Perfusion, ISSN 0267-6591, E-ISSN 1477-111X, Vol. 34, no 7, p. 552-560Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiopulmonary bypass and postoperative cardiac dysfunction cause splanchnic hypoperfusion resulting in intra-abdominal anaerobic metabolism and risk for gastrointestinal complications. The intra-abdominal metabolism can be monitored by intraperitoneal measurement of relevant metabolites using microdialysis. The aim of this study was to investigate the intraperitoneal metabolism using microdialysis during and after cardiopulmonary bypass at 34°C.

METHODS: In six patients undergoing elective coronary artery bypass grafting or aortic valve replacement under cardiopulmonary bypass, microdialysis was used to measure intraperitoneal and subcutaneous glucose, lactate, pyruvate, glycerol and glutamate concentrations, intraoperatively and up to 36 hours postoperatively. Arterial and central venous blood gases were analysed as were haemodynamics and the development of complications.

RESULTS: All patients had an ordinary perioperative course and did not develop gastrointestinal complications. The arterial, intraperitoneal and subcutaneous lactate concentrations changed during the perioperative course with differences between compartments. The highest median (interquartile range) concentration was recorded in the intraperitoneal compartment at 1 hour after the end of cardiopulmonary bypass (2.1 (1.9-2.5) mM compared to 1.3 (1.2-1.7) mM and 1.5 (1.0-2.2) mM in the arterial and subcutaneous compartments, respectively). In parallel with the peak increase in lactate concentration, the intraperitoneal lactate/pyruvate ratio was elevated to 33.4 (12.9-54.1).

CONCLUSION: In cardiac surgery, intraperitoneal microdialysis detected changes in the abdominal metabolic state, which were more pronounced than could be shown by arterial blood gas analysis. Despite an uneventful perioperative course, patients undergoing low-risk surgery under cardiopulmonary bypass might be subjected to a limited and subclinical intra-abdominal anaerobic state.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Extracorporeal circulation, gastrointestinal metabolism, glucose, glutamate, glycerol, intraperitoneal microdialysis, lactate, pyruvate, splanchnic hypoperfusion
National Category
Cardiac and Cardiovascular Systems Gastroenterology and Hepatology
Identifiers
urn:nbn:se:oru:diva-73247 (URN)10.1177/0267659119835463 (DOI)000485294500004 ()30880576 (PubMedID)
Funder
Swedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County  

ALF Grants at Region Örebro County 

Available from: 2019-03-20 Created: 2019-03-20 Last updated: 2019-10-02Bibliographically approved
Dogan, E. M., Beskow, L., Calais, F., Hörer, T. M., Axelsson, B. & Nilsson, K. F. (2019). Resuscitative Endovascular Balloon Occlusion of the Aorta in Experimental Cardiopulmonary Resuscitation: Aortic Occlusion Level Matters. Shock, 52(1), 67-74
Open this publication in new window or tab >>Resuscitative Endovascular Balloon Occlusion of the Aorta in Experimental Cardiopulmonary Resuscitation: Aortic Occlusion Level Matters
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2019 (English)In: Shock, ISSN 1073-2322, E-ISSN 1540-0514, Vol. 52, no 1, p. 67-74Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Aortic occlusion during cardiopulmonary resuscitation (CPR) increases systemic arterial pressures. Correct thoracic placement during the resuscitative endovascular balloon occlusion of the aorta (REBOA) may be important for achieving effective CPR.

HYPOTHESIS: The positioning of the REBOA in the thoracic aorta during CPR will affect systemic arterial pressures.

METHODS: Cardiac arrest was induced in 27 anesthetized pigs. After 7 min of CPR with a mechanical compression device, REBOA in the thoracic descending aorta at heart level (zone Ib, REBOA-Ib, n = 9), at diaphragmatic level (zone Ic, REBOA-Ic, n = 9) or no occlusion (control, n = 9) was initiated. The primary outcome was systemic arterial pressures during CPR.

