29 results on '"Rueffert, H"'
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2. European Neuromuscular Centre consensus statement on anaesthesia in patients with neuromuscular disorders
- Author
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Bersselaar, L.R. van den, Heytens, L., Silva, H.C.A., Reimann, Jens, Tasca, G., Díaz-Cambronero, Ó., Løkken, N., Hellblom, A., Hopkins, P.M., Rueffert, H., Bastian, B., Vilchez, J.J., Gillies, R., Johannsen, S., Veyckemans, F., Muenster, T., Klein, A., Litman, R., Jungbluth, H., Riazi, S., Voermans, N.C., Snoeck, M.M.J., Bersselaar, L.R. van den, Heytens, L., Silva, H.C.A., Reimann, Jens, Tasca, G., Díaz-Cambronero, Ó., Løkken, N., Hellblom, A., Hopkins, P.M., Rueffert, H., Bastian, B., Vilchez, J.J., Gillies, R., Johannsen, S., Veyckemans, F., Muenster, T., Klein, A., Litman, R., Jungbluth, H., Riazi, S., Voermans, N.C., and Snoeck, M.M.J.
- Abstract
Item does not contain fulltext, BACKGROUND AND PURPOSE: Patients with neuromuscular conditions are at increased risk of suffering perioperative complications related to anaesthesia. There is currently little specific anaesthetic guidance concerning these patients. Here, we present the European Neuromuscular Centre (ENMC) consensus statement on anaesthesia in patients with neuromuscular disorders as formulated during the 259th ENMC Workshop on Anaesthesia in Neuromuscular Disorders. METHODS: International experts in the field of (paediatric) anaesthesia, neurology, and genetics were invited to participate in the ENMC workshop. A literature search was conducted in PubMed and Embase, the main findings of which were disseminated to the participants and presented during the workshop. Depending on specific expertise, participants presented the existing evidence and their expert opinion concerning anaesthetic management in six specific groups of myopathies and neuromuscular junction disorders. The consensus statement was prepared according to the AGREE II (Appraisal of Guidelines for Research & Evaluation) reporting checklist. The level of evidence has been adapted according to the SIGN (Scottish Intercollegiate Guidelines Network) grading system. The final consensus statement was subjected to a modified Delphi process. RESULTS: A set of general recommendations valid for the anaesthetic management of patients with neuromuscular disorders in general have been formulated. Specific recommendations were formulated for (i) neuromuscular junction disorders, (ii) muscle channelopathies (nondystrophic myotonia and periodic paralysis), (iii) myotonic dystrophy (types 1 and 2), (iv) muscular dystrophies, (v) congenital myopathies and congenital dystrophies, and (vi) mitochondrial and metabolic myopathies. CONCLUSIONS: This ENMC consensus statement summarizes the most important considerations for planning and performing anaesthesia in patients with neuromuscular disorders.
- Published
- 2022
3. Mutation screening of the RYR1-cDNA from peripheral B-lymphocytes in 15 Swedish malignant hyperthermia index cases
- Author
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Broman, M., Gehrig, A., Islander, G., Bodelsson, M., Ranklev-Twetman, E., Rüffert, H., and Müller, C.R.
- Published
- 2009
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4. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
- Author
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Kirmeier E. a, Eriksson L. I. c, Lewald H. a, Jonsson Fagerlund, M. c Hoeft, A. f Hollmann, M. g Meistelman, C. e Hunter, J. M. d Ulm, K. b Blobner, M. aEmail Author, Abad Gurumeta, A. Abernethy, C. Abigail, P. Achaibar, K. Adam, E. Afshari, Agudelo Montoya, M. E. Akgün, F. N. Aletti, G. Alkış, N. Allan, K. Allan, A. Allaouchiche, B. Allcock, C. Almasy, E. Amey, I. Amigoni, M. Andersen, E. Andersson, P. Anipchenko, N. Antunes, P. Armstrong, E. Aslam, T. N. Aslin, B. Assunção, J. P. Ausserer, J. Avvai, M. Awad, Ayas Montero, B. Ayuso, M. Azevedo, P. Badarau, V. Badescu, Baiardo Redaelli, M. Baird, C. Baird, Y. Baker, T. Balaji, P. Bălan, C. Balandin, A. Balescu-Arion, C. Baliuliene, Baltasar Isabel, J. Baluch, S. N. Bandrabur, D. Bankewitz, C. Barber, K. Barbera, F. Barcraft-Barnes, H. Barletti, V. Barnett, G. Baron, K. Barros, A. Barsan, V. Bartlett, P. Batistaki, C. Baumgarten, G. Baytas, V. Beauchamp, Becerra Cayetano, I. A. Bell, S. Bellandi, M. Belletti, Belmonte Cuenca, J. Benitez-Cano, A. Beretta, L. Berger, M. Bergmann, N. Bergmark, Bermudez Lopez, M. Bernotaite, M. Beurskens, C. Bidd, H. Bifulco, F. Bignami, E. Bilic, A. Bilskiene, D. Bischoff, P. Bishop, L. Bjonness, T. Blaylock, H. Blethyn, K. Blincoe, T. Blokhin, I. Blunt, N. Boer, C. Bois, G. Bonicolini, E. Booth, J. Borecka-Kedzierska, M. Borstnar, K. Borys, M. Boselli, E. Bouvet, L. Bouwman, A. Bowen, L. Bowrey, S. Boxall, L. Božić, T. Bradley, T. Branco, T. Brazzi, L. Brazzoni, M. Brear, T. Brogly, N. Brohi, F. Broms, J. Bubliauskas, A. Bucolo, G. E. Buerkle, H. Buggy, D. Buhre, W. Bukauskas, T. Butturini, F. Byttner, Cabrera Díaz, I. Calderon, A. Calhau, R. Callejo, A. Cammu, G. Campesato, M. Can, Ö. S. Candeias, M. Cantor, A. Carise, E. Carmona, C. Carreteiro, J. Carrieri, C. Carter, A. Casal, M. Casanova, I. Cascella, M. Casero, L. M. Casiraghi, G. M. Castelo-Branco, Castro Arranz, C. Cernea, D. D. Cervantes, J. Chandler, B. Charnock, R. Chatzimicali, A. Chinery, E. Chishti, A. Chondhury, P. Christie, E. Christodoudiles, G. Ciardo, S. Cimpeanu, L. Cindea, I. Cinnella, G. Clark, S. Clayton, M. Cocu, S. Collyer, T. Colvin, C. Cope, S. Copeta, F. Copotoiu, S. -M., Correia de Barros, F. Corso, R. M. Cortegiani, A. Costa, G. Cowton, A. Cox, N. Craig, J. Cricca, V. Cronin, J. Cunha, M. Cuomo, A. Curley, K. Czuczwar, M. Dabrowska, D. Damster, Danguy des Déserts, M. Daniliuc, A. Danninger, T. Darwish, I. Dascalu, C. Davies, K. Davies, De Boer, De Flaviis, De Selincourt, G. Deana, C. Debaene, B. Debreceni, G. Dedhia, Delgado Garcia, Della Rocca, G. Delroy-Buelles, L. Desai, T. Dhillon, Di Giacinto, Di Mauro, Diaz Gomez, T. V. Dimitrovski, A. Dinic, V. Dîrzu, D. -S., Divander M. B., Dolinar J., Domingues S., Doolan J., Downes C., Dragoescu N. A., Droc G., Dum E., Dumitrescu A., Duncan L., Dzurňáková P., Eberl S., Edwards J., Edwards M., Ekelund K., Ekengren P., Elghouty E., Ellerkmann R., Ellis H., Elme A., Ernst T., Errando C. L., Estenes S., Ewaldsson C., Farid N., Featherstone J., Febres D., Fedorov S., Feggeler J., Feijten P., Fellmann T., Fernandez Candil, Fernandez Castineira, Fernández Castineira, J. Fernando, A. Ferrando, C. Ferreira, L. Ferreira, P. Feyling, A. Filipescu, D. Fleischer, A. Floris, L. Foerster, U. Fox, B. Franke, U. Frasca, D. Frey, C. Frost, V. Fullin, G. Fumagalli, J. Furneval, J. Fusari, M. Gallacher, S. Galushka, S. Gambale, G. Gambino, I. Garcia-Perez, M. L. Garg, S. Garlak, J. Gavranovic, Z. Gavrilov, R. Gaynor, Gecaj Gashi, A. Georghiou, M. Gerjevic, B. Gferer, G. Giarratano, A. Gibson, A. Gievski, V. Giles, J. Gillberg, L. Gilowska, Gilsanz Rodriguez, F. Gioia, A. Giovannoni, C. Girotra, V. Gkinas, D. Gkiokas, G. Godoroja, D. Goebel, U. Goel, V. Gonzalez, M. Goranovic, T. Gornik-Wlaszczuk, E. Gosavi, S. Gottfridsson, P. Gottschalk, A. Granell, M. Granstrom, A. Grassetto, A. Greenwood, A. Grigoras, I. Grintescu, I. Gritsan, A. Gritsan, G. Grynyuk, A. Guadagnin, G. M. Guarnieri, M. Güçlü, Guerrero Diez, M. Gunenc, F. Günther, U. Gupta, P. Guttenthaler, V. Hack, Y. Hafisayena, A. Hagau, N. Haldar, J. Hales, D. Hancı, V. Hanna-Jumma, S. Harazim, H. Harlet, P. Harper, D. Harris, B. Harvey, O. Hashimi, M. Hawkins, L. Hayes, C. Heaton, J. Heier, T. Helliwell, L. Hemmes, S. Henderson, K. Hermanides, J. Hermanns, Herrera Hueso, B. Hestenes, S. Hettiarachchi, R. Highgate, J. Hodgson, K. Hoelbling, D. Holland, J. Horhota, L. Hormis, A. Hribar, R. Hua, A. Humphreys, S. Humphries, R. Humpliková, S. Hunt, J. Husnain, A. Hussein, A. Hyams, B. Iannuccelli, F. Ilette, K. Ilyas, C. Inan, T. India, I. Ionițăv, V. Irwin, F. Jain, V. Janez, B. Jankovic, R. Jenkins, S. Jenko, M. Jimenez, Jiménez