21 results on '"Anton Lund"'
Search Results
2. The impact of age and obesity on outcomes among patients hospitalized with COVID‐19 in Denmark: A nationwide cohort study
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Anton Lund Andersen, Sigrid Bjerge Gribsholt, Lars Pedersen, Reimar Wernich Thomsen, Thomas Lars Benfield, Ole Søgaard, Stig Lønberg Nielsen, Lars Haukali Omland, Birgitte Lindegaard, Bjørn Richelsen, Jacob Bodilsen, and Jens Meldgaard Bruun
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body mass index (BMI) ,infections ,mortality ,obesity ,Internal medicine ,RC31-1245 - Abstract
Abstract Purpose Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID‐19). Age may impact the association between body weight and severity of COVID‐19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID‐19 in the initial wave of the pandemic. Patients and methods Based on data from the nationwide, clinical database: COVID‐DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment. Results Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID‐19 patients without obesity, patients with obesity displayed a non‐significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID‐19 patients with obesity,
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- 2023
- Full Text
- View/download PDF
3. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury
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Anton Lund, Mette B. Damholt, Ditte G. Strange, Jesper Kelsen, Hasse Møller-Sørensen, and Kirsten Møller
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Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.
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- 2017
- Full Text
- View/download PDF
4. The impact of age and obesity on outcomes among patients hospitalized with COVID-19 in Denmark:A nationwide cohort study
- Author
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Andersen, Anton Lund, Gribsholt, Sigrid Bjerge, Pedersen, Lars, Thomsen, Reimar Wernich, Benfield, Thomas Lars, Søgaard, Ole, Nielsen, Stig Lønberg, Omland, Lars Haukali, Lindegaard, Birgitte, Richelsen, Bjørn, Bodilsen, Jacob, Bruun, Jens Meldgaard, Andersen, Anton Lund, Gribsholt, Sigrid Bjerge, Pedersen, Lars, Thomsen, Reimar Wernich, Benfield, Thomas Lars, Søgaard, Ole, Nielsen, Stig Lønberg, Omland, Lars Haukali, Lindegaard, Birgitte, Richelsen, Bjørn, Bodilsen, Jacob, and Bruun, Jens Meldgaard
- Abstract
Purpose: Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID-19). Age may impact the association between body weight and severity of COVID-19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID-19 in the initial wave of the pandemic. Patients and methods: Based on data from the nationwide, clinical database: COVID-DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment. Results: Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID-19 patients without obesity, patients with obesity displayed a non-significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID-19 patients with obesity, <60 years had highly increased risk of ICU admission (RR 1.92, CI 1.14; 3.24) and IMV (RR 1.95, CI 1.09; 3.49). Conclusions: In hospitalized COVID-19 patients, obesity conferred an approximately 20% increased risk for ICU admission, IMV, and death, although these relationships did not reach statistical significance. COVID-19 patients with obesity and <60 years had an almost doubled risk of ICU admission and IMV.
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- 2023
5. The impact of age and obesity on outcomes among patients hospitalized with COVID‐19 in Denmark: A nationwide cohort study.