RESULTS: During CPR, REBOA-Ic increased systolic blood pressure from 86 mmHg (confidence interval [CI] 71-101) to 128 mmHg (CI 107-150, P < 0.001). Simultaneously, mean and diastolic blood pressures increased significantly in REBOA-Ic (P < 0.001 and P = 0.006, respectively), and were higher than in REBOA-Ib (P = 0.04 and P = 0.02, respectively) and control (P = 0.005 and P = 0.003, respectively). REBOA-Ib did not significantly affect systemic blood pressures. Arterial pH decreased more in control than in REBOA-Ib and REBOA-Ic after occlusion (P = 0.004 and P = 0.005, respectively). Arterial lactate concentrations were lower in REBOA-Ic compared with control and REBOA-Ib (P = 0.04 and P < 0.001, respectively).

CONCLUSIONS: Thoracic aortic occlusion in zone Ic during CPR may be more effective in increasing systemic arterial pressures than occlusion in zone Ib. REBOA during CPR was found to be associated with a more favorable acid-base status of circulating blood. If REBOA is used as an adjunct in CPR, it may be of importance to carefully determine the aortic occlusion level.The study was performed following approval of the Regional Animal Ethics Committee in Linköping, Sweden (application ID 418).

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
Keywords
Cardiac arrest, cardiopulmonary resuscitation, hemodynamics, metabolism, resuscitative endovascular balloon occlusion of the aorta, return of spontaneous circulation
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-75674 (URN)10.1097/SHK.0000000000001236 (DOI)000480796100010 ()30067564 (PubMedID)2-s2.0-85067806297 (Scopus ID)
Funder
Swedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County 

Nyckelfonden, at Örebro University Hospital  

ALF Grants (Agreement concerning research and education of doctors)  

Region Örebro County 

Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-08-29Bibliographically approved
Wikström, M., Krantz, J., Hörer, T. M. & Nilsson, K. F. (2019). Resuscitative endovascular balloon occlusion of the inferior vena cava is made hemodynamically possible by concomitant endovascular balloon occlusion of the aorta: a porcine study. Journal of Trauma and Acute Care Surgery
Open this publication in new window or tab >>Resuscitative endovascular balloon occlusion of the inferior vena cava is made hemodynamically possible by concomitant endovascular balloon occlusion of the aorta: a porcine study
2019 (English)In: Journal of Trauma and Acute Care Surgery, ISSN 2163-0755, E-ISSN 2163-0763Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Resuscitative endovascular balloon occlusion of the vena cava inferior (REBOVC) may provide a minimal invasive alternative for hepatic vascular and inferior vena cava isolation in severe retrohepatic bleeding. However, circulatory stability may be compromised by the obstruction of venous return. The aim was to explore which combinations of arterial and venous endovascular balloon occlusions, and the Pringle maneuver, are hemodynamically possible in a normovolemic pig model. The hypothesis was that lower body venous blood pooling from REBOVC can be avoided by prior resuscitative endovascular aortic balloon occlusion (REBOA).

METHODS: Nine anesthetized, ventilated, instrumented and normovolemic pigs were used to explore the hemodynamic effects of eleven combinations of REBOA and REBOVC, with or without the Pringle maneuver, in randomized order. The occlusions were performed for 5 minutes but interrupted if systolic blood pressure dropped below 40 mmHg. Hemodynamic variables were measured.

RESULTS: Proximal REBOVC, isolated or in combination with other methods of occlusion, caused severely decreased systemic blood pressure and cardiac output, and had to be terminated before 5 min. The decreases in systemic blood pressure and cardiac output were avoided by REBOA at the same or a more proximal level. The Pringle maneuver had similar hemodynamic effects to proximal REBOVC.

