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Ringer SK, Schmid A, Weiss M, Ohlerth S, Spielmann N, Clausen NG. Non-surgical external jugular vein catheterization using an ear vein access in piglets. Lab Anim 2023; 57:642-649. [PMID: 37077144 DOI: 10.1177/00236772231167224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
The objective of this study was to investigate the feasibility of external jugular vein catheterization through an ear vein in piglets. Forty-six sevoflurane-midazolam anaesthetized piglets were included. External jugular vein catheterization was conducted through the ear vein using the Seldinger technique. Part 1 (n = 27): optimal puncture site was based on the deltoid tuberosity as a landmark to reach the external jugular vein. The final position of the catheter was verified in 25 piglets using computer tomography. Catheterization time was recorded and patency of the catheter assessed by repeated blood sampling for up to 4 h. Part 2 (n = 19): ear vein catheterization was without taking into account any landmarks. Functionality for blood sampling was evaluated as described in part 1. Catheter advancement was possible in 25/27 and 18/19 piglets in parts 1 and 2, respectively. Median (range) time required for successful catheterization was 1.95 (1-10) min (n = 38). The deltoid tuberosity was a good landmark to reach the external jugular vein. But blood sampling was also possible through catheters ending slightly cranial to the external jugular vein. Despite successful catheter advancement, blood sampling was not possible from one catheter in each part of the study (total: two piglets). One of these catheters presented luminal damage, while the other one presented as normal after being removed from the animal. Summarizing, central vein catheterization through the ear vein was feasible in 93.5% and repeated blood sampling was possible in 89.1% of the piglets (n = 46).
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Affiliation(s)
- S K Ringer
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty University of Zurich, Switzerland
| | - A Schmid
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty University of Zurich, Switzerland
| | - M Weiss
- Department of Anaesthesia, University Children's Hospital Zurich, Switzerland
- Children's Research Centre, University Children's Hospital of Zurich, University of Zurich, Switzerland
| | - S Ohlerth
- Clinic of Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty University of Zurich, Switzerland
| | - N Spielmann
- Department of Anaesthesia, University Children's Hospital Zurich, Switzerland
- Children's Research Centre, University Children's Hospital of Zurich, University of Zurich, Switzerland
| | - N G Clausen
- Department of Anaesthesia, University Children's Hospital Zurich, Switzerland
- Children's Research Centre, University Children's Hospital of Zurich, University of Zurich, Switzerland
- Department of Anaesthesiology and Intensive Care, Odense University Hospital, Denmark
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Reimann G, Gerlini R, Spielmann N, Heyne E, Szibor M, Gailus-Durner V, Komlodi T, Gnaiger E, De Angelis MH, Doenst T, Schwarzer M. Defect in Complex III of the Mitochondrial Electron Transfer System Affects Cardiac Insulin Sensitivity but Not Contractile Function. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Buehler PK, Spielmann N, Buehrer S, Schmidt AR, Weiss M, Schmitz A. Intraoperative music application in children and adolescents - a pilot study. Acta Anaesthesiol Scand 2017; 61:895-903. [PMID: 28685824 DOI: 10.1111/aas.12935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 05/29/2017] [Accepted: 06/11/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hospitalization, surgery and anaesthesia may lead to new-onset maladaptive behaviour, emotional distress and trauma. This pilot study aims to investigate the influence of intraoperatively applied music on post-operative behaviour in children and adolescents. METHODS Children with an ASA physical state classification of I or II, aged from 4 to 16 years and scheduled for elective circumcision or inguinal hernia repair under combined general and caudal anaesthesia were included. The children were randomized into two groups. They wore headphones during surgery, and were either exposed to music or not. All involved staff were blinded. Post-operative behaviour was documented by parents on day 7, 14 and 28 after surgery, using a questionnaire adapted from the "Post Hospitalization Behavioural Questionnaire" (PHBQ). Overall occurrence of at least one item indicating maladaptive behaviour was the primary outcome. Data are presented as median (interquartile range). RESULTS In total, 135 children aged 6.6 (5.3-8.5) years, weighing 22 (19-29) kg, were included, with 112 completed questionnaires returned. Overall occurrence of at least one maladaptive item was lower in the music group, with a significantly lower incidence on day 7 (51% vs. 77% in controls; P < 0.01). CONCLUSION Intraoperative music application in children undergoing minor surgical procedures may reduce the incidence of post-operative maladaptive behaviour within the first week.