Gomez, B. Joachim, S. Joelsson-Alm, E. John, J. Jonikaite, L. Jovic, M. Jungwirth, B. Junke, E. Kabakov, B. Kadaoui, S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgäßner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert, A. W. M. M. Kopp, K. Korfiotis, D. Korolkov, O. Kosinová, M. Köstenberger, M. Kotzinger, O. Kovačević, M. Kranke, P. Kranke, E. Kraus, C. Kraus, S. Kubitzek, C. Kucharski, R. Kucukguclu, S. Kudrashou, A. Kumar, V. Kummen, L. Kunit, C. Kushakovsky, V. Kuvaki, B. Kuzmanovska, B. Kyttari, A. Landoni, G. Lau, G. Lazarev, K. Legett, S. Legrottaglie, A. M. Leonardi, S. Leong, M. Lercher, H. Leuvrey, M. Leva, B. Levstek, M. Limb, J. Lindholm, E. Linton, F. Liperi, C. Lipski, F. Lirk, P. Lisi, A. Lišková, Lluch Oltra, A. Loganathan, V. Lombardi, S. Lopez, Lopez Rodríguez, M. Lorenzini, L. Lowicka, M. Lugovoy, A. Luippold, M. Lumb, A. Macas, A. Macgregor, M. Machado, H. Maciariello, M. Madeira, I. Maitan, S. Majewski, J. Maldini, B. Malewski, G. Manfredini, L. Männer, O. Marchand, B. Marcu, A. Margalef, J. Margarson, M. Marinheiro, L. Markic, Markovic Bozic, J. Marrazzo, F. Martin, Martin Ayuso, M. Martinez, E. Martino, E. A. Martinson, V. Marusic-Gaser, K. Mascarenhas, C. Mathis, C. Matsota, P. Mavrommati, Mazul Sunko, B. McCourt, K. McGill, N. McKee, R. Meço, B. C. Meier, S. Melbourne, S. Melbybråthen, G. Meli, A. Melia, A. Melotti, R. M. Menga, M. R. Mercer, P. Merotra, S. Mescolini, S. Metterlein, T. Michalov, M. Michlig, S. Midgley, S. Milić, M. Milojevic, M. Miñana, A. Minto, G. Mirabella, L. Mirea, L. Mittelstädt, L. Moeglen, A. Moise, A. Mokini, Z. Molin, A. Moltó, L. Monea, M. C. Montalto, F. Montgomery, J. Montgomery, C. Montillo, G. Moore, S. Moore, F. Moreira, Z. Moreno, T. Moreno, R. Moret, E. Moreton, S. Morgan, Moro Velasco, C. Morri, D. Moull, A. Moura, F. Mráz, P. Mrozek, K. Mukhtar, K. Muniyappa, S. Murray, H. Murthy, B. V. Mushambi, M. Nadolski, M. Nardelli, P. Nardin, Navarro Pérez, R. Naveiro, A. Negri, Nesek Adam, V. Neskovic, V. Neuwersch, S. Neves, M. Nguyen, Ní Eochagáin, A. Nicholas, C. Nightingale, J. Norrie, K. Novak-Jankovic, V. Novakova, A. Novillo, M. Numan, S. Oduro-Dominah, L. Oldner, A. Oliveira, I. Ologoiu, D. Oloktsidou, I. O'Reilly, R. Orlando, A. Ovezov, A. Ozbilgin, S. Paal, Padin Barreiro, L. Palugniok, R. Papaioannou, A. Papapostolou, K. Paranthaman, Pardey Bracho, G. Parente, S. Parfeni, A. Pasin, L. Passey, S. Pastor, E. Patch, S. Patil, A. Paunescu, M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero, Pérez García, Pérez Soto, Perez Tejero, G. Perez-Cerda, F. Pesenti, A. Petta, R. Philippe, S. Pickering, Pico Veloso, J. Pina, P. Pinho-Oliveira, V. Pinol, S. Pinto, R. Pistidda, L. Pitterle, M. Piwowarczyk, P. Plotnikova, O. Pohl, H. Poldermann, J. Polkovicová, L. Pompei, L. Popescu, M. Popović, Pota V, Potocnik M., Potręć B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi, M. Rajamanickam, T. Rajput, Z. Ramachandran, R. Ramasamy, R. Ramessur, S. Rao, R. Rasmussen, A. Rato, A. Razaque, Real Navacerrada, M. I. Reavley, C. Reid, J. Reschreiter, H. Rial, Ribas Carrasco, P. Ribeiro, S. Rich, N. Richardson, L. Rimaitis, K. Rimaitis, M. Ringvold, E. -M., Ripke F., Ristescu I., Ritchie K., Ródenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter, M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sà J., Sà Couto, P. Saby, S. Sagic, J. Saleh, O. Sales, Sánchez Sánchez, Y. Sanghera, Şanli Karip, Santiveri Papiol, F. J. Santos, S. Sarno, S. Saul, D. Saunders, D. Savic, N. Scalco, L. Scanlon, D. Schaller, S. Schax, C. Scheffer, G. J. Schening, A. Schiavone, V. Schmidt-Ehrenberg, F. Schmidt-Mutter, C. Schönberg, C. Schopflin, C. Schreiber, J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojčić N., Soler Pedrola, M. Somanath, S. Sonksen, J. Sorella, M. C. Sörmus, A. Soro, M. Soto, C. Spada, A. Spadaro, S. Spaeth, J. Sparr, H. Spielmann, A. Spindler-Vesel, A. Stamelos, Stancombe L, L. Stanculescu, A. Standl, T. Standley, T. Stanek, O. Stanisavljević, S. Starczewska, M. Stäuble, C. Steen, J. Stefan, O. M. Stell, E. Stera, C. Stevens, M. Stoerckel, M. Stošić, B. Stourac, P. Stroumpoulis, K. Struck, Suarez de la Rica, A. Sultanpori, Sundara Rajan, R. Suying, O. Svensen, C. Swan, L. Syrogianni, P. Sysiak, J. Szederjesi, J. Taddei, Tan Hao, E. Tanou, V. Tarabová, Tardaguila Sancho, P. Tarroso, M. Tartaglione, M. Taylor, E. Tbaily, L. Telford, R. Terenzoni, M. Theodoraki, K. Thornley, H. Tiganiuc, L. Toim, H. Tomescu, D. Tommasino, C. Toni, J. Toninelli, A. Toretti, I. Townley, S. Trepenaitis, D. Trethowan, B. Tsaousi, G. Tsiftsi, A. Tudor, A. Turan, G. Turhan, S. Ç. Unic-Stojanovic, D. Unterbuchner, C. Unzueta, C. Uranjek, J. Ursic, T. Vaida, Valldeperas Ferrer, Valldeperas Hernandez, M. I. Valsamidis, Van Beek, Van dasselaer, Van Der Beek, Van Duivenvoorde, van Klei, W. A., Van Poorter, Van Zaane, Van Zundert, Van Zyl, Vargas Munoz, A. M. Varsani, N. Vasconcelos, P. Vassilakis, G. Vecchiatini, T. Vecera, L. Vercauteren, M. Verdouw, B. Verheyen, V. Verri, Vicari Sottosanti, L. G. Vico, Vidal Mitjans, P. Vilardi, A. Vissicchio, D. Vitale, G. Vitković, B. Vizcaychipi, M. P. Voicu, A. Voje, M. Volfová, I. Volta, C. A., Von Lutterotti, von Tiesenhausen, A. Vrecic-Slabe, S. Vukcevic, D. Vukovic, R. Vullo, P. A. Wade, A. Wallberg, H. Wallden, J. Wallner, Walther Sturesson, L. Watson, D. Weber, Wegiel Leskiewiq, A. Weller, D. Wensing, C. Werkmann, M. Westberg, H. Wikström, E. Williams, B. Wilson, R. Wirth, S. Wittmann, M. Wood, L. Wright, S. Zachoval, C. Zambon, M. Zampieri, S. Zampone, S. Zangrillo, A. Zani, G. Zavackiene, A. Zieglerder, R. Zonneveldt, H. Zsisku, L. Zucker, T. -P., Żukowski M., Zuleika M., Zupanĕiĕ D., Kirmeier, E. a., Eriksson, L. I. c., Lewald, H. a., Jonsson, Fagerlund, Hoeft, M. c., Hollmann, A. f., Meistelman, M. g., Hunter, C. e., Ulm, J. M. d., Blobner, K. b., M., aEmail Author, Abad, Gurumeta, A., Abernethy, C., Abigail, P., Achaibar, K., Adam, E., Afshari, Agudelo, Montoya, M. E., Akgün, F. N., Aletti, G., Alkış, N., Allan, K., Allan, A., Allaouchiche, B., Allcock, C., Almasy, E., Amey, I., Amigoni, M., Andersen, E., Andersson, P., Anipchenko, N., Antune, P., Armstrong, E., Aslam, T. N., Aslin, B., Assunção, J. P., Ausserer, J., Avvai, M., Awad, Ayas, Montero, B., Ayuso, M., Azevedo, P., Badarau, V., Badescu, Baiardo, Redaelli, M., Baird, C., Baird, Y., Baker, T., Balaji, P., Bălan, C., Balandin, A., Balescu-Arion, C., Baliuliene, Baltasar, Isabel, J., Baluch, S. N., Bandrabur, D., Bankewitz, C., Barber, K., Barbera, F., Barcraft-Barne, H., Barletti, V., Barnett, G., Baron, K., Barro, A., Barsan, V., Bartlett, P., Batistaki, C., Baumgarten, G., Bayta, V., Beauchamp, Becerra, Cayetano, I. A., Bell, S., Bellandi, M., Belletti, Belmonte, Cuenca, J., Benitez-Cano, A., Beretta, L., Berger, M., Bergmann, N., Bergmark, Bermudez, Lopez, M., Bernotaite, M., Beursken, C., Bidd, H., Bifulco, F., Bignami, E., Bilic, A., Bilskiene, D., Bischoff, P., Bishop, L., Bjonne, T., Blaylock, H., Blethyn, K., Blincoe, T., Blokhin, I., Blunt, N., Boer, C., Boi, G., Bonicolini, E., Booth, J., Borecka-Kedzierska, M., Borstnar, K., Bory, M., Boselli, E., Bouvet, L., Bouwman, A., Bowen, L., Bowrey, S., Boxall, L., Božić, T., Bradley, T., Branco, T., Brazzi, L., Brazzoni, M., Brear, T., Brogly, N., Brohi, F., Brom, J., Bubliauska, A., Bucolo, G. E., Buerkle, H., Buggy, D., Buhre, W., Bukauska, T., Butturini, F., Byttner, Cabrera, Díaz, I., Calderon, A., Calhau, R., Callejo, A., Cammu, G., Campesato, M., Can, Ö. S., Candeia, M., Cantor, A., Carise, E., Carmona, C., Carreteiro, J., Carrieri, C., Carter, A., Casal, M., Casanova, I., Cascella, M., Casero, L. M., Casiraghi, G. M., Castelo-Branco, Castro, Arranz, C., Cernea, D. D., Cervante, J., Chandler, B., Charnock, R., Chatzimicali, A., Chinery, E., Chishti, A., Chondhury, P., Christie, E., Christodoudile, G., Ciardo, S., Cimpeanu, L., Cindea, I., Cinnella, G., Clark, S., Clayton, M., Cocu, S., Collyer, T., Colvin, C., Cope, S., Copeta, F., Copotoiu, S., -M., Correia