CONCLUSIONS: A combination of REBOA and REBOVC provides hemodynamic stability, in contrast to REBOVC alone or with the Pringle maneuver, and may be a possible adjunct in severe retrohepatic venous bleedings.Level of evidenceBasic science study, therapeutic.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-75810 (URN)10.1097/TA.0000000000002467 (DOI)31397743 (PubMedID)
Available from: 2019-08-23 Created: 2019-08-23 Last updated: 2019-08-23Bibliographically approved
Seilitz, J., Hörer, T. M., Skoog, P., Sadeghi, M., Jansson, K., Axelsson, B. & Nilsson, K. F. (2019). Splanchnic Circulation and Intraabdominal Metabolism in Two Porcine Models of Low Cardiac Output. Journal of Cardiovascular Translational Research, 12(3), 240-249
Open this publication in new window or tab >>Splanchnic Circulation and Intraabdominal Metabolism in Two Porcine Models of Low Cardiac Output
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2019 (English)In: Journal of Cardiovascular Translational Research, ISSN 1937-5387, E-ISSN 1937-5395, Vol. 12, no 3, p. 240-249Article in journal (Refereed) Published
Abstract [en]

The impact of acute cardiac dysfunction on the gastrointestinal tract was investigated in anesthetized and instrumented pigs by sequential reductions of cardiac output (CO). Using a cardiac tamponade (n = 6) or partial inferior caval vein balloon inflation (n = 6), CO was controllably reduced for 1 h each to 75% (CO75%), 50% (CO50%), and 35% (CO35%) of the baseline value. Cardiac output in controls (n = 6) was not manipulated and maintained. Mean arterial pressure, superior mesenteric arterial blood flow, and intestinal mucosal perfusion started to decrease at CO50% in the intervention groups. The decrease in superior mesenteric arterial blood flow was non-linear and exaggerated at CO35%. Systemic, venous mesenteric, and intraperitoneal lactate concentrations increased in the intervention groups from CO50%. Global and mesenteric oxygen uptake decreased at CO35%. In conclusion, gastrointestinal metabolism became increasingly anaerobic when CO was reduced by 50%. Anaerobic gastrointestinal metabolism in low CO can be detected using intraperitoneal microdialysis.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Cardiac dysfunction, Cardiac tamponade, Caval vein balloon, Intraperitoneal microdialysis, Laser Doppler flowmetry, Porcine model
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:oru:diva-70279 (URN)10.1007/s12265-018-9845-6 (DOI)000474567100009 ()30456737 (PubMedID)2-s2.0-85056828149 (Scopus ID)
Funder
Swedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County  

Nyckelfonden at Örebro University Hospital  

ALF Grants (Agreement concerning research and education of doctors) at Region Örebro County 

Available from: 2018-11-22 Created: 2018-11-22 Last updated: 2019-07-29Bibliographically approved
Nilsson, K. F. & Gustafsson, L. E. (2019). Treatment with new organic nitrites in pulmonary hypertension of acute experimental pulmonary embolism. Pharmacology research & perspectives, 7(1), Article ID e00462.
Open this publication in new window or tab >>Treatment with new organic nitrites in pulmonary hypertension of acute experimental pulmonary embolism
2019 (English)In: Pharmacology research & perspectives, E-ISSN 2052-1707, Vol. 7, no 1, article id e00462Article in journal (Refereed) Published
Abstract [en]

Acute pulmonary embolism may cause right heart failure due to increased pulmonary vascular resistance and arterial hypoxemia. Effective vasodilator therapy of the pulmonary hypertension is highly needed. Therefore, we investigated the effects of a newly developed effective pulmonary vasodilator, the organic mononitrites of 1,2-propanediol (PDNO), in a rabbit model of acute pulmonary embolism. In anesthetized and ventilated rabbits, systemic and pulmonary hemodynamics, exhaled nitric oxide (NO), plasma nitrite concentration, and blood gases were monitored. First, dose response experiments with intravenous and left heart ventricle infusions of PDNO and inorganic nitrite were done in naive animals and in pulmonary hypertension induced by a thromboxane A(2) analogue. Second, acute pulmonary embolism was induced and either PDNO or placebo were administered intravenously within 20 minutes and evaluated within 1 hour after pulmonary embolization. PDNO intravenously, in contrast to inorganic nitrite intravenously, increased exhaled NO and counteracted pulmonary hypertension and vasodilated the systemic circulation, dose-dependently, thereby showing efficient NO donation. Pulmonary embolization induced pulmonary hypertension and gas exchange disturbances. PDNO significantly decreased and normalized pulmonary vascular resistance and the right ventricle rate-pressure product, without causing tolerance, with no significant side effects on the systemic circulation, nor on blood-gas values or on methemoglobin formation. In conclusion, PDNO is a NO donor and an efficient vasodilator in the pulmonary circulation. Treatment with this or similar organic nitrites intravenously may be a future option to avoid right heart failure in life-threatening acute pulmonary embolism.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
U46619, alkyl nitrites, chromatography, high pressure liquid, hypertension, inorganic nitrite, lung, nitric oxide, nitric oxide donors, nitrites, organic nitrites, pulmonary, pulmonary circulation, pulmonary embolism
National Category
Anesthesiology and Intensive Care Pharmacology and Toxicology
Identifiers
urn:nbn:se:oru:diva-72042 (URN)10.1002/prp2.462 (DOI)000459169800014 ()30693089 (PubMedID)2-s2.0-85060576741 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Society for Medical Research (SSMF), P14-0170Swedish Research Council, 07919Lars Hierta Memorial FoundationSwedish National Space Board
Note