- Author
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Andersen, Anton Lund, Gribsholt, Sigrid Bjerge, Pedersen, Lars, Thomsen, Reimar Wernich, Benfield, Thomas Lars, Søgaard, Ole, Nielsen, Stig Lønberg, Omland, Lars Haukali, Lindegaard, Birgitte, Richelsen, Bjørn, Bodilsen, Jacob, and Bruun, Jens Meldgaard
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COVID-19 ,COVID-19 pandemic ,OBESITY ,COHORT analysis ,INTENSIVE care units - Abstract
Purpose: Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID‐19). Age may impact the association between body weight and severity of COVID‐19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID‐19 in the initial wave of the pandemic. Patients and methods: Based on data from the nationwide, clinical database: COVID‐DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment. Results: Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID‐19 patients without obesity, patients with obesity displayed a non‐significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID‐19 patients with obesity, <60 years had highly increased risk of ICU admission (RR 1.92, CI 1.14; 3.24) and IMV (RR 1.95, CI 1.09; 3.49). Conclusions: In hospitalized COVID‐19 patients, obesity conferred an approximately 20% increased risk for ICU admission, IMV, and death, although these relationships did not reach statistical significance. COVID‐19 patients with obesity and <60 years had an almost doubled risk of ICU admission and IMV. [ABSTRACT FROM AUTHOR]
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- 2023
- Full Text
- View/download PDF
6. The impact of age and obesity on outcomes among patients hospitalized with COVID-19 in Denmark:A nationwide cohort study
- Author
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Anton Lund Andersen, Sigrid Bjerge Gribsholt, Lars Pedersen, Reimar Wernich Thomsen, Thomas Lars Benfield, Ole Søgaard, Stig Lønberg Nielsen, Lars Haukali Omland, Birgitte Lindegaard, Bjørn Richelsen, Jacob Bodilsen, and Jens Meldgaard Bruun
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obesity ,Nutrition and Dietetics ,Endocrinology, Diabetes and Metabolism ,body mass index (BMI) ,infections ,mortality - Abstract
Purpose: Obesity may alter the severity of infection with Coronavirus disease 2019 (COVID-19). Age may impact the association between body weight and severity of COVID-19 in patients with obesity. The aim of the study was to examine the association between obesity and severity of infection in a Danish cohort hospitalized with COVID-19 in the initial wave of the pandemic. Patients and methods: Based on data from the nationwide, clinical database: COVID-DK, risks of intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and mortality were compared among patients with and without obesity. Interaction with age was examined and we used Inverse Probability of Treatment Weighting regression for confounder adjustment. Results: Among 524 patients, 142 (27%) were admitted to the ICU, 112 (21%) required IMV, and 109 (21%) died. Compared to COVID-19 patients without obesity, patients with obesity displayed a non-significant increased risk of ICU admission (Relative Risk [RR] 1.19, 95% Confidence Interval [CI] 0.88; 1.60), IMV (RR 1.23, CI 0.86; 1.75) and mortality (RR 1.21, CI 0.84; 1.75). COVID-19 patients with obesity
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- 2023
7. Impact of hyperoxia and phenylephrine on cerebral oxygenation: An experimental clinical study
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Sofie S. Pedersen, Christian S. Meyhoff, Markus Harboe Olsen, Zara R. Stisen, Anton Lund, Kirsten Møller, Jane Skjøth‐Rasmussen, Finn B. Moltke, and Martin Kryspin Sørensen
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Adult ,Oxygen ,Phenylephrine ,Anesthesiology and Pain Medicine ,Brain Injuries ,Hypertension ,Humans ,Brain ,General Medicine ,Hyperoxia - Abstract
BackgroundOxygen supply to the brain is of special importance during intracranial surgery because it may be compromised by intracranial pathology. A high arterial blood pressure (mean arterial pressure above 80 mmHg) and a high arterial oxygen tension (PaO2 above 12 kPa) is therefore often targeted in these patients, when for example intracranial pressure is increased or when a mass effect on brain tissue from a tumour is present, and it is pursued by administering vasopressors such as phenylephrine and by increasing inspiratory oxygen fraction (FiO2). However, whether these interventions increase cerebral oxygenation remains uncertain. We aimed to investigate the effect of hyperoxia and phenylephrine on brain tissue oxygen tension (PbtO2) in patients undergoing craniotomy.MethodsIn this experimental study, we included 17 adult patients scheduled for elective craniotomy. After securing a stable baseline of the oxygen probe, PbtO2 was measured in white matter peripherally in the surgical field during general anaesthesia. Primary comparisons were PbtO2 before versus after an increase in FiO2 from 0.30 to 0.80 as well as before versus after a bolus dose of phenylephrine (0.1–0.2 mg depending on patient haemodynamics). Data were analysed with the Wilcoxon signed rank test.ResultsWe obtained complete data sets in 11 patients undergoing the FiO2 increase and six patients receiving the phenylephrine bolus. PbtO2 was 22 (median; 5%–95% range, 4.6–54) mmHg during 30% oxygen, 68 (8.4–99) mmHg during 80% oxygen (p = .004 compared to 30% oxygen), 21 (4.5–81) mmHg before phenylephrine, and 19 (4.2–56) mmHg after phenylephrine (p = .56 compared to before phenylephrine).ConclusionIn patients undergoing craniotomy under general anaesthesia, brain tissue oxygen tension increased with a high inspiratory oxygen fraction but remained unchanged after a bolus dose of phenylephrine.