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Affiliation(s)
- P. K. Buehler
- Department of Anaesthesiology; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Centre; University Children's Hospital Zurich; Zurich Switzerland
| | - N. Spielmann
- Department of Anaesthesiology; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Centre; University Children's Hospital Zurich; Zurich Switzerland
| | - S. Buehrer
- Clinic of Psychiatry and Psychotherapy; University Hospital Zurich; Zurich Switzerland
| | - A. R. Schmidt
- Department of Anaesthesiology; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Centre; University Children's Hospital Zurich; Zurich Switzerland
| | - M. Weiss
- Department of Anaesthesiology; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Centre; University Children's Hospital Zurich; Zurich Switzerland
| | - A. Schmitz
- Department of Anaesthesiology; University Children's Hospital Zurich; Zurich Switzerland
- Children's Research Centre; University Children's Hospital Zurich; Zurich Switzerland
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Abstract
Intravenous fentanyl (10 mcg/kg) or saline (control) was randomly administered to 10 healthy sevoflurane-mono-anaesthetized piglets. Trembling was assessed by two blinded observers using a visual analogue scale (VAS) and a simple ordinal scale at baseline and 5 min (T5) after drug administration. If no trembling was observed at that time point, the opposite treatment was administered and piglets were re-evaluated after another 5 min (T10). Four out of five piglets showed trembling after fentanyl (T5), while none given saline showed any trembling. With fentanyl the VAS scores were significantly higher at T5 compared either with baseline or with the control treatment. Control animals received fentanyl after the 5 min evaluation and all piglets showed clear trembling afterwards. The median time after fentanyl administration until first muscle tremors was 51 (20–840) s. In summary, nine out of 10 sevoflurane-anaesthetized piglets showed muscle tremors after intravenous fentanyl. Tremors subsided over time and no specific treatment was necessary.
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Affiliation(s)
- S K Ringer
- Section Anaesthesiology Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - N Spielmann
- Department of Anaesthesiology, University Children’s Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - M Weiss
- Department of Anaesthesiology, University Children’s Hospital Zurich, Zurich, Switzerland
- Children's Research Center, University Children's Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - J Y Mauch
- Department of Anaesthesiology, Luzerner Kantonsspital, Lucerne, Switzerland
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Haas T, Spielmann N, Restin T, Seifert B, Henze G, Obwegeser J, Min K, Jeszenszky D, Weiss M, Schmugge M. Higher fibrinogen concentrations for reduction of transfusion requirements during major paediatric surgery: A prospective randomised controlled trial. Br J Anaesth 2015; 115:234-43. [PMID: 25982134 DOI: 10.1093/bja/aev136] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2015] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Hypofibrinogenaemia is one of the main reasons for development of perioperative coagulopathy during major paediatric surgery. The aim of this study was to assess whether prophylactic maintenance of higher fibrinogen concentrations through administration of fibrinogen concentrate would decrease the volume of transfused red blood cell (RBCs). METHODS In this prospective, randomised, clinical trial, patients aged 6 months to 17 yr undergoing craniosynostosis and scoliosis surgery received fibrinogen concentrate (30 mg kg(-1)) at two predefined intraoperative fibrinogen concentrations [ROTEM(®) FIBTEM maximum clot firmness (MCF) of <8 mm (conventional) or <13 mm (early substitution)]. Total volume of transfused RBCs was recorded over 24 h after start of surgery. RESULTS Thirty children who underwent craniosynostosis surgery and 19 children who underwent scoliosis surgery were treated per protocol. During craniosynostosis surgery, children in the early substitution group received significantly less RBCs (median, 28 ml kg(-1); IQR, 21 to 50 ml kg(-1)) compared with the conventional fibrinogen trigger of <8 mm (median, 56 ml kg(-1); IQR, 28 to 62 ml kg(-1)) (P=0.03). Calculated blood loss as per cent of estimated total blood volume decreased from a median of 160% (IQR, 110-190%) to a median of 90% (IQR, 78-110%) (P=0.017). No significant changes were observed in the scoliosis surgery population. No bleeding events requiring surgical intervention, postoperative transfusions of RBCs, or treatment-related adverse events were observed. CONCLUSIONS Intraoperative administration of fibrinogen concentrate using a FIBTEM MCF trigger level of <13 mm can be successfully used to significantly decrease bleeding, and transfusion requirements in the setting of craniosynostosis surgery, but not scoliosis. CLINICAL TRIAL REGISTRY NUMBER ClinicalTrials.gov NCT01487837.