Funding Agencies:

Fraenckel's foundation for Medical Research  

European Space Agency 

Region Örebro län ALF grants

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-06-19Bibliographically approved
Sadeghi, M., Hörer, T. M., Forsman, D., Dogan, E. M., Jansson, K., Kindler, C., . . . Nilsson, K. F. (2018). Blood pressure targeting by partial REBOA is possible in severe hemorrhagic shock in pigs and produces less circulatory, metabolic and inflammatory sequelae than total REBOA. Injury, 49(12), 2132-2141
Open this publication in new window or tab >>Blood pressure targeting by partial REBOA is possible in severe hemorrhagic shock in pigs and produces less circulatory, metabolic and inflammatory sequelae than total REBOA
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2018 (English)In: Injury, ISSN 0020-1383, E-ISSN 1879-0267, Vol. 49, no 12, p. 2132-2141Article in journal (Refereed) Published
Abstract [en]

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an effective adjunct in exsanguinating torso hemorrhage, but causes ischemic injury to distal organs. The aim was to investigate whether blood pressure targeting by partial REBOA (pREBOA) is possible in porcine severe hemorrhagic shock and to compare pREBOA and total REBOA (tREBOA) regarding hemodynamic, metabolic and inflammatory effects.

Methods: Eighteen anesthetized pigs were exposed to induced controlled hemorrhage to a systolic blood pressure (SBP) of 50 mmHg and randomized into three groups of thoracic REBOA: 30 min of pREBOA (target SBP 80-100 mmHg), tREBOA, and control. They were then resuscitated by autologous transfusion and monitored for 3 h. Hemodynamics, blood gases, mesenteric blood flow, intraperitoneal metabolites, organ damage markers, histopathology from the small bowel, and inflammatory markers were analyzed.

Results: Severe hemorrhagic shock was induced in all groups. In pREBOA the targeted blood pressure was reached. The mesenteric blood flow was sustained in pREBOA, while it was completely obstructed in tREBOA. Arterial pH was lower, and lactate and troponin levels were significantly higher in tREBOA than in pREBOA and controls during the reperfusion period. Intraperitoneal metabolites, the cytokine response and histological analyses from the small bowel were most affected in the tREBOA compared to the pREBOA and control groups.

Conclusion: Partial REBOA allows blood pressure titration while maintaining perfusion to distal organs, and reduces the ischemic burden in a state of severe hemorrhagic shock. Partial REBOA may lower the risks of post-resuscitation metabolic and inflammatory impacts, and organ dysfunction. (C) 2018 Published by Elsevier Ltd.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Hemorrhage, REBOA, Trauma, Injury, Anaerobic metabolism, Aortic balloon occlusion, Shock, Partial REBOA, Ischemia reperfusion injury, Inflammatory response
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
urn:nbn:se:oru:diva-70857 (URN)10.1016/j.injury.2018.09.052 (DOI)000452313500005 ()30301556 (PubMedID)2-s2.0-85054438400 (Scopus ID)
Funder
Swedish Society of MedicineSwedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County  