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- 2023
8. Tympanic membrane temperature decreases during head up tilt: relation to frontal lobe oxygenation and middle cerebral artery mean blood flow velocity
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Mats Fredrikson, Anton Lund, Niels H. Secher, and David Lorr
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Adult ,Male ,Middle Cerebral Artery ,Tympanic Membrane ,Ultrasonography, Doppler, Transcranial ,Posture ,education ,Clinical Biochemistry ,030204 cardiovascular system & hematology ,Body Temperature ,Young Adult ,03 medical and health sciences ,Oxygen Consumption ,0302 clinical medicine ,Tilt-Table Test ,medicine.artery ,medicine ,Humans ,skin and connective tissue diseases ,Mean Blood Flow Velocity ,Internal jugular vein ,health care economics and organizations ,business.industry ,General Medicine ,Blood flow ,Oxygenation ,Anatomy ,Frontal Lobe ,Cerebral blood flow ,Frontal lobe ,Regional Blood Flow ,Cerebrovascular Circulation ,Anesthesia ,Middle cerebral artery ,cardiovascular system ,sense organs ,Internal carotid artery ,business ,Blood Flow Velocity ,030217 neurology & neurosurgery - Abstract
Changes in blood flow influence temperature of surrounding tissues. Since the internal carotid artery (ICA) and internal jugular vein (IJV) neighbor the tympanic membrane, changes in their blood flow most likely determine changes in tympanic membrane temperature (TMT). We sought to evaluate the relationship between changes during a head-up tilt (HUT) induced reduction in cerebral blood flow (CBF) and TMT.Ten male subjects (age 19-28 years) underwent 50° HUT until presyncope. A non-contact infrared sensor in the ear canal targeted the tympanic membrane. Changes in CBF were monitored by transcranial Doppler which determined the mean blood flow velocity in the middle cerebral artery (MCA VDuring HUT, TMT decreased by 0.6 °C (median; range 0.2 to 1.6 °C) related to a decrease in MCA VDuring an orthostatic challenge TMT decreases and the decrease is related to a reduction in CBF as indicated by MCA V
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- 2017
9. Muscle oxygen saturation increases during head-up tilt-induced (pre)syncope
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Niels D. Olesen, Henrik Toft Sørensen, Henning B. Nielsen, Anton Lund, T. W. Jensen, Niels Vidiendal Olsen, Niels H. Secher, and Mads J. Niemann
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Adult ,Male ,medicine.medical_specialty ,Cardiac output ,Mean arterial pressure ,Physiology ,Hypovolemia ,Posture ,Blood Pressure ,Vasodilation ,030204 cardiovascular system & hematology ,Syncope ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Heart rate ,medicine ,Humans ,Cerebral perfusion pressure ,Muscle, Skeletal ,business.industry ,Hemodynamics ,Stroke volume ,Oxygenation ,Oxygen ,Cerebral blood flow ,Anesthesia ,Cardiology ,Vascular Resistance ,business ,030217 neurology & neurosurgery - Abstract
AIM To evaluate whether muscle vasodilatation plays a role for hypotension developed during central hypovolaemia, muscle oxygenation (Sm O2 ) was examined during (pre)syncope induced by head-up tilt (HUT). Skin blood flow (SkBF) and oxygenation (Sskin O2 ) were determined because evaluation of Sm O2 may be affected by superficial tissue oxygenation. Furthermore, we evaluated cerebral oxygenation (Sc O2 ) and middle cerebral artery mean blood flow velocity (MCAvmean ). METHODS Twenty healthy male volunteers (median age 24 years; range 19-38) were subjected to passive 50° HUT for 1 h or until (pre)syncope. Sc O2 and Sm O2 (near-infrared spectroscopy), MCAvmean (transcranial