Current anaesthesia and critical care最新文献_第2页

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-10 DOI: 10.1016/j.cacc.2010.07.012

Paul L. Chazot

引用次数: 0

Update on transplantation tolerance 移植耐受的最新进展

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-12 DOI: 10.1016/j.cacc.2010.07.008

Anne Cunningham

{"title":"Update on transplantation tolerance","authors":"Anne Cunningham","doi":"10.1016/j.cacc.2010.07.008","DOIUrl":"10.1016/j.cacc.2010.07.008","url":null,"abstract":"<div><p>The induction of transplantation tolerance has become a major goal, because modern immunosuppressive therapy has not improved chronic rejection rates, and is associated with significant side effects. This article aims to explain the principles of immunological tolerance. Mechanisms of central tolerance involve deletion of self-reactive T cells. Mechanisms of peripheral tolerance are reviewed and also the identification of a subset of regulatory T cells which are characterised by the expression of the transcription factor FoxP3.</p><p>Interesting recent insights on the role of the ‘anti-inflammatory’ cytokine transforming growth factor β which can ultimately lead to the generation of inhibitory Tregs or inflammatory Th17 cells (CD4 helper T cells which secrete the pro-inflammatory cytokine IL17) are discussed.</p><p>There are many ways to induce experimental tolerance in animals, however these are difficult to translate tolerance into the clinical context. In addition, standard immunosuppressive agents are calcineurin inhibitors which block T cell activation and IL-2 production. These drugs not only inhibit the activation of effector T cells, but also Tregs, therefore inhibiting Treg driven tolerance induction. Other classes of immunosuppressive drugs should be introduced into the clinic to allow for the possibility of tolerance induction. Strategies to modulate immune responses following transplantation and their potential risks are discussed.</p></div>","PeriodicalId":81055,"journal":{"name":"Current anaesthesia and critical care","volume":"21 5","pages":"Pages 229-232"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cacc.2010.07.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75665114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Treatment of anesthesia-induced lung collapse with lung recruitment maneuvers 肺复吸手法治疗麻醉致肺塌陷

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-17 DOI: 10.1016/j.cacc.2010.07.007

Gerardo Tusman , Javier F. Belda

{"title":"Treatment of anesthesia-induced lung collapse with lung recruitment maneuvers","authors":"Gerardo Tusman , Javier F. Belda","doi":"10.1016/j.cacc.2010.07.007","DOIUrl":"10.1016/j.cacc.2010.07.007","url":null,"abstract":"<div><p>General anesthesia causes atelectasis and airway closure in dependent areas of the lung. Both kinds of collapse induce a deterioration of gas exchange characterized by a decrease in arterial oxygenation and an increase in dead space. The severity of this lung dysfunction is proportional to the amount of collapsed tissue that depends on anesthesia, surgical and patient’s factors.</p><p>Lung collapse can be partially prevented by decreasing FiO<sub>2</sub> and/or by applying CPAP during the induction of anesthesia. However, only lung recruitment maneuvers can resolve atelectasis completely. These recruitment maneuvers are ventilatory strategies aimed to restore the normal aeration of the lungs. The maneuvers consist in a brief and controlled increase in airway pressure to open up those pulmonary areas with collapse. Afterward, the lungs are ventilated with a protective strategy setting keeping the lungs open in time with enough positive-end expiratory pressure and low driving pressure. This article describes the physiological and clinical background of lung recruitment maneuvers applied during the intra-operative period.</p></div>","PeriodicalId":81055,"journal":{"name":"Current anaesthesia and critical care","volume":"21 5","pages":"Pages 244-249"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cacc.2010.07.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80744539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 21

Functional characteristics of anesthesia machines with circle breathing system 循环呼吸麻醉机的功能特点

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-18 DOI: 10.1016/j.cacc.2010.07.009

Marina Soro, F. Javier Belda, María Luisa García-Perez, Gerardo Aguilar

引用次数: 7

Perfusates: Their properties and usage for the maintenance and storage of organs for transplantation 灌注剂:它们在维持和储存移植器官方面的特性和用途

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-07-25 DOI: 10.1016/j.cacc.2010.03.008

Aimee Kibondo , Dave Talbot , David Cullis-Hill , Klaus Maag , Anne C. Cunningham , Noel M. Carter

{"title":"Perfusates: Their properties and usage for the maintenance and storage of organs for transplantation","authors":"Aimee Kibondo , Dave Talbot , David Cullis-Hill , Klaus Maag , Anne C. Cunningham , Noel M. Carter","doi":"10.1016/j.cacc.2010.03.008","DOIUrl":"10.1016/j.cacc.2010.03.008","url":null,"abstract":"<div><p>Organ transplantation remains the most cost-effective treatment for many patients with end-stage organ diseases. In clinical transplantation, the main concern is the continuing rise in the number of patients on transplant waiting lists and the widening imbalance between demand and supply of organs from suitable donors. In renal transplantation, the majority of kidneys available are recovered from heart beating donors (HBDs). In recent years, shortage of kidneys from these donors has led to using organs from non-heart-beating donors (NHBDs) to expand the donor pool. However, these organs are often exposed to periods of both warm and cold ischaemic damage which determine short-term and long-term functional and survival outcomes of allografts. Therefore, minimising organ responsiveness to ischaemic injury could be beneficial in improving immediate allograft function. A wide range of protocols and techniques are being developed aiming to minimise ischaemic damage and maintain organ viability between organ harvesting and transplantation. Hypothermic preservation is being used in many transplantation centres to reduce metabolic requirements and promote cellular tolerance to ischaemia. In this article, techniques used in ex-vivo organ preservation will be discussed as well as characteristics of perfusate solutions that are being used to prolong organ viability pre-transplantation.</p></div>","PeriodicalId":81055,"journal":{"name":"Current anaesthesia and critical care","volume":"21 5","pages":"Pages 216-219"},"PeriodicalIF":0.0,"publicationDate":"2010-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cacc.2010.03.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79664412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Continuing Professional Development: Mechanical Ventilation in the OR MCQs and Self-assessment 持续专业发展:手术室机械通气mcq和自我评估

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-18 DOI: 10.1016/j.cacc.2010.07.018

引用次数: 0

Continuing Professional Development: Mechanical Ventilation in the OR MCQs and self-assessment questions 持续专业发展:手术室机械通气mcq和自我评估问题

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-18 DOI: 10.1016/j.cacc.2010.07.017

引用次数: 0

Continuing Professional Development: Transplantation MCQs and self-assessment answers 持续专业发展:移植mcq和自我评估答案

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-08-18 DOI: 10.1016/j.cacc.2010.07.013

引用次数: 0

Anesthetic management of combined emergency cesarean section and craniotomy for intracerebral hemorrhage in a patient with severe pre-eclampsia 急诊剖宫产联合开颅术治疗1例重度子痫前期脑出血患者的麻醉处理

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-07-30 DOI: 10.1016/j.cacc.2010.06.001

S. Roopa , Harihar V. Hegde , Shrirang V. Torgal , Sateesh Melkundi , T.H. Sunita , Rajashekar R. Mudaraddi , P. Raghavendra Rao

引用次数: 5

Fat embolism – An update 脂肪栓塞——最新进展

Current anaesthesia and critical care Pub Date : 2010-10-01 Epub Date: 2010-04-15 DOI: 10.1016/j.cacc.2010.03.003

Pratik Sinha, Nick Bunker, Neil Soni

引用次数: 7