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Affiliation(s)
- T Haas
- Department of Anaesthesia, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - N Spielmann
- Department of Anaesthesia, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - T Restin
- Department of Anaesthesia, University Hospital Zurich, Zurich, Switzerland
| | - B Seifert
- Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - G Henze
- Department of Anaesthesia, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - J Obwegeser
- Department of Oral and Maxillofacial Surgery, University Children's Hospital Zurich, Zurich, Switzerland
| | - K Min
- Swiss Scoliosis, Centre for Spinal and Scoliosis Surgery, Zurich, Switzerland
| | - D Jeszenszky
- Department of Spine Surgery and Neurosurgery, Schulthess Clinic, Zurich, Switzerland
| | - M Weiss
- Department of Anaesthesia, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - M Schmugge
- Department of Haematology, University Children's Hospital Zurich, Zurich, Switzerland
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Mauch J, Spielmann N, Hartnack S, Weiss M. Electrocardiographic and haemodynamic alterations caused by three different test solutions of local anaesthetics to detect accidental intravascular injection in children. Br J Anaesth 2012; 108:283-9. [DOI: 10.1093/bja/aer389] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Haas T, Spielmann N, Mauch J, Madjdpour C, Speer O, Schmugge M, Weiss M. Comparison of thromboelastometry (ROTEM®) with standard plasmatic coagulation testing in paediatric surgery. Br J Anaesth 2011; 108:36-41. [PMID: 22086509 DOI: 10.1093/bja/aer342] [Citation(s) in RCA: 267] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thromboelastometry (ROTEM(®)) might be useful to detect intraoperative coagulation disorders early in major paediatric surgery. This observational trial compares this technique to standard coagulation tests. METHODS Intraoperative blood sampling was obtained in children undergoing elective major surgery. At each time point, standard coagulation tests [activated partial thromboplastin time (aPTT), prothrombin time (PT), and fibrinogen level] and ROTEM(®) analyses (InTEM, ExTEM, and FibTEM) were performed simultaneously by trained hospital laboratory staff. RESULTS A total of 288 blood samples from 50 subjects were analysed. While there was a poor correlation between PT and aPTT to ExTEM clotting time (CT) and InTEM CT, respectively, a good correlation was detected between PT and aPTT to clot formation time, and a very good correlation between fibrinogen level and FibTEM assay (r=0.882, P<0.001). Notably, 64% of PT and 94% of aPTT measurements were outside the reference range, while impaired CT was observed in 13% and 6.3%, respectively. Standard coagulation test results were available after a median of 53 min [inter-quartile range (IQR): 45-63 min], whereas 10 min values of ROTEM(®) results were available online after 23 min (IQR: 21-24 min). CONCLUSIONS PT and aPTT cannot be interchangeably used with ROTEM(®) CT. Based on the results of ROTEM(®), recommended thresholds for PT and aPTT might overestimate the need for coagulation therapy. A good correlation was found between the fibrinogen level and the FibTEM assay. In addition, ROTEM(®) offered faster turnaround times.
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Affiliation(s)
- T Haas
- Department of Anaesthesia, University Children’s Hospital Zurich, Steinwiesstrasse 75, Zurich 8032, Switzerland.