Doppler) along with mean arterial pressure (MAP), heart rate (HR), stroke volume (SV), cardiac output (CO) and total peripheral resistance (TPR) (Modelflow® ) were determined. RESULTS (Pre)syncopal symptoms appeared in 17 subjects after 11 min (median; range 2-34) accompanied by a decrease in MAP, SV, CO and TPR, while HR remained elevated. During (pre)syncope, Sc O2 decreased [73% (71-76; mean and 95% CI) to 68% (65-71), P < 0.0001] along with MCAvmean [40 (37-43) to 32 (29-35) cm s-1 , P < 0.0001]. In contrast, Sm O2 increased [63 (56-69)% to 71% (65-78), P < 0.0001], while Sskin O2 [64% (58-69) to 53% (47-58), P < 0.0001] and SkBF [71 (44-98) compared to a baseline of 99 (72-125) units, P = 0.020] were reduced. CONCLUSION We confirm that the decrease in MAP during HUT is associated with a reduction in indices of cerebral perfusion. (Pre)syncope was associated with an increase in Sm O2 despite reduced Sskin O2 and SkBF, supporting that muscle vasodilation plays an important role in the circulatory events leading to hypotension during HUT.
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- 2017
10. Intracranial pressure during hemodialysis in patients with acute brain injury
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Kirsten Møller, Ditte Strange, Jørgen Wiis, Mette Brimnes Damholt, Jesper Kelsen, and Anton Lund
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Intracranial Pressure ,Critical Illness ,medicine.medical_treatment ,030232 urology & nephrology ,Brain Edema ,Dialysis disequilibrium syndrome ,Cerebral edema ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,Interquartile range ,Internal medicine ,Humans ,Urea ,Medicine ,Renal replacement therapy ,Dialysis ,Aged ,Retrospective Studies ,Intracranial pressure ,integumentary system ,business.industry ,Area under the curve ,General Medicine ,Middle Aged ,medicine.disease ,humanities ,Renal Replacement Therapy ,Anesthesiology and Pain Medicine ,Blood-Brain Barrier ,Area Under Curve ,Brain Injuries ,Acute Disease ,Cardiology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business ,030217 neurology & neurosurgery - Abstract
Background Because osmotic fluid shifts may occur over the blood-brain barrier, patients with acute brain injury are theoretically at risk of surges in intracranial pressure (ICP) during hemodialysis. However, this remains poorly investigated. We studied changes in ICP during hemodialysis in such patients. Methods We performed a retrospective study of patients with acute brain injury admitted to Rigshospitalet (Copenhagen, Denmark) from 2012 to 2016 who received intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) while undergoing ICP monitoring. Data from each patient's first dialysis session were collected. Area under the curve divided by time (AUC/t) for ICP was calculated separately before and during dialysis. Results Thirteen patients were included. During dialysis, ICP increased from a baseline of 11.9 mm Hg (median; interquartile range 6.3-14.7) to a maximum of 21 mm Hg (18-27) (P = 0.0024), and AUC/t for ICP was greater during dialysis (15.2 (13.4-18.8) vs 11.7 mm Hg (6.4-15.1), P = 0.042). The maximum ICP increase was independent of dialysis modality, but peak values were reached earlier in patients treated with IHD (N = 4) compared to CRRT (N = 9) (75 [30-90] vs 375 min [180-420] after start of treatment, P = 0.0095). The maximum ICP increase correlated positively to the baseline plasma urea concentration (Spearman's r = 0.69, P = 0.017). Conclusion Hemodialysis is associated with increased ICP in neurocritically ill patients, and the magnitude of the increase may be related to initial plasma urea levels.