Nyckelfonden at Örebro University Hospital  

Region Örebro County  

ALF 

Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-10-15Bibliographically approved
Nilsson, K. F., Gozdzik, W., Frostell, C., Zielinski, S., Zielinska, M., Ratajczak, K., . . . Gustafsson, L. E. (2018). Organic mononitrites of 1,2-propanediol act as an effective NO-releasing vasodilator in pulmonary hypertension and exhibit no cross-tolerance with nitroglycerin in anesthetized pigs. Drug Design, Development and Therapy, 12, 685-694
Open this publication in new window or tab >>Organic mononitrites of 1,2-propanediol act as an effective NO-releasing vasodilator in pulmonary hypertension and exhibit no cross-tolerance with nitroglycerin in anesthetized pigs
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2018 (English)In: Drug Design, Development and Therapy, ISSN 1177-8881, E-ISSN 1177-8881, Vol. 12, p. 685-694Article in journal (Refereed) Published
Abstract [en]

Purpose: Clinically available intravenous (IV) nitric oxide (NO) donor drugs such as nitroglycerin (GTN) cause systemic hypotension and/or tolerance development. In a porcine model, novel NO donor compounds - the organic mononitrites of 1,2-propanediol (PDNO) were compared to GTN with regard to pulmonary selectivity and tolerance development. The vasodilatory effects of inorganic nitrite were investigated.

Materials and methods: In anesthetized piglets, central hemodynamics were monitored. At normal pulmonary vascular resistance (PVR), IV infusions of PDNO (15-60 nmol kg(-1) min(-1)), GTN (13-132 nmol kg(-1) min(-1)), and inorganic nitrite (dosed as PDNO) were administered. At increased PVR (by U46619 IV), IV infusions of PDNO (60-240 nmol kg(-1) min(-1)) and GTN (75-300 nmol kg(-1) min(-1)) before and after a 5 h infusion of GTN (45 nmol kg-1 min-1) were given.

Results: At normal PVR, PDNO (n=12) and GTN (n=7) caused significant dose-dependent decreases in mean systemic and pulmonary arterial pressures, whereas inorganic nitrite (n=13) had no significant effect. At increased PVR, PDNO (n=6) and GTN (n=6) significantly decreased mean systemic and pulmonary pressures and resistances, but only PDNO reduced the ratio between pulmonary and systemic vascular resistances significantly. After the 5 h GTN infusion, the hemodynamic response to GTN infusions (n=6) was significantly suppressed, whereas PDNO (n=6) produced similar hemodynamic effects to those observed before the GTN infusion.

Conclusion: PDNO is a vasodilator with selectivity for pulmonary circulation exhibiting no cross-tolerance to GTN, but GTN causes non selective vasodilatation with substantial tolerance development in the pulmonary and systemic circulations. Inorganic nitrite has no vasodilatory properties at relevant doses.

Place, publisher, year, edition, pages
DOVE Medical Press Ltd., 2018
Keywords
nitrites, nitrates, nitric oxide donors, tachyphylaxis, PDNO
National Category
Pharmacology and Toxicology
Identifiers
urn:nbn:se:oru:diva-66657 (URN)10.2147/DDDT.S149727 (DOI)000428802300004 ()29636602 (PubMedID)2-s2.0-85044831003 (Scopus ID)
Funder
Swedish Heart Lung FoundationSwedish Society for Medical Research (SSMF)
Note

Funding Agencies:

European Space Agency  

Fraenckel Foundation  

Lars Hierta Foundation  

Karolinska Institutet  

Region Örebro County  

CF Research and Consulting AB, Stockholm, Sweden  

Available from: 2018-04-19 Created: 2018-04-19 Last updated: 2018-09-04Bibliographically approved
Sadeghi, M., Nilsson, K. F., Larzon, T., Pirouzram, A., Toivola, A., Skoog, P., . . . Hörer, T. M. (2018). The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry. European Journal of Trauma and Emergency Surgery, 44(4), 491-501
Open this publication in new window or tab >>The use of aortic balloon occlusion in traumatic shock: first report from the ABO trauma registry
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2018 (English)In: European Journal of Trauma and Emergency Surgery, ISSN 1863-9933, E-ISSN 1863-9941, Vol. 44, no 4, p. 491-501Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary stabilization of patients with non-compressible torso hemorrhage. This technique has been increasingly used worldwide during the past decade. Despite the good outcomes of translational studies, clinical studies are divided. The aim of this multicenter-international study was to capture REBOA-specific data and outcomes.