de, Barro, F., Corso, R. M., Cortegiani, A., Costa, G., Cowton, A., Cox, N., Craig, J., Cricca, V., Cronin, J., Cunha, M., Cuomo, A., Curley, K., Czuczwar, M., Dabrowska, D., Damster, Danguy des, Désert, M., Daniliuc, A., Danninger, T., Darwish, I., Dascalu, C., Davie, K., Davie, De, Boer, De, Flavii, De, Selincourt, G., Deana, C., Debaene, B., Debreceni, G., Dedhia, Delgado, Garcia, Della, Rocca, G., Delroy-Buelle, L., Desai, T., Dhillon, Di, Giacinto, Di, Mauro, Diaz, Gomez, T. V., Dimitrovski, A., Dinic, V., Dîrzu, D., -S., Divander, M. B., Dolinar, J., Domingues, S., Doolan, J., Downes, C., Dragoescu, N. A., Droc, G., Dum, E., Dumitrescu, A., Duncan, L., Dzurňáková, P., Eberl, S., Edwards, J., Edwards, M., Ekelund, K., Ekengren, P., Elghouty, E., Ellerkmann, R., Ellis, H., Elme, A., Ernst, T., Errando, C. L., Estenes, S., Ewaldsson, C., Farid, N., Featherstone, J., Febres, D., Fedorov, S., Feggeler, J., Feijten, P., Fellmann, T., Fernandez, Candil, Fernandez, Castineira, Fernández, Castineira, J., Fernando, A., Ferrando, C., Ferreira, L., Ferreira, P., Feyling, A., Filipescu, D., Fleischer, A., Flori, L., Foerster, U., Fox, B., Franke, U., Frasca, D., Frey, C., Frost, V., Fullin, G., Fumagalli, J., Furneval, J., Fusari, M., Gallacher, S., Galushka, S., Gambale, G., Gambino, I., Garcia-Perez, M. L., Garg, S., Garlak, J., Gavranovic, Z., Gavrilov, R., Gaynor, Gecaj, Gashi, A., Georghiou, M., Gerjevic, B., Gferer, G., Giarratano, A., Gibson, A., Gievski, V., Gile, J., Gillberg, L., Gilowska, Gilsanz, Rodriguez, F., Gioia, A., Giovannoni, C., Girotra, V., Gkina, D., Gkioka, G., Godoroja, D., Goebel, U., Goel, V., Gonzalez, M., Goranovic, T., Gornik-Wlaszczuk, E., Gosavi, S., Gottfridsson, P., Gottschalk, A., Granell, M., Granstrom, A., Grassetto, A., Greenwood, A., Grigora, I., Grintescu, I., Gritsan, A., Gritsan, G., Grynyuk, A., Guadagnin, G. M., Guarnieri, M., Güçlü, Guerrero, Diez, M., Gunenc, F., Günther, U., Gupta, P., Guttenthaler, V., Hack, Y., Hafisayena, A., Hagau, N., Haldar, J., Hale, D., Hancı, V., Hanna-Jumma, S., Harazim, H., Harlet, P., Harper, D., Harri, B., Harvey, O., Hashimi, M., Hawkin, L., Haye, C., Heaton, J., Heier, T., Helliwell, L., Hemme, S., Henderson, K., Hermanide, J., Hermann, Herrera, Hueso, B., Hestene, S., Hettiarachchi, R., Highgate, J., Hodgson, K., Hoelbling, D., Holland, J., Horhota, L., Hormi, A., Hribar, R., Hua, A., Humphrey, S., Humphrie, R., Humpliková, S., Hunt, J., Husnain, A., Hussein, A., Hyam, B., Iannuccelli, F., Ilette, K., Ilya, C., Inan, T., India, I., Ionițăv, V., Irwin, F., Jain, V., Janez, B., Jankovic, R., Jenkin, S., Jenko, M., Jimenez, Jiménez, Gomez, B., Joachim, S., Joelsson-Alm, E., John, J., Jonikaite, L., Jovic, M., Jungwirth, B., Junke, E., Kabakov, B., Kadaoui, S., -D., Kanski, A., Karadag, S., Karbonskiene, A., Karjagin, J., Kasnik, D., Katanolli, F., Katsika, E., Kaufmann, K., Keane, H., Kelly, M., Kent, M., Keraitiene, G., Khudhur, A., Khuenl-Brady, K., Kidd, L., King, S., Kirchgäßner, K., Klancir, T., Klucniks, A., Knotzer, J., Knowlden, P., Koers, L., Kompan, J., Koneti, K. K., Kooij, F., Koolen, E., Koopman, - van Gemert, A. W. M. M., Kopp, K., Korfioti, D., Korolkov, O., Kosinová, M., Köstenberger, M., Kotzinger, O., Kovačević, M., Kranke, P., Kranke, E., Krau, C., Krau, S., Kubitzek, C., Kucharski, R., Kucukguclu, S., Kudrashou, A., Kumar, V., Kummen, L., Kunit, C., Kushakovsky, V., Kuvaki, B., Kuzmanovska, B., Kyttari, A., Landoni, G., Lau, G., Lazarev, K., Legett, S., Legrottaglie, A. M., Leonardi, S., Leong, M., Lercher, H., Leuvrey, M., Leva, B., Levstek, M., Limb, J., Lindholm, E., Linton, F., Liperi, C., Lipski, F., Lirk, P., Lisi, A., Lišková, Lluch, Oltra, A., Loganathan, V., Lombardi, S., Lopez, Lopez, Rodríguez, M., Lorenzini, L., Lowicka, M., Lugovoy, A., Luippold, M., Lumb, A., Maca, A., Macgregor, M., Machado, H., Maciariello, M., Madeira, I., Maitan, S., Majewski, J., Maldini, B., Malewski, G., Manfredini, L., Männer, O., Marchand, B., Marcu, A., Margalef, J., Margarson, M., Marinheiro, L., Markic, Markovic, Bozic, J., Marrazzo, F., Martin, Martin, Ayuso, M., Martinez, E., Martino, E. A., Martinson, V., Marusic-Gaser, K., Mascarenha, C., Mathi, C., Matsota, P., Mavrommati, Mazul, Sunko, B., Mccourt, K., Mcgill, N., Mckee, R., Meço, B. C., Meier, S., Melbourne, S., Melbybråthen, G., Meli, A., Melia, A., Melotti, R. M., Menga, M. 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Sarno, S, Saul, D, Saunders, D, Savic, N, Scalco, L, Scanlon, D, Schaller, S, Schax, C, Scheffer, G, Schening, A, Schiavone, V, Schmidt-Ehrenberg, F, Schmidt-Mutter, C, Schonberg, C, Schopflin, C, Schreiber, J, Schultz, M, Schurig, M, Scott, C, Sebestian, S, Sehgal, S, Sem, V, Semenas, E, Serafini, E, Serchan, P, Shields, M, Shobha, R, Shosholcheva, M, Siamansour, T, Siddaiah, N, Siddiqi, K, Sinclair, R, Singh, P, Singh, R, Sinha, A, Skinner, A, Smee, E, Smekalova, O, Smith, N, Smith, T, Smitz, C, Smole, D, Sojcic, N, Soler Pedrola, M, Somanath, S, Sonksen, J, Sorella, M, Sormus, A, Soro, M, Soto, C, Spada, A, Spadaro, S, Spaeth, J, Sparr, H, Spielmann, A, Spindler-Vesel, A, Stamelos, M, Stancombe L, L, Stanculescu, A, Standl, T, Standley, T, Stanek, O, Stanisavljevic, S, Starczewska, M, Stauble, C, Steen, J, Stefan, O, Stell, E, Stera, C, Stevens, M, Stoerckel, M, Stosic, B, Stourac, P, Stroumpoulis, K, Struck, R, Suarez de la Rica, A, Sultanpori, A, Sundara Rajan, R, Suying, O, Svensen, C, Swan, L, Syrogianni, P, Sysiak, J, Szederjesi, J, Taddei, S, Tan Hao, E, Tanou, V, Tarabova, K, Tardaguila Sancho, P, Tarroso, M, Tartaglione, M, Taylor, E, Tbaily, L, Telford, R, Terenzoni, M, Theodoraki, K, Thornley, H, Tiganiuc, L, Toim, H, Tomescu, D, Tommasino, C, Toni, J, Toninelli, A, Toretti, I, Townley, S, Trepenaitis, D, Trethowan, B, Tsaousi, G, Tsiftsi, A, Tudor, A, Turan, G, Turhan, S, Unic-Stojanovic, D, Unterbuchner, C, Unzueta, C, Uranjek, J, Ursic, T, Vaida, S, Valldeperas Ferrer, S, Valldeperas Hernandez, M, Valsamidis, D, Van Beek, R, Van dasselaer, N, Van Der Beek, T, Van Duivenvoorde, Y, van Klei, W, Van Poorter, F, Van Zaane, B, Van Zundert, T, Van Zyl, R, Vargas Munoz, A, Varsani, N, Vasconcelos, P, Vassilakis, G, Vecchiatini, T, Vecera, L, Vercauteren, M, Verdouw, B, Verheyen, V, Verri, M, Vicari Sottosanti, L, Vico, M, Vidal Mitjans, P, Vilardi, A, Vissicchio, D, Vitale, G, Vitkovic, B, Vizcaychipi, M, Voicu, A, Voje, M, Volfova, I, Volta, C, Von 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André, Razaque, Usman, Real Navacerrada, M. 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Agostina, Wade, Andrew, Wallberg, Hanna, Wallden, Jakob, Wallner, Johann, Walther Sturesson, Louise, Watson, Davina, Weber, Stefan, Wegiel Leskiewiq, Anna, Weller, Debbie, Wensing, Carine, Werkmann, Marku, Westberg, Henrik, Wikström, Erik, Williams, Benedict, Wilson, Robin, Wirth, Steffen, Wittmann, Maria, Wood, Laura, Wright, Stella, Zachoval, Christian, Zambon, Massimo, Zampieri, Silvia, Zampone, Salvatore, Zangrillo, Alberto, Zani, Gianluca, Zavackiene, Asta, Zieglerder, Raphael, Zonneveldt, Harry, Zsisku, Lajo, Zucker, Tom-Philipp, Żukowski, Maciej, Zuleika, Mehrun, and Zupanĕiĕ, Darja
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Pulmonary and Respiratory Medicine ,pulmonary complications, muscle relaxants, Post-anaesthesia complications ,Neuromuscular Blockade ,pulmonary complication, muscle relaxant ,neuromuscular block ,postoperative pulmonary complication ,business.industry ,Retrospective cohort study ,post-operative pulmonary complications ,Neuromuscular monitoring ,Neuromuscular Blocking Agents ,Sugammadex ,NO ,Anaesthesia ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Anesthesia ,Medicine ,General anaesthesia ,Neuromuscular Agents ,030212 general & internal medicine ,MED/41 - ANESTESIOLOGIA ,Prospective cohort study ,business ,medicine.drug - Abstract
Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology.