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- 2018
11. Role of spleen and liver for enhanced hemostatic competence following administration of adrenaline to humans
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Henning B. Nielsen, Thomas B. Lunen, Mads J. Niemann, Morten Zaar, Jens Otto Clemmesen, Niels H. Secher, Peter Plomgaard, and Anton Lund
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Adult ,Male ,Platelet aggregation ,Epinephrine ,medicine.medical_treatment ,Spleen ,030204 cardiovascular system & hematology ,Liver transplantation ,Fibrin ,Hemostatics ,03 medical and health sciences ,0302 clinical medicine ,Healthy control ,medicine ,Humans ,Platelet ,Blood Coagulation ,Hemostasis ,biology ,business.industry ,Hematology ,Liver Transplantation ,Thrombelastography ,medicine.anatomical_structure ,Liver ,030220 oncology & carcinogenesis ,Anesthesia ,biology.protein ,Splenectomy ,Female ,business ,Maximum amplitude - Abstract
This study evaluated by thrombelastography® (TEG) and Multiplate® analyses the role of the spleen and the liver for adrenaline-induced enhanced hemostatic competence. Eight splenectomized subjects and eight matched healthy control subjects were exposed to one-hour infusion of adrenaline (6 μg/kg/h). Administration of adrenaline to the healthy subjects reduced time to TEG-detected initial fibrin formation (by 22%) and increased rate of clot development (by 10%), maximal amplitude (by 8%), platelet count (by 30%), and Multiplate evaluated Ristocetin-induced platelet aggregation (by 21%) (all p ≤ 0.05), but infusion of adrenaline did not result in significant arterial to liver vein differences for plasma markers of coagulation. In the splenectomized subjects, adrenaline reduced the TEG-determined time to initial fibrin formation (by 17%; p = 0.005) whereas rate of clot development and maximum amplitude were unaffected. Also, 6 patients undergoing liver transplantation were exposed to infusion of adrenaline (4.8 μg/kg/h) during the anhepatic phase of the operation and that increased TEG-determined rate of clot formation (by 10%; p 0.05), maximal amplitude (by 9%; p = 0.002) and tended to reduce time to initial fibrin formation (p = 0.1). In conclusion, adrenaline enhances hemostasis as evaluated by TEG in both healthy subjects and in anhepatic patients during liver transplantation and Ristocetin-induced aggregation in control subjects. In contrast, infusion of adrenaline reduces only time to initial fibrin formation in splenectomized subjects. These findings suggest that mobilization of platelets from the spleen dominates the adrenaline-induced enhanced hemostatic competence.