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Abstract
For the past two decades, salivary diagnostic approaches have been developed to monitor oral diseases such as periodontal diseases and to assess caries risk. Recently, the combination of emerging biotechnologies and salivary diagnostics has extended the range of saliva-based diagnostics from the oral cavity to the whole physiologic system as most compounds found in blood are also present in saliva. Accordingly, saliva can reflect the physiologic state of the body, including emotional, endocrinal, nutritional and metabolic variations and acts as a source for the monitoring of oral and also systemic health. This review presents an update on the status of saliva diagnostics and delves into their applications to the discovery of biomarkers for cancer detection and therapeutic applications. Translating scientific findings of nucleic acids, proteins and metabolites in body fluids to clinical applications is a cumbersome and challenging journey. Our research group is pursuing the biology of salivary analytes and the development of technologies for detection of distinct biomarkers with high sensitivity and specificity. The avenue of saliva diagnostics incorporating transcriptomic, proteomic and metabolomic findings will enable us to connect salivary molecular analytes to monitor therapies, therapeutic outcomes, and finally disease progression in cancer.
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Affiliation(s)
- N Spielmann
- School of Dentistry and Dental Research Institute, University of California at Los Angeles, Los Angeles, CA, USA.
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Mauch J, Kutter A, Madjdpour C, Spielmann N, Balmer C, Frotzler A, Bettschart-Wolfensberger R, Weiss M. Electrocardiographic changes during continuous intravenous application of bupivacaine in neonatal pigs. Br J Anaesth 2010; 105:437-41. [DOI: 10.1093/bja/aeq197] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Dave M, Frotzler A, Spielmann N, Madjdpour C, Weiss M. Effect of tracheal tube cuff shape on fluid leakage across the cuff: an in vitro study. Br J Anaesth 2010; 105:538-43. [DOI: 10.1093/bja/aeq202] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Spielmann N, Mutch DM, Rousseau F, Tores F, Hager J, Bertrais S, Basdevant A, Tounian P, Dubern B, Galan P, Clément K. Cathepsin S genotypes are associated with Apo-A1 and HDL-cholesterol in lean and obese French populations. Clin Genet 2008; 74:155-63. [DOI: 10.1111/j.1399-0004.2008.01043.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Lai EY, Patzak A, Steege A, Mrowka R, Brown R, Spielmann N, Persson PB, Fredholm BB, Persson AEG. Contribution of adenosine receptors in the control of arteriolar tone and adenosine–angiotensin II interaction. Kidney Int 2006; 70:690-8. [PMID: 16807541 DOI: 10.1038/sj.ki.5001650] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Adenosine (Ado) mediates vasoconstriction via A(1)-Ado receptors and vasodilation via A(2)-Ado receptors in the kidney. It interacts with angiotensin II (Ang II), which is important for renal hemodynamics and tubuloglomerular feedback (TGF). The aim was to investigate the function of Ado receptors in the Ado-Ang II interaction in mouse microperfused, afferent arterioles. Ado (10(-11)-10(-4) mol/l) caused a biphasic response: arteriolar diameters were reduced (-7%) at Ado 10(-11)-10(-9) mol/l and returned to control values at higher concentrations. Treatment with Ang II (10(-10) mol/l) transformed the response into a concentration-dependent constriction. N(6)-cyclopentyladenosine (A(1)-Ado receptor agonist) reduced diameters (12% at 10(-6) mol/l). Application of CGS21680 (10(-12)-10(-4) mol/l, A(2A) receptor agonist) increased the diameter by 13%. Pretreatment with ZM241385 (A(2A)-Ado receptor antagonist) alone or in combination with MRS1706 (A(2B)-Ado receptor antagonist) resulted in a pure constriction upon Ado, whereas 8-cyclopentyltheophylline (CPT) (A(1)-Ado receptor antagonist) inhibited the constrictor response. Afferent arterioles of mice lacking A(1)-Ado receptor did not show constriction upon Ado. Treatment with Ado (10(-8) mol/l) increased the response upon Ang II, which was blocked by CPT. Ado (10(-5) mol/l) did not influence the Ang II response, but an additional blockade of A(2)-Ado receptors enhanced it. The action of Ado on constrictor A(1)-Ado receptors and dilatory A(2)-Ado receptors modulates the interaction with Ang II. Both directions of Ado-Ang II interaction, which predominantly leads to an amplification of the contractile response, are important for the operation of the TGF.
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Affiliation(s)
- E Y Lai
- Department of Medical Cell Biology, Division of Physiology, University of Uppsala, Uppsala, Sweden
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