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- 2019
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5. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
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L., Garg S., Garlak J., Gavranovic Z., Gavrilov R., Gaynor L., Gecaj Gashi A., Georghiou M., Gerjevic B., Gferer G., Giarratano A., Gibson A., Gievski V., Giles J., Gillberg L., Gilowska K., Gilsanz Rodriguez F., Gioia A., Giovannoni C., Girotra V., Gkinas D., Gkiokas G., Godoroja D., Goebel U., Goel V., Gonzalez M., Goranovic T., Gornik-Wlaszczuk E., Gosavi S., Gottfridsson P., Gottschalk A., Granell M., Granstrom A., Grassetto A., Greenwood A., Grigoras I., Grintescu I., Gritsan A., Gritsan G., Grynyuk A., Guadagnin G. M., Guarnieri M., Guclu C., Guerrero Diez M., Gunenc F., Gunther U., Gupta P., Guttenthaler V., Hack Y., Hafisayena A., Hagau N., Haldar J., Hales D., Hanci V., Hanna-Jumma S., Harazim H., Harlet P., Harper D., Harris B., Harvey O., Hashimi M., Hawkins L., Hayes C., Heaton J., Heier T., Helliwell L., Hemmes S., Henderson K., Hermanides J., Hermanns H., Herrera Hueso B., Hestenes S., Hettiarachchi R., Highgate J., Hodgson K., Hoelbling D., Holland J., Horhota L., Hormis A., Hribar R., Hua A., Humphreys S., Humphries R., Humplikova S., Hunt J., Husnain A., Hussein A., Hyams B., Iannuccelli F., Ilette K., Ilyas C., Inan T., India I., Ionitav V., Irwin F., Jain V., Janez B., Jankovic R., Jenkins S., Jenko M., Jimenez R., Jimenez Gomez B., Joachim S., Joelsson-Alm E., John J., Jonikaite L., Jovic M., Jungwirth B., Junke E., Kabakov B., Kadaoui S. -D., Kanski A., Karadag S., Karbonskiene A., Karjagin J., Kasnik D., Katanolli F., Katsika E., Kaufmann K., Keane H., Kelly M., Kent M., Keraitiene G., Khudhur A., Khuenl-Brady K., Kidd L., King S., Kirchgassner K., Klancir T., Klucniks A., Knotzer J., Knowlden P., Koers L., Kompan J., Koneti K. K., Kooij F., Koolen E., Koopman - van Gemert A. W. M. M., Kopp K., Korfiotis D., Korolkov O., Kosinova M., Kostenberger M., Kotzinger O., Kovacevic M., Kranke P., Kranke E., Kraus C., Kraus S., Kubitzek C., Kucharski R., Kucukguclu S., Kudrashou A., Kumar V., Kummen L., Kunit C., Kushakovsky V., Kuvaki B., Kuzmanovska B., Kyttari A., Landoni G., Lau G., Lazarev K., Legett S., Legrottaglie A. M., Leonardi S., Leong M., Lercher H., Leuvrey M., Leva B., Levstek M., Limb J., Lindholm E., Linton F., Liperi C., Lipski F., Lirk P., Lisi A., Liskova K., Lluch Oltra A., Loganathan V., Lombardi S., Lopez E., Lopez Rodriguez M., Lorenzini L., Lowicka M., Lugovoy A., Luippold M., Lumb A., Macas A., Macgregor M., Machado H., Maciariello M., Madeira I., Maitan S., Majewski J., Maldini B., Malewski G., Manfredini L., Manner O., Marchand B., Marcu A., Margalef J., Margarson M., Marinheiro L., Markic A., Markovic Bozic J., Marrazzo F., Martin J., Martin Ayuso M., Martinez E., Martino E. A., Martinson V., Marusic-Gaser K., Mascarenhas C., Mathis C., Matsota P., Mavrommati E., Mazul Sunko B., McCourt K., McGill N., McKee R., Meco B. C., Meier S., Melbourne S., Melbybrathen G., Meli A., Melia A., Melotti R. M., Menga M. R., Mercer P., Merotra S., Mescolini S., Metterlein T., Michalov M., Michlig S., Midgley S., Milic M., Milojevic M., Minana A., Minto G., Mirabella L., Mirea L., Mittelstadt L., Moeglen A., Moise A., Mokini Z., Molin A., Molto L., Monea M. C., Montalto F., Montgomery J., Montgomery C., Montillo G., Moore S., Moore F., Moreira Z., Moreno T., Moreno R., Moret E., Moreton S., Morgan M., Moro Velasco C., Morri D., Moull A., Moura F., Mraz P., Mrozek K., Mukhtar K., Muniyappa S., Murray H., Murthy B. V., Mushambi M., Nadolski M., Nardelli P., Nardin G., Navarro Perez R., Naveiro A., Negri M., Nesek Adam V., Neskovic V., Neuwersch S., Neves M., Nguyen B., Ni Eochagain A., Nicholas C., Nightingale J., Norrie K., Novak-Jankovic V., Novakova A., Novillo M., Numan S., Oduro-Dominah L., Oldner A., Oliveira I., Ologoiu D., Oloktsidou I., O'Reilly R., Orlando A., Ovezov A., Ozbilgin S., Paal P., Padin Barreiro L., Palugniok R., Papaioannou A., Papapostolou K., Paranthaman P., Pardey Bracho G., Parente S., Parfeni A., Pasin L., Passey S., Pastor E., Patch S., Patil A., Paunescu M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero P., Perez Garcia A., Perez Soto A., Perez Tejero G., Perez-Cerda F., Pesenti A., Petta R., Philippe S., Pickering D., Pico Veloso J., Pina P., Pinho-Oliveira V., Pinol S., Pinto R., Pistidda L., Pitterle M., Piwowarczyk P., Plotnikova O., Pohl H., Poldermann J., Polkovicova L., Pompei L., Popescu M., Popovic R., Pota V., Potocnik M., Potrec B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi M., Rajamanickam T., Rajput Z., Ramachandran R., Ramasamy R., Ramessur S., Rao R., Rasmussen A., Rato A., Razaque U., Real Navacerrada M. I., Reavley C., Reid J., Reschreiter H., Rial E., Ribas Carrasco P., Ribeiro S., Rich N., Richardson L., Rimaitis K., Rimaitis M., Ringvold E. -M., Ripke F., Ristescu I., Ritchie K., Rodenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sa J., Sa Couto P., Saby S., Sagic J., Saleh O., Sales G., Sanchez Sanchez Y., Sanghera S., Sanli Karip C., Santiveri Papiol F. J., Santos S., Sarno S., Saul D., Saunders D., Savic N., Scalco L., Scanlon D., Schaller S., Schax C., Scheffer G. J., Schening A., Schiavone V., Schmidt-Ehrenberg F., Schmidt-Mutter C., Schonberg C., Schopflin C., Schreiber J. -U., Schultz M., Schurig M., Scott C., Sebestian S., Sehgal S., Sem V., Semenas E., Serafini E., Serchan P., Shields M., Shobha R., Shosholcheva M., Siamansour T., Siddaiah N., Siddiqi K., Sinclair R., Singh P., Singh R., Sinha A., Skinner A., Smee E., Smekalova O., Smith N., Smith T., Smitz C., Smole D., Sojcic N., Soler Pedrola M., Somanath S., Sonksen J., Sorella M. C., Sormus A., Soro M., Soto C., Spada A., Spadaro S., Spaeth J., Sparr H., Spielmann A., Spindler-Vesel A., Stamelos M., Stancombe L L., Stanculescu A., Standl T., Standley T., Stanek O., Stanisavljevic S., Starczewska M., Stauble C., Steen J., Stefan O. M., Stell E., Stera C., Stevens M., Stoerckel M., Stosic B., Stourac P., Stroumpoulis K., Struck R., Suarez de la Rica A., Sultanpori A., Sundara Rajan R., Suying O., Svensen C., Swan L., Syrogianni P., Sysiak J., Szederjesi J., Taddei S., Tan Hao E., Tanou V., Tarabova K., Tardaguila Sancho P., Tarroso M., Tartaglione M., Taylor E., Tbaily L., Telford R., Terenzoni M., Theodoraki K., Thornley H., Tiganiuc L., Toim H., Tomescu D., Tommasino C., Toni J., Toninelli A., Toretti I., Townley S., Trepenaitis D., Trethowan B., Tsaousi G., Tsiftsi A., Tudor A., Turan G., Turhan S. C., Unic-Stojanovic D., Unterbuchner C., Unzueta C., Uranjek J., Ursic T., Vaida S., Valldeperas Ferrer S., Valldeperas Hernandez M. I., Valsamidis D., Van Beek R., Van dasselaer N., Van Der Beek T., Van Duivenvoorde Y., van Klei W. A., Van Poorter F., Van Zaane B., Van Zundert T., Van Zyl R., Vargas Munoz A. M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., Zupaneie D., Kirmeier, E, Eriksson, L, Lewald, H, Jonsson Fagerlund, M, Hoeft, A, Hollmann, M, Meistelman, C, Hunter, J, Ulm, K, Blobner, M, Abad Gurumeta, A, Abernethy, C, Abigail, P, Achaibar, K, Adam, E, Afshari, A, Agudelo Montoya, M, Akgun, F, Aletti, G, Alkis, N, Allan, K, Allan, A, Allaouchiche, B, Allcock, C, Almasy, E, Amey, I, Amigoni, M, Andersen, E, Andersson, P, Anipchenko, N, Antunes, P, Armstrong, E, Aslam, T, Aslin, B, Assuncao, J, Ausserer, J, Avvai, M, Awad, N, Ayas Montero, B, Ayuso, M, Azevedo, P, Badarau, V, Badescu, R, Baiardo