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- 2018
12. Ultrasound tagged near infrared spectroscopy does not detect hyperventilation-induced reduction in cerebral blood flow
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Shigehiko Ogoh, Henrik Winther Schytz, Takeshi Hashimoto, Messoud Ashina, Henrik Toft Sørensen, Anton Lund, Niels H. Secher, and Ai Hirasawa
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Adult ,Male ,Middle Cerebral Artery ,medicine.medical_specialty ,Mean arterial pressure ,Ultrasonography, Doppler, Transcranial ,Clinical Biochemistry ,Phenylephrine ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,medicine.artery ,Internal medicine ,Hyperventilation ,Humans ,Medicine ,Mean Blood Flow Velocity ,Monitoring, Physiologic ,Ultrasonography, Doppler, Duplex ,Spectroscopy, Near-Infrared ,business.industry ,General Medicine ,Blood flow ,Laser Doppler velocimetry ,Transcranial Doppler ,Surgery ,Oxygen ,Cerebral blood flow ,Cerebrovascular Circulation ,Carotid Artery, External ,Middle cerebral artery ,Cardiology ,medicine.symptom ,business ,Blood Flow Velocity ,Carotid Artery, Internal ,030217 neurology & neurosurgery - Abstract
Continuous non-invasive monitoring of cerebral blood flow (CBF) may be important during anaesthesia and several options are available. We evaluated the CerOx monitor that employs ultrasound tagged near infrared spectroscopy to estimate changes in a CBF index (CFI).Seven healthy males (age 21-26 years) hyperventilated and were administered phenylephrine to increase mean arterial pressure by 20-30 mmHg. Frontal lobe tissue oxygenation (ScO2) and CFI were obtained using the CerOx and mean blood flow velocity in the middle cerebral artery (MCAv mean) was determined by transcranial Doppler. Blood flow in the internal and external carotid artery (ICAf and ECAf) was determined using duplex ultrasonography and forehead skin blood flow (SkBF) and oxygenation (S skin O2) by laser Doppler and white light spectroscopy.During hyperventilation MCAv mean and ICAf decreased by 44% (median; interquartile range 40-49; p = 0.016) and 46% (40-53; p = 0.03), respectively. Conversely, CFI increased by 9% (2-31; p = 0.016), while no significant change was observed in ScO2. SkBF increased by 19% (9-53; p = 0.016) and S skin O2 by 6% (1-7; p = 0.047), although ECAf was unchanged. Administration of phenylephrine was not associated with any changes in MCAv mean, ICAf, ECAf, ScO2, SkBF, S skin O2, or CFI.The CerOx was able to detect a stable CBF during administration of phenylephrine. However, during hyperventilation MCAv mean and ICAf decreased while CFI increased, likely due to an increase in superficial tissue oxygenation. Thus, CFI does not provide an unbiased evaluation of changes in CBF.
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- 2015
13. Increased Intracranial Pressure during Hemodialysis in a Patient with Anoxic Brain Injury
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Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller, Ditte Strange, Mette Brimnes Damholt, and Anton Lund
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,Acute kidney injury ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Case Report ,lcsh:RC86-88.9 ,Critical Care and Intensive Care Medicine ,medicine.disease ,Inferior vena cava ,Dialysis disequilibrium syndrome ,Hypertonic saline ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.vein ,Anesthesia ,medicine ,Renal replacement therapy ,Hemodialysis ,business ,030217 neurology & neurosurgery ,Dialysis ,Intracranial pressure - Abstract
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension. CT of the brain showed diffuse cerebral edema. CRRT was discontinued, sedation was increased, and hypertonic saline was administered, upon which ICP normalized. Due to persistent hyperkalemia and overhydration, ultrafiltration and intermittent hemodialysis were performed separately on day 4 with a small dialyzer, low blood and dialysate flow, and high dialysate sodium content. During subsequent treatments, isolated ultrafiltration was well tolerated, whereas hemodialysis was associated with increased ICP necessitating frequent pauses or early cessation of dialysis. In patients at risk of DDS, hemodialysis should be performed with utmost care and continuous monitoring of ICP should be considered.