METHODS: REBOA practicing centers were invited to join this online register, which was established in September 2014. REBOA cases were reported, both retrospective and prospective. Demographics, injury patterns, hemodynamic variables, REBOA-specific data, complications and 30-days mortality were reported.

RESULTS: Ninety-six cases from 6 different countries were reported between 2011 and 2016. Mean age was 52 ± 22 years and 88% of the cases were blunt trauma with a median injury severity score (ISS) of 41 (IQR 29-50). In the majority of the cases, Zone I REBOA was used. Median systolic blood pressure before balloon inflation was 60 mmHg (IQR 40-80), which increased to 100 mmHg (IQR 80-128) after inflation. Continuous occlusion was applied in 52% of the patients, and 48% received non-continuous occlusion. Occlusion time longer than 60 min was reported as 38 and 14% in the non-continuous and continuous groups, respectively. Complications, such as extremity compartment syndrome (n = 3), were only noted in the continuous occlusion group. The 30-day mortality for non-continuous REBOA was 48%, and 64% for continuous occlusion.

CONCLUSIONS: This observational multicenter study presents results regarding continuous and non-continuous REBOA with favorable outcomes. However, further prospective studies are needed to be able to draw conclusions on morbidity and mortality.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2018
Keywords
Aortic occlusion, Hemorrhage, IABO, REBOA, Trauma
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-61724 (URN)10.1007/s00068-017-0813-7 (DOI)000440981100002 ()28801841 (PubMedID)2-s2.0-85027305588 (Scopus ID)
Funder
Swedish Society for Medical Research (SSMF)
Note

Funding Agencies:

Research Committee of Region Örebro County  

Nyckelfonden at Örebro University Hospital  

ALF Grants (Agreement concerning research and education of doctors)  

Region Örebro County 

Available from: 2017-11-07 Created: 2017-11-07 Last updated: 2019-10-15Bibliographically approved
Seilitz, J., Westerling-Andersson, K., Axelsson, B. & Nilsson, K. F. (2017). Assessment of acute gastrointestinal injury score in postoperative cardiac surgical patients. Acta Anaesthesiologica Scandinavica, 61(8), 1044-1044
Open this publication in new window or tab >>Assessment of acute gastrointestinal injury score in postoperative cardiac surgical patients
2017 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 8, p. 1044-1044Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Gastrointestinal (GI) complications following cardiac surgery are infrequent but feared due to high morbidity and mortality. In 2012 new guidelines for grading acute GI injury (AGI score) in the intensive care setting were presented (1). We aimed to apply the AGI score in postoperative cardiac surgical patients.

Methods: A total number of 352 adult patients undergoing elective heart surgery with extra-corporeal circulation completed the study. Prospectively, AGI score was assessed daily during the first three post-operative days according to normal GI function (AGI 0), risk of developing GI dysfunction (AGI 1), GI dysfunction (AGI 2), GI failure (AGI 3) and GI failure with severe impact on distant organ function (AGI 4).

Results: Ninety-eight percent of the patients were assessed to have a daily peak score of ≤1, but only 36% were completely free from GI symptoms. Seven patients received a peak score of 2–3. The two patients with the highest peak and accumulated AGI scores died later due to GI complications.

Conclusions: Postoperative assessment of AGI score in cardiac surgical patients is feasible. A majority presented with a risk of developing GI dysfunction but did not progress further. Early postoperative GI dys-function might predispose for later GI complications, but a larger study population is needed to further investigate this association.

Reference:1. Reintam BA et al. Intens Care Med 2012; 38: 384–94.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-59285 (URN)10.1111/aas.12941 (DOI)000407231100139 ()
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2019-03-26Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8461-5074

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