Redaelli, M, Baird, C, Baird, Y, Baker, T, Balaji, P, Balan, C, Balandin, A, Balescu-Arion, C, Baliuliene, V, Baltasar Isabel, J, Baluch, S, Bandrabur, D, Bankewitz, C, Barber, K, Barbera, F, Barcraft-Barnes, H, Barletti, V, Barnett, G, Baron, K, Barros, A, Barsan, V, Bartlett, P, Batistaki, C, Baumgarten, G, Baytas, V, Beauchamp, N, Becerra Cayetano, I, Bell, S, Bellandi, M, Belletti, A, Belmonte Cuenca, J, Benitez-Cano, A, Beretta, L, Berger, M, Bergmann, N, Bergmark, K, Bermudez Lopez, M, Bernotaite, M, Beurskens, C, Bidd, H, Bifulco, F, Bignami, E, Bilic, A, Bilskiene, D, Bischoff, P, Bishop, L, Bjonness, T, Blaylock, H, Blethyn, K, Blincoe, T, Blokhin, I, Blunt, N, Boer, C, Bois, G, Bonicolini, E, Booth, J, Borecka-Kedzierska, M, Borstnar, K, Borys, M, Boselli, E, Bouvet, L, Bouwman, A, Bowen, L, Bowrey, S, Boxall, L, Bozic, T, Bradley, T, Branco, T, Brazzi, L, Brazzoni, M, Brear, T, Brogly, N, Brohi, F, Broms, J, Bubliauskas, A, Bucolo, G, Buerkle, H, Buggy, D, Buhre, W, Bukauskas, T, Butturini, F, Byttner, A, 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Gioia, A, Giovannoni, C, Girotra, V, Gkinas, D, Gkiokas, G, Godoroja, D, Goebel, U, Goel, V, Gonzalez, M, Goranovic, T, Gornik-Wlaszczuk, E, Gosavi, S, Gottfridsson, P, Gottschalk, A, Granell, M, Granstrom, A, Grassetto, A, Greenwood, A, Grigoras, I, Grintescu, I, Gritsan, A, Gritsan, G, Grynyuk, A, Guadagnin, G, Guarnieri, M, Guclu, C, Guerrero Diez, M, Gunenc, F, Gunther, U, Gupta, P, Guttenthaler, V, Hack, Y, Hafisayena, A, Hagau, N, Haldar, J, Hales, D, Hanci, V, Hanna-Jumma, S, Harazim, H, Harlet, P, Harper, D, Harris, B, Harvey, O, Hashimi, M, Hawkins, L, Hayes, C, Heaton, J, Heier, T, Helliwell, L, Hemmes, S, Henderson, K, Hermanides, J, Hermanns, H, Herrera Hueso, B, Hestenes, S, Hettiarachchi, R, Highgate, J, Hodgson, K, Hoelbling, D, Holland, J, Horhota, L, Hormis, A, Hribar, R, Hua, A, Humphreys, S, Humphries, R, Humplikova, S, Hunt, J, Husnain, A, Hussein, A, Hyams, B, Iannuccelli, F, Ilette, K, Ilyas, C, Inan, T, India, I, Ionitav, V, Irwin, F, Jain, V, Janez, B, Jankovic, 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Oltra, A, Loganathan, V, Lombardi, S, Lopez, E, Lopez Rodriguez, M, Lorenzini, L, Lowicka, M, Lugovoy, A, Luippold, M, Lumb, A, Macas, A, Macgregor, M, Machado, H, Maciariello, M, Madeira, I, Maitan, S, Majewski, J, Maldini, B, Malewski, G, Manfredini, L, Manner, O, Marchand, B, Marcu, A, Margalef, J, Margarson, M, Marinheiro, L, Markic, A, Markovic Bozic, J, Marrazzo, F, Martin, J, Martin Ayuso, M, Martinez, E, Martino, E, Martinson, V, Marusic-Gaser, K, Mascarenhas, C, Mathis, C, Matsota, P, Mavrommati, E, Mazul Sunko, B, Mccourt, K, Mcgill, N, Mckee, R, Meco, B, Meier, S, Melbourne, S, Melbybrathen, G, Meli, A, Melia, A, Melotti, R, Menga, M, Mercer, P, Merotra, S, Mescolini, S, Metterlein, T, Michalov, M, Michlig, S, Midgley, S, Milic, M, Milojevic, M, Minana, A, Minto, G, Mirabella, L, Mirea, L, Mittelstadt, L, Moeglen, A, Moise, A, Mokini, Z, Molin, A, Molto, L, Monea, M, Montalto, F, Montgomery, J, Montgomery, C, Montillo, G, Moore, S, Moore, F, Moreira, Z, Moreno, T, Moreno, R, 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A., Martinson V., Marusic-Gaser K., Mascarenhas C., Mathis C., Matsota P., Mavrommati E., Mazul Sunko B., McCourt K., McGill N., McKee R., Meco B. C., Meier S., Melbourne S., Melbybrathen G., Meli A., Melia A., Melotti R. M., Menga M. R., Mercer P., Merotra S., Mescolini S., Metterlein T., Michalov M., Michlig S., Midgley S., Milic M., Milojevic M., Minana A., Minto G., Mirabella L., Mirea L., Mittelstadt L., Moeglen A., Moise A., Mokini Z., Molin A., Molto L., Monea M. C., Montalto F., Montgomery J., Montgomery C., Montillo G., Moore S., Moore F., Moreira Z., Moreno T., Moreno R., Moret E., Moreton S., Morgan M., Moro Velasco C., Morri D., Moull A., Moura F., Mraz P., Mrozek K., Mukhtar K., Muniyappa S., Murray H., Murthy B. V., Mushambi M., Nadolski M., Nardelli P., Nardin G., Navarro Perez R., Naveiro A., Negri M., Nesek Adam V., Neskovic V., Neuwersch S., Neves M., Nguyen B., Ni Eochagain A., Nicholas C., Nightingale J., Norrie K., Novak-Jankovic V., Novakova A., Novillo M., Numan S., Oduro-Dominah L., Oldner A., Oliveira I., Ologoiu D., Oloktsidou I., O'Reilly R., Orlando A., Ovezov A., Ozbilgin S., Paal P., Padin Barreiro L., Palugniok R., Papaioannou A., Papapostolou K., Paranthaman P., Pardey Bracho G., Parente S., Parfeni A., Pasin L., Passey S., Pastor E., Patch S., Patil A., Paunescu M. -A., Pehboeck D., Pereira M., Pereira C., Perez Caballero P., Perez Garcia A., Perez Soto A., Perez Tejero G., Perez-Cerda F., Pesenti A., Petta R., Philippe S., Pickering D., Pico Veloso J., Pina P., Pinho-Oliveira V., Pinol S., Pinto R., Pistidda L., Pitterle M., Piwowarczyk P., Plotnikova O., Pohl H., Poldermann J., Polkovicova L., Pompei L., Popescu M., Popovic R., Pota V., Potocnik M., Potrec B., Potter A., Pramod N., Prchalova M., Preckel B., Pugh R., Pulletz M., Radoeshki A., Rafi A., Ragazzi R., Raineri Santi M., Rajamanickam T., Rajput Z., Ramachandran R., Ramasamy R., Ramessur S., Rao R., Rasmussen A., Rato A., Razaque U., Real Navacerrada M. I., Reavley C., Reid J., Reschreiter H., Rial E., Ribas Carrasco P., Ribeiro S., Rich N., Richardson L., Rimaitis K., Rimaitis M., Ringvold E. -M., Ripke F., Ristescu I., Ritchie K., Rodenas F., Rodrigues P., Rogers E., Rogerson D., Romagnoli S., Romero E., Rondovic G., Rose B. O., Roth W., Rotter M. -T., Rousseau G., Rudjord A., Rueffert H., Rundgren M., Rupprecht K., Rushton A., Russotto V., Rypulak E., Ryszka M., Sa J., Sa Couto P., Saby S., Sagic J., Saleh O., Sales G., Sanchez Sanchez Y., Sanghera S., Sanli Karip C., Santiveri Papiol F. J., Santos S., Sarno S., Saul D., Saunders D., Savic N., Scalco L., Scanlon D., Schaller S., Schax C., Scheffer G. 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M., Stell E., Stera C., Stevens M., Stoerckel M., Stosic B., Stourac P., Stroumpoulis K., Struck R., Suarez de la Rica A., Sultanpori A., Sundara Rajan R., Suying O., Svensen C., Swan L., Syrogianni P., Sysiak J., Szederjesi J., Taddei S., Tan Hao E., Tanou V., Tarabova K., Tardaguila Sancho P., Tarroso M., Tartaglione M., Taylor E., Tbaily L., Telford R., Terenzoni M., Theodoraki K., Thornley H., Tiganiuc L., Toim H., Tomescu D., Tommasino C., Toni J., Toninelli A., Toretti I., Townley S., Trepenaitis D., Trethowan B., Tsaousi G., Tsiftsi A., Tudor A., Turan G., Turhan S. C., Unic-Stojanovic D., Unterbuchner C., Unzueta C., Uranjek J., Ursic T., Vaida S., Valldeperas Ferrer S., Valldeperas Hernandez M. I., Valsamidis D., Van Beek R., Van dasselaer N., Van Der Beek T., Van Duivenvoorde Y., van Klei W. A., Van Poorter F., Van Zaane B., Van Zundert T., Van Zyl R., Vargas Munoz A. M., Varsani N., Vasconcelos P., Vassilakis G., Vecchiatini T., Vecera L., Vercauteren M., Verdouw B., Verheyen V., Verri M., Vicari Sottosanti L. G., Vico M., Vidal Mitjans P., Vilardi A., Vissicchio D., Vitale G., Vitkovic B., Vizcaychipi M. P., Voicu A., Voje M., Volfova I., Volta C. A., Von Lutterotti T., von Tiesenhausen A., Vrecic-Slabe S., Vukcevic D., Vukovic R., Vullo P. A., Wade A., Wallberg H., Wallden J., Wallner J., Walther Sturesson L., Watson D., Weber S., Wegiel Leskiewiq A., Weller D., Wensing C., Werkmann M., Westberg H., Wikstrom E., Williams B., Wilson R., Wirth S., Wittmann M., Wood L., Wright S., Zachoval C., Zambon M., Zampieri S., Zampone S., Zangrillo A., Zani G., Zavackiene A., Zieglerder R., Zonneveldt H., Zsisku L., Zucker T. -P., Zukowski M., Zuleika M., and Zupaneie D.