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- 2017
14. A mesenteric traction syndrome affects near-infrared spectroscopy evaluated cerebral oxygenation because skin blood flow increases
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Lars Bo Svendsen, Rikard Ambrus, Niels H. Secher, Niels D. Olesen, Anton Lund, and Henrik Toft Sørensen
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Male ,Cardiac output ,Health Informatics ,Critical Care and Intensive Care Medicine ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Heart Rate ,Risk Factors ,medicine.artery ,Tachycardia ,Abdomen ,medicine ,Humans ,Anesthesia ,Prospective Studies ,Aged ,Skin ,Spectroscopy, Near-Infrared ,business.industry ,Hemodynamics ,Signal Processing, Computer-Assisted ,Ultrasonography, Doppler ,Oxygenation ,Blood flow ,Laser Doppler velocimetry ,Middle Aged ,Transcranial Doppler ,Frontal Lobe ,Oxygen ,Anesthesiology and Pain Medicine ,Cerebral blood flow ,Cerebrovascular Circulation ,Surgical Procedures, Operative ,Middle cerebral artery ,Female ,Hypotension ,business ,030217 neurology & neurosurgery ,Blood Flow Velocity ,Abdominal surgery - Abstract
During abdominal surgery manipulation of internal organs may induce a “mesenteric traction syndrome” (MTS) including a triad of flushing, hypotension, and tachycardia that lasts for about 30 min. We evaluated whether MTS affects near-infrared spectroscopy (NIRS) assessed frontal lobe oxygenation (ScO2) by an increase in forehead skin blood flow (SkBF). The study intended to include 10 patients who developed MTS during pancreaticoduodenectomy and 22 patients were enrolled (age 61 ± 8 years; mean ± SD). NIRS determined ScO2, laser Doppler flowmetry determined SkBF, cardiac output (CO) was evaluated by pulse-contour analysis (Modelflow), and transcranial Doppler assessed middle cerebral artery mean flow velocity (MCA Vmean). MTS was identified by flushing within 60 min after start of surgery. MTS developed 20 min (12–24; median with range) after the start of surgery and heart rate (78 ± 16 vs. 68 ± 17 bpm; P = 0.0032), CO (6.2 ± 1.4 vs. 5.3 ± 1.1 L min−1; P = 0.0086), SkBF (98 ± 35 vs. 80 ± 23 PU; P = 0.0271), and ScO2 (71 ± 6 vs. 67 ± 8%; P
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- 2016
15. SP230INTRACRANIAL PRESSURE DURING HEMODIALYSIS IN PATIENTS WITH ACUTE BRAIN INJURY
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Joergen Wiis, Strange Ditte G, Anton Lund, Kirsten Moeller, and Mette Brimnes Damholt
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Transplantation ,Nephrology ,business.industry ,medicine.medical_treatment ,Anesthesia ,medicine ,In patient ,Hemodialysis ,business - Published
- 2018
16. Occupational stress is associated with sex and subregion specific modifications of the amygdala volumes
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Nilab Nasrullah, B Khorashad Sorouri, Anton Lundmark, Rene Seiger, and Ivanka Savic
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exhaustion syndrome ,mri ,hippocampus subfields ,amygdala subfields ,chronic stress ,occupational stress ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Background: Despite the rapid increase in reports of exhaustion syndrome (ES) due to daily occupational stress, the mechanisms underlying ES are unknown. In the present study, we investigated whether occupational ES is associated with specific modifications of the subfields of the amygdala and hippocampus resembling those described in other chronic stress conditions. Special focus was paid to possible sex differences. Methods: As a follow up to our previous studies of occupational ES, we carried out MRI-based subfield segmentation of the hippocampus and amygdala volumes in 58 patients with occupational ES (22 males) and 65 age-matched controls (27 males) (age range 30–46 years). Results: There was a significant and bilateral enlargement of the lateral, basal and central nucleus of the amygdala in patients with ES (corrected for the total intracranial volume (ICV)). These differences were detected only in females. Higher values in the right central and right basal amygdala remained when the whole amygdala volume was used as reference, instead of the ICV. Notably, in female patients the volumes of these specific nuclei were positively correlated with the degree of perceived stress. No changes in the hippocampus subfields were detected in female or male patients. Conclusions: The findings underline that ES is a chronic stress condition, suggesting that not only extreme forms of stress, but also the everyday stress is associated with localized differences from controls in the amygdala. The absence of significant alterations among men with ES despite a similar degree of perceived stress supports the notion that women seem more susceptible to stress-related cerebral changes, and may explain the higher prevalence of ES among women.
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- 2023
- Full Text
- View/download PDF
17. High-dose erythropoietin for tissue protection
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Carsten Lundby, Niels Vidiendal Olsen, and Anton Lund
- Subjects
Oncology ,medicine.medical_specialty ,Cardiotonic Agents ,medicine.drug_class ,Clinical Biochemistry ,Pharmacology ,Biochemistry ,law.invention ,Randomized controlled trial ,law ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,Adverse effect ,Stroke ,Erythropoietin ,Randomized Controlled Trials as Topic ,business.industry ,General Medicine ,Erythropoiesis-stimulating agent ,medicine.disease ,Recombinant Proteins ,Clinical trial ,Neuroprotective Agents ,Cytoprotection ,Toxicity ,Hematinics ,Kidney Diseases ,business ,medicine.drug - Abstract
Background The discovery of potential anti-apoptotic and cytoprotective effects of recombinant human erythropoietin (rHuEPO) has led to clinical trials investigating the use of high-dose, short-term rHuEPO therapy for tissue protection in conditions such as stroke and myocardial infarction. Experimental studies have been favourable, but the clinical efficacy has yet to be validated. Materials and methods We have reviewed clinical studies regarding the use of high-dose, short-term rHuEPO therapy for tissue protection in humans with the purpose to detail the safety and efficacy of rHuEPO for this indication. A systematic literature search was performed using the PubMed/MEDLINE database for randomized, placebo-controlled clinical trials. Results Twenty-six randomized controlled trials that enrolled 3176 patients were included. The majority of trials (20 trials including 2724 patients) reported no effect of rHuEPO therapy on measures of tissue protection. Five trials including 1025 patients reported safety concerns in the form of increased mortality or adverse event rates. No studies reported reduced mortality. Conclusions Evidence is sparse to support a tissue-protective benefit of rHuEPO in humans. Moreover, a number of studies indicate that short-term administration of high-dose rHuEPO is associated with an increased risk of mortality and serious adverse events. Further work is needed to elucidate the mechanisms of toxicity of rHuEPO in humans.
- Published
- 2014
18. Systemic Nitrosative/Oxidative Stress in Patients With Acute Brain Injury (NOX)
- Author
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University of South Wales and Anton Lund, MD
- Published
- 2024
19. Cerebral Nitrosative/Oxidative Stress in Aneurysmal Subarachnoid Haemorrhage (NOX2)
- Author
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University of South Wales and Anton Lund, Principal Investigator
- Published
- 2024
20. CFD Analysis of Turbulent Fibre Suspension Flow
- Author
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Vijay Shankar, Anton Lundberg, Taraka Pamidi, Lars-Olof Landström, and Örjan Johansson
- Subjects
cellulose fibre ,CFD ,non-Newtonian fluids ,Bingham model ,orientation distribution function (ODF) ,Thermodynamics ,QC310.15-319 ,Descriptive and experimental mechanics ,QC120-168.85 - Abstract
A new model for turbulent fibre suspension flow is proposed by introducing a model for the fibre orientation distribution function (ODF). The coupling between suspended fibres and the fluid momentum is then introduced through the second and fourth order fibre orientation tensors, respectively. From the modelled ODF, a method to construct explicit expressions for the components of the orientation tensors as functions of the flow field is derived. The implementation of the method provides a fibre model that includes the anisotropic detail of the stresses introduced due to presence of the fibres, while being significantly cheaper than solving the transport of the ODF and computing the orientation tensors from numerical integration in each iteration. The model was validated and trimmed using experimental data from flow over a backwards facing step. The model was then further validated with experimental data from a turbulent fibre suspension channel flow. Simulations were also carried out using a Bingham viscoplastic fluid model for comparison. The ODF model and the Bingham model performed reasonably well for the turbulent flow areas, and the latter model showed to be slightly better given the parameter settings tested in the present study. The ODF model may have good potential, but more rigorous study is needed to fully evaluate the model.
- Published
- 2020
- Full Text
- View/download PDF
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