- Abstract
Background: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary
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- 2019
6. Reply
- Author
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Rueffert, H. and Olthoff, D.
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- 2003
7. Increased sensitivity to 4-chloro-m-cresol and caffeine in primary myotubes from malignant hyperthermia susceptible individuals carrying the ryanodine receptor 1 Thr2206Met (C6617T) mutation
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Wehner, M, Rueffert, H, Koenig, F, Neuhaus, J, and Olthoff, D
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- 2002
8. Mutation screening in the ryanodine receptor 1 gene (RYR1) in patients susceptible to malignant hyperthermia who show definite IVCT results: identification of three novel mutations
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Rueffert, H, Olthoff, D, Deutrich, C, Meinecke, C. D, and Froster, U. G
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- 2002
9. Homozygous and heterozygous Arg614Cys mutations (1840C→T) in the ryanodine receptor gene co-segregate with malignant hyperthermia susceptibility in a German family
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Rueffert, H., Olthoff, D., Deutrich, C., Thamm, B., and Froster, U. G.
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- 2001
10. Determination of a positive malignant hyperthermia (MH) disposition without the in vitro contracture test in families carrying the RYR1 Arg614Cys mutation
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Rueffert, H, Olthoff, D, Deutrich, C, and Froster, U G
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- 2001
11. Direct increase of the intracellular calcium concentration in porcine vascular smooth muscle cells by protamine
- Author
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Wehner, M., primary, Rueffert, H., additional, Geier, D., additional, Krist, K., additional, and Koenig, F., additional
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- 2007
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12. Determination of the blood-gas partition coefficients for isoflurane, sevoflurane and desflurane
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Esper, T., primary, Wehner, M., additional, Rueffert, H., additional, Geier, D., additional, and Koenig, F., additional
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- 2007
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13. Calcium Release from Sarcoplasmic Reticulum Is Facilitated in Human Myotubes Derived from Carriers of the Ryanodine Receptor Type 1 Mutations Ile2182Phe and Gly2375Ala
- Author
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Wehner, M., primary, Rueffert, H., additional, Koenig, F., additional, and Olthoff, D., additional
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- 2003
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14. Recent advances in the diagnosis of malignant hyperthermia susceptibility: How confident can we be of genetic testing?
- Author
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Robinson, R L, primary, Anetseder, M J, additional, Brancadoro, V, additional, van Broekhoven, C, additional, Carsana, A, additional, Censier, K, additional, Fortunato, G, additional, Girard, T, additional, Heytens, L, additional, Hopkins, P M, additional, Jurkat-Rott, K, additional, Klinger, W, additional, Kozak-Ribbens, G, additional, Krivosic, R, additional, Monnier, N, additional, Nivoche, Y, additional, Olthoff, D, additional, Rueffert, H, additional, Sorrentino, V, additional, Tegazzin, V, additional, and Mueller, C R, additional
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- 2003
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- View/download PDF
15. Identification of a novel mutation in the ryanodine receptor gene (RYR1) in patients with malignant hyperthermia
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Rueffert, H., primary, Kraus, H., additional, Olthoff, D., additional, Deutrich, C., additional, and Froster, U.G., additional
- Published
- 2001
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16. Identification of a novel polymorphism (IVS45+20 C/A) in the splice site of intron 45 of the ryanodine receptor gene (RYR1) Communicated by: Mark H. Paalman Online Citation: Human Mutation, Mutation and Polymorphism Report #164 (2000) Online http://journals.wiley.com/1059-7794/pdf/mutation/mpr164.pdf
- Author
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Rueffert, H., primary, Olthoff, D., additional, Deutrich, C., additional, Kraus, H., additional, and Froster, U.G., additional
- Published
- 2000
- Full Text
- View/download PDF
17. Homozygous and heterozygous Arg614Cys mutations (1840C-->T) in the ryanodine receptor gene co-segregate with malignant hyperthermia susceptibility in a German family.
- Author
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Rueffert, H, Olthoff, D, Deutrich, C, Thamm, B, and Froster, U G
- Abstract
The determination of susceptibility to malignant hyperthermia (MH) by genetic investigation is a controversial issue because of the genetic heterogeneity of this disorder. The requirement for such an approach in MH diagnosis is a strong correlation between MH-associated genetic abnormalities and phenotypic findings in the in vitro contracture test (IVCT). After a severe clinical MH crisis during general anaesthesia a patient was diagnosed by the IVCT in which susceptibility to MH was confirmed. Genetic screening for MH-related mutations in the RYR1 gene revealed the presence of a homozygous 1840C-->T base exchange (Arg614Cys substitution) in this patient. A specific search for this defect in 20 relatives led to the identification of a total of 11 Arg614Cys mutations. Of these, 10 were heterozygous (including both parents) and one was homozygous (sister). Further IVCTs were subsequently performed on the parents of the index patient, the homozygous sister and all relatives who did not carry the Arg614Cys in order to determine the genotype/phenotype correlation. After analysing these data, and because of the strong correlation between clinical, phenotypic, and genetic results in the index patient, we assigned the diagnosis 'MHS' to all the remaining Arg614Cys mutation carriers of that family without performing the IVCT.
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- 2001
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18. Spontaneous occurrence of the disposition to malignant hyperthermia.
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Rueffert H, Olthoff D, Deutrich C, Rueffert, Henrik, Olthoff, Derk, and Deutrich, Christine
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- 2004
19. European Neuromuscular Centre consensus statement on anaesthesia in patients with neuromuscular disorders.
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van den Bersselaar LR, Heytens L, Silva HCA, Reimann J, Tasca G, Díaz-Cambronero Ó, Løkken N, Hellblom A, Hopkins PM, Rueffert H, Bastian B, Vilchez JJ, Gillies R, Johannsen S, Veyckemans F, Muenster T, Klein A, Litman R, Jungbluth H, Riazi S, Voermans NC, and Snoeck MMJ
- Subjects
- Humans, Child, Neuromuscular Diseases, Muscular Diseases, Anesthesia, Anesthetics, Neuromuscular Junction Diseases
- Abstract
Background and Purpose: Patients with neuromuscular conditions are at increased risk of suffering perioperative complications related to anaesthesia. There is currently little specific anaesthetic guidance concerning these patients. Here, we present the European Neuromuscular Centre (ENMC) consensus statement on anaesthesia in patients with neuromuscular disorders as formulated during the 259th ENMC Workshop on Anaesthesia in Neuromuscular Disorders., Methods: International experts in the field of (paediatric) anaesthesia, neurology, and genetics were invited to participate in the ENMC workshop. A literature search was conducted in PubMed and Embase, the main findings of which were disseminated to the participants and presented during the workshop. Depending on specific expertise, participants presented the existing evidence and their expert opinion concerning anaesthetic management in six specific groups of myopathies and neuromuscular junction disorders. The consensus statement was prepared according to the AGREE II (Appraisal of Guidelines for Research & Evaluation) reporting checklist. The level of evidence has been adapted according to the SIGN (Scottish Intercollegiate Guidelines Network) grading system. The final consensus statement was subjected to a modified Delphi process., Results: A set of general recommendations valid for the anaesthetic management of patients with neuromuscular disorders in general have been formulated. Specific recommendations were formulated for (i) neuromuscular junction disorders, (ii) muscle channelopathies (nondystrophic myotonia and periodic paralysis), (iii) myotonic dystrophy (types 1 and 2), (iv) muscular dystrophies, (v) congenital myopathies and congenital dystrophies, and (vi) mitochondrial and metabolic myopathies., Conclusions: This ENMC consensus statement summarizes the most important considerations for planning and performing anaesthesia in patients with neuromuscular disorders., (© 2022 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
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- 2022
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20. An Assessment of Penetrance and Clinical Expression of Malignant Hyperthermia in Individuals Carrying Diagnostic Ryanodine Receptor 1 Gene Mutations.
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Ibarra Moreno CA, Hu S, Kraeva N, Schuster F, Johannsen S, Rueffert H, Klingler W, Heytens L, and Riazi S
- Subjects
- Adolescent, Adult, Case-Control Studies, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Registries, Young Adult, Genetic Predisposition to Disease genetics, Malignant Hyperthermia diagnosis, Malignant Hyperthermia genetics, Mutation genetics, Penetrance, Ryanodine Receptor Calcium Release Channel genetics
- Abstract
Background: Malignant hyperthermia (MH) is a potentially lethal disorder triggered by certain anesthetics. Mutations in the ryanodine receptor 1 (RYR1) gene account for about half of MH cases. Discordance between the low incidence of MH and a high prevalence of mutations has been attributed to incomplete penetrance, which has not been quantified yet. The authors aimed to examine penetrance of MH-diagnostic RYR1 mutations and the likelihood of mutation carriers to develop MH, and to identify factors affecting severity of MH clinical expression., Methods: In this multicenter case-control study, data from 125 MH pedigrees between 1994 and 2017 were collected from four European registries and one Canadian registry. Probands (survivors of MH reaction) and their relatives with at least one exposure to anesthetic triggers, carrying one diagnostic RYR1 mutation, were included. Penetrance (percentage of probands among all genotype-positive) and the probability of a mutation carrier to develop MH were obtained. MH onset time and Clinical Grading Scale score were used to assess MH reaction severity., Results: The overall penetrance of nine RYR1 diagnostic mutations was 40.6% (93 of 229), without statistical differences among mutations. Likelihood to develop MH on exposure to triggers was 0.25 among all RYR1 mutation carriers, and 0.76 in probands (95% CI of the difference 0.41 to 0.59). Penetrance in males was significantly higher than in females (50% [62 of 124] vs. 29.7% [30 of 101]; P = 0.002). Males had increased odds of developing MH (odds ratio, 2.37; 95% CI, 1.36 to 4.12) despite similar levels of exposure to trigger anesthetics. Proband's median age was 12 yr (interquartile range 6 to 32.5)., Conclusions: Nine MH-diagnostic RYR1 mutations have sex-dependent incomplete penetrance, whereas MH clinical expression is influenced by patient's age and the type of anesthetic. Our quantitative evaluation of MH penetrance reinforces the notion that a previous uneventful anesthetic does not preclude the possibility of developing MH.
- Published
- 2019
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21. Blood/Gas partition coefficients for isoflurane, sevoflurane, and desflurane in a clinically relevant patient population.
- Author
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Esper T, Wehner M, Meinecke CD, and Rueffert H
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Body Mass Index, Desflurane, Female, Hematocrit, Hemoglobins metabolism, Humans, Isoflurane blood, Male, Middle Aged, Reproducibility of Results, Sevoflurane, Sex Factors, Young Adult, Anesthetics, Inhalation blood, Blood Gas Analysis statistics & numerical data, Isoflurane analogs & derivatives, Methyl Ethers blood
- Abstract
Background: The blood/gas partition coefficient of a certain volatile anesthetic is of clinical importance because it determines its velocity of uptake into and elimination from the body of a patient and thus its pharmacokinetic behavior. To date, the blood/gas partition coefficients of isoflurane, sevoflurane, and desflurane have been measured in small numbers of subjects or in particular study groups, for example, healthy volunteers, patients experiencing a common kind of disease, or mothers immediately after giving birth. The objective of this study was to determine the blood/gas partition coefficients of these volatile anesthetics at 37°C in a larger clinically relevant and adult patient population. Furthermore, we tested whether age, gender, body mass index, hemoglobin concentration, or hematocrit had an influence on the coefficients., Methods: Blood samples were taken from 120 fasting operative patients with ASA physical status I to III and aged 19 to 86 years. All subjects were randomly enrolled in study groups for the separate determinations of the blood/gas partition coefficients of isoflurane (n = 41), sevoflurane (n = 41), and desflurane (n = 38) by headspace gas chromatography. To check the quality of the measurements, we determined the distilled water/gas partition coefficients of those anesthetics and compared them with previously published values., Results: We found a blood/gas partition coefficient of 1.45 ± 0.12 (mean ± SD) for isoflurane, 0.74 ± 0.06 for sevoflurane, and 0.57 ± 0.04 for desflurane. Values of this study are 5.07%, 12.12%, and 7.55% higher for isoflurane, sevoflurane, and desflurane, respectively, than the previously published mean values (all P ≤ 0.001). There were only trends for small correlations between the blood/gas partition coefficient of isoflurane and hemoglobin concentration (Pearson r = 0.32; P = 0.041) and hematocrit (r = 0.37; P = 0.016). We found no other potentially significant correlations of the partition coefficients with patient age, body mass index, hemoglobin concentration, or hematocrit (all remaining P > 0.069). Furthermore, the coefficients did not differ significantly between female and male patients. The evaluation of the distilled water/gas partition coefficients of isoflurane (0.59 ± 0.04), sevoflurane (0.37 ± 0.04), and desflurane (0.27 ± 0.03) proved the validity of the gas chromatography method used in this study., Conclusions: The blood/gas partition coefficients of the modern volatile anesthetics, in particular, those of sevoflurane and desflurane, may be higher than that has been hitherto reported. Therefore, their uptake and elimination may occur more slowly in some patients than has been supposed. The blood/gas partition coefficients of isoflurane, sevoflurane, and desflurane measured in this study appear to be representative because they were determined in a clinically and numerically relevant patient cohort.
- Published
- 2015
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22. Search for genetic variants in the ryanodine receptor 1 gene in patients with symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage.
- Author
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Rueffert H, Gumplinger A, Renner C, Dengl M, Reske A, Kaisers UX, and Meixensberger J
- Subjects
- Adult, Female, Genetic Carrier Screening, Genetic Predisposition to Disease genetics, Genetic Testing, Genotype, Glasgow Outcome Scale, Humans, Male, Middle Aged, Pilot Projects, Polymorphism, Single Nucleotide genetics, Prognosis, Risk Factors, Alleles, Genetic Variation genetics, Ryanodine Receptor Calcium Release Channel genetics, Subarachnoid Hemorrhage genetics, Vasospasm, Intracranial genetics
- Abstract
Background: Cerebral vasospasm is one of the most serious complications after subarachnoid hemorrhage (SAH). The cerebral artery diameter is regulated by complex physiological mechanisms. Among them the regulation of intracellular calcium homeostasis seems to play a crucial role. Recent data suggest that ryanodine receptors (RYRs) are involved in regulating the luminal calcium concentration in vascular smooth muscle cells. In this gene association investigation, we studied the question as to whether variants in the gene for the ryanodine receptors subtype 1 (RYR1) are associated with symptomatic cerebral vasospasm following SAH., Methods: After informed consent genomic DNA analysis was performed from a whole blood sample in 46 patients suffering from aneurysmal SAH. 16 Patients were affected by symptomatic vasospasm. The RYR1 gene was screened for possible genetic variants by means of direct sequencing. The association of these variants was correlated to the development of symptomatic vasospasm, which was confirmed by clinical examination combined with cerebral angiography, transcranial doppler sonography, or CT scan., Results: Three different genetic RYR1 variants (c.5360C>T, c.6178G>T, and c.7244G>A) were identified in the study. The G/T genotype of RYR1 c.6178G>T was associated with an increased risk for development of symptomatic vasospasm (odds ratio 6.4; 95% CI 1.1-37.8; P = 0.04)., Conclusion: Our pilot study suggests that RYRs are involved in the complex pathophysiology of vasospasm development following SAH. The potential role of RYR1 as a biomarker for prediction of cerebral vasospasm after SAH has to be confirmed in a larger clinical trial.
- Published
- 2011
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23. Clinical utility gene card for: malignant hyperthermia.
- Author
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Rosenberg H and Rueffert H
- Subjects
- Age Factors, Biopsy, Calcium Channels, L-Type, Dantrolene administration & dosage, Diagnosis, Differential, Gene Frequency, Humans, Incidence, Malignant Hyperthermia drug therapy, Malignant Hyperthermia epidemiology, Myopathies, Structural, Congenital genetics, Neuroleptic Malignant Syndrome genetics, Polymerase Chain Reaction, Polymorphism, Restriction Fragment Length, Predictive Value of Tests, Restriction Mapping, Risk Factors, Sequence Analysis, DNA, Calcium Channels genetics, Malignant Hyperthermia diagnosis, Malignant Hyperthermia genetics, Mutation, Myopathies, Structural, Congenital diagnosis, Neuroleptic Malignant Syndrome diagnosis, Ryanodine Receptor Calcium Release Channel genetics
- Published
- 2011
- Full Text
- View/download PDF
24. Do variations in the 5-HT3A and 5-HT3B serotonin receptor genes (HTR3A and HTR3B) influence the occurrence of postoperative vomiting?
- Author
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Rueffert H, Thieme V, Wallenborn J, Lemnitz N, Bergmann A, Rudlof K, Wehner M, Olthoff D, and Kaisers UX
- Subjects
- 5' Flanking Region, Adolescent, Adult, Aged, Aged, 80 and over, Case-Control Studies, Exons, Female, Gene Frequency, Genetic Predisposition to Disease, Humans, Introns, Logistic Models, Male, Middle Aged, Odds Ratio, Phenotype, Pilot Projects, Receptors, Serotonin, 5-HT3, Risk Assessment, Risk Factors, Young Adult, Polymorphism, Genetic, Postoperative Nausea and Vomiting genetics, Receptors, Serotonin genetics
- Abstract
Background: Postoperative nausea and vomiting are unpleasant side effects of general anesthesia. Besides known risk factors (female gender, nonsmoker, history, and opioids), a genetic influence of the serotonin receptor system on the development of nausea and vomiting has repeatedly been proposed. In this pilot study, we therefore investigated the genes of the serotonin receptor subunits A and B (HTR3A and HTR3B) for genetic variants., Methods: We included 95 patients who had suffered from postoperative vomiting (POV) after general anesthesia and 94 control patients. After DNA isolation, the entire HTR3A and HTR3B coding regions, the 5' flanking regions, and exon/intron boundaries were screened for genetic variants. Correlation of identified genetic variants with POV was determined by logistic regression., Results: We identified 16 different variants in the HTR3A gene and 19 in the HTR3B gene. By using a multivariate logistic regression model that also included classical risk factors, the HTR3A variant c1377A>G was associated with a significantly higher risk (odds ratio [OR] 2.972; 95% confidence interval [CI] 1.466-6.021; P = 0.003) and the HTR3B variants c5+201_+202delCA (OR 0.421; 95% CI 0.257-0.69; P = 0.001) and c6-137C>T (OR 0.034; 95% CI 0.003-0.332; P = 0.004) were associated with a lower risk for POV. However, all significant genetic variants were located in noncoding regions of their gene., Conclusions: Genetic variations in the HTR3A and HTR3B gene seem to be associated with the individual risk of developing POV. How strong their influence is within the multifactorial genesis of POV needs to be investigated in additional studies with an appropriate sample size.
- Published
- 2009
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25. Mild clinical and histopathological features in patients who carry the frequent and causative malignant hyperthermia RyR1 mutation p.Thr2206Met.
- Author
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Rueffert H, Wehner M, Ogunlade V, Meinecke C, and Schober R
- Subjects
- Adolescent, Biopsy, Contracture pathology, Female, Genetic Predisposition to Disease genetics, Humans, Male, Muscle Cramp metabolism, Muscle, Skeletal metabolism, Muscle, Skeletal pathology, Pedigree, Creatine Kinase metabolism, Malignant Hyperthermia genetics, Malignant Hyperthermia pathology, Muscle Cramp pathology, Mutation genetics, Ryanodine Receptor Calcium Release Channel genetics
- Abstract
Objective: Malignant hyperthermia (MH) is a classically unapparent pharmacogenetic disorder of the skeletal muscles triggered by inhalational anesthetics or depolarizing muscle relaxants. The disposition to MH is inherited in an autosomal-dominant manner and is primarily due to mutations in the gene for the ryanodine receptor type 1 (RyR1). The present study intended to analyze whether mild muscular symptoms (elevation of the resting CK, cramps in the calves, slight calf hypertrophy) may be associated with susceptibility to MH and/or with histopathological changes., Methods: A muscle biopsy was taken from 12 out of 44 blood relatives (three generations) of a large family and was investigated with the halothane/caffeine in vitro contracture test (IVCT). Afterwards a histological, histochemical and immunhistological examination was performed. Altogether in 29 persons the DNA was analyzed for mutations in the RyR1-gene., Results: Eight persons were diagnosed as susceptible to MH (MHS) by the IVCT, 4 were MH negative. All MHS persons carried the MH causative c.6617C > T (Thr2206Met) mutation and showed slight clinical signs of a myopathy as well as mild biopsy changes with isolated hypotrophic fibers and disseminated small areas with reduction of oxidative staining (multi-minicore like lesions). The Thr2206Met mutation was identified in another further 9 relatives who also experienced mild myopathological features. Clinical MH incidents were not reported in this large family., Conclusion: The RyR1 Thr2206Met mutation is one of the most frequent mutations in the European MH population but carriers are normally healthy. In this study we could demonstrate that the MH causative Thr2206Met mutation may also be associated both with clinical symptoms of a mild myopathy and histopathological changes in the oxidative inter myofibrillar network.
- Published
- 2009
26. Core myopathies and risk of malignant hyperthermia.
- Author
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Klingler W, Rueffert H, Lehmann-Horn F, Girard T, and Hopkins PM
- Subjects
- Calcium metabolism, Genetic Predisposition to Disease, Humans, Malignant Hyperthermia metabolism, Muscle, Skeletal pathology, Muscle, Skeletal physiopathology, Muscular Diseases genetics, Muscular Diseases metabolism, Mutation, Myopathies, Nemaline complications, Myopathy, Central Core complications, Phenotype, Risk Assessment, Risk Factors, Ryanodine Receptor Calcium Release Channel genetics, Anesthesia adverse effects, Malignant Hyperthermia etiology, Muscle, Skeletal metabolism, Muscular Diseases complications
- Abstract
In this article, we analyze myopathies with cores, for which an association to malignant hyperthermia (MH) has been suggested. We discuss the clinical features, the underlying genetic defects, subsequent effects on cellular calcium metabolism, and in vitro muscle responses to MH triggers. We describe in detail central core disease, multiminicore disease, and nemaline rod myopathy. We categorize the diseases according to the affected proteins and discuss the risk for MH, which is high or theoretically possible when the calcium-conducting proteins are affected.
- Published
- 2009
- Full Text
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27. Functional characterization of malignant hyperthermia-associated RyR1 mutations in exon 44, using the human myotube model.
- Author
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Wehner M, Rueffert H, Koenig F, and Olthoff D
- Subjects
- Adolescent, Adult, Aged, Anesthetics pharmacology, Biopsy, Caffeine pharmacology, Calcium metabolism, Cells, Cultured, Central Nervous System Stimulants pharmacology, Child, Child, Preschool, Cresols pharmacology, Dose-Response Relationship, Drug, Family Health, Fungicides, Industrial pharmacology, Fura-2 metabolism, Halothane pharmacology, Humans, In Vitro Techniques, Male, Malignant Hyperthermia physiopathology, Middle Aged, Molecular Biology, Muscle Contraction drug effects, Muscle Contraction genetics, Muscle Fibers, Skeletal drug effects, Muscle, Skeletal cytology, Muscle, Skeletal drug effects, Muscle, Skeletal physiopathology, Exons, Malignant Hyperthermia genetics, Muscle Fibers, Skeletal metabolism, Mutation, Ryanodine Receptor Calcium Release Channel genetics
- Abstract
Malignant hyperthermia (MH) is a pharmacogenetic disorder with an autosomal dominant inheritance. During exposure to triggering agents as volatile anaesthetics, affected individuals may develop a potentially fatal hypermetabolic syndrome caused by excessive calcium release from the sarcoplasmic reticulum in skeletal muscle. More than 60 MH associated mutations were found in the gene of skeletal muscle ryanodine receptor (RyR1), but only some of them have been functionally characterized. Primary human myotubes were cultured from carriers of RyR1 mutations in exon 44 (Ala2350Thr, Arg2355Trp, Gly2375Ala) and from MH non-susceptible individuals. Investigation of calcium homeostasis with the calcium sensitive probe Fura 2 showed a higher sensitivity to the ryanodine receptor agonists 4-chloro-m-cresol, caffeine and halothane for the myotubes derived from the mutation carriers as compared to those of the control group. The presence of RyR1 mutations with impact on calcium homeostasis emphasizes the functional significance of exon 44.
- Published
- 2004
- Full Text
- View/download PDF
28. A new mutation in the skeletal ryanodine receptor gene (RYR1) is potentially causative of malignant hyperthermia, central core disease, and severe skeletal malformation.
- Author
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Rueffert H, Olthoff D, Deutrich C, Schober R, and Froster UG
- Subjects
- Adolescent, Base Sequence, Caffeine pharmacology, DNA chemistry, DNA genetics, DNA Mutational Analysis, Dysostoses pathology, Dysostoses physiopathology, Family Health, Female, Genotype, Halothane pharmacology, Humans, Male, Malignant Hyperthermia complications, Muscle Contraction drug effects, Musculoskeletal Abnormalities complications, Musculoskeletal Abnormalities genetics, Myopathy, Central Core complications, Pedigree, Phenotype, Point Mutation, Dysostoses genetics, Malignant Hyperthermia pathology, Mutation, Myopathy, Central Core pathology, Ryanodine Receptor Calcium Release Channel genetics
- Abstract
Malignant hyperthermia susceptibility (MHS) and central core disease (CCD) have been shown to result from missense mutations in the ryanodine receptor gene of the skeletal muscle (RYR1). A 15-year-old patient who had spondylocostal dysostosis (SCD) developed an MH crisis during general anesthesia. The patient was characterized phenotypically by block vertebrae, vertebral fusion, short neck and thorax, fused ribs, craniofacial abnormalities, spina bifida occulta, and a diaphragmatic defect closed surgically in early infancy. The diagnosis MH susceptible (MHS) was confirmed by the in vitro contracture test (IVCT) on a muscle biopsy. Surprisingly, the histopathological investigation revealed the presence of CCD too. Molecular genetic investigation of the RYR1 gene was performed to search for known MH-related mutations. Cluster regions of the RYR1 gene, in which mutations have already been found, were examined by direct automated sequencing. In addition to the diagnosis MHS and CCD we were able to identify a novel RYR1 mutation in exon 46: 7358ATC > ACC, resulting in an Ile2453Thr substitution. This mutation was also present in the mother, in whom MH disposition and CCD were determined by muscle investigations. We suggest that the newly identified RYR1 mutation is closely associated with MH and CCD. A probable causative role of the RYR1 gene in SCD patients should be assessed by further genetic investigations., (Copyright 2003 Wiley-Liss, Inc.)
- Published
- 2004
- Full Text
- View/download PDF
29. The Ile2453Thr mutation in the ryanodine receptor gene 1 is associated with facilitated calcium release from sarcoplasmic reticulum by 4-chloro-m-cresol in human myotubes.
- Author
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Wehner M, Rueffert H, Koenig F, Meinecke CD, and Olthoff D
- Subjects
- Adolescent, Adult, Aged, Child, Female, Genetic Predisposition to Disease, Humans, Male, Malignant Hyperthermia genetics, Muscle Fibers, Skeletal drug effects, Pedigree, Calcium metabolism, Cresols pharmacology, Muscle Fibers, Skeletal metabolism, Mutation, Myopathy, Central Core genetics, Ryanodine Receptor Calcium Release Channel genetics, Sarcoplasmic Reticulum metabolism
- Abstract
Central core disease (CCD) is a congenital disorder of skeletal muscle that is characterised histologically by typical central cores in type 1 skeletal muscle fibres. This disease is associated with malignant hyperthermia susceptibility and has been linked to the gene of skeletal muscle ryanodine receptor RYR1. In this study, we present a family with the spontaneous occurrence of the RYR1 Ile2453Thr mutation. Affected individuals were diagnosed as susceptible to malignant hyperthermia in the in vitro contracture test (IVCT) and showed histological signs of CCD. Myotubes were derived from the index patient. The calcium homeostasis in response to the ryanodine receptor agonist 4-chloro-m-cresol (4CmC) was investigated by calcium imaging using the Ca(2+)-sensitive fluorescent probe FURA 2. In the myotubes derived from the mutation carrier, the EC(50) of 4CmC was reduced to 94 micro as compared to 201 microM in a control group of 16 individuals non-susceptible to malignant hyperthermia. In the myotubes of the non-affected family members, the EC(50) was found within the same range as that of the control group. The reduction of EC(50) indicates a facilitated calcium release from sarcoplasmic reticulum in the myotubes of the index patient suggesting that the RYR1 Ile2453Thr mutation is pathogenic for the malignant hyperthermia susceptibility and CCD of the two affected individuals.
- Published
- 2003
- Full Text
- View/download PDF
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