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3. Cutaneous sensory block area of the ultrasound-guided subcostal transversus abdominis plane block:an observational study

Author

Salmonsen, Christopher Blom, Lange, Kai Henrik Wiborg, Rothe, Christian, Kleif, Jakob, Bertelsen, Claus Anders, Salmonsen, Christopher Blom, Lange, Kai Henrik Wiborg, Rothe, Christian, Kleif, Jakob, and Bertelsen, Claus Anders

Abstract

Background and objectives The transversus abdominis plane block (TAP) can be applied using different approaches, resulting in varying cutaneous analgesic distributions. This study aimed to assess the cutaneous sensory block area (CSBA) after ultrasound-guided TAP (US-TAP) using the subcostal approach. Methods Thirty patients undergoing elective laparoscopic cholecystectomy received a subcostal US-TAP with 20 mL 2.5 mg/mL ropivacaine bilaterally. Measurements were performed 150 min after block application. The CSBA was mapped using cold sensation and a sterile marker, photodocumented, and transferred to a transparency. The area of the CSBA was calculated from the transparencies. Results The median CSBA of the subcostal US-TAP was 174 cm2 (IQR 119–219 cm2; range 52–398 cm2). In all patients, the CSBA had a periumbilical distribution. In 42 of the 60 (70%) unilateral blocks, the CSBA had both an epigastric and infraumbilical component; in 12 of the 60 (20%) unilateral blocks, it covered only the epigastrium; and in 4 of the 60 (7%) unilateral blocks, it had only an infraumbilical distribution. No CSBA was found in 2 of the 60 (3%) unilateral blocks. In none of the patients did the CSBA cover the abdominal wall lateral to a vertical line through the anterior superior iliac spine. Conclusion The subcostal US-TAP results in a heterogeneous non-dermatomal CSBA with varying size and distribution across the medial abdominal wall., Background and objectives: The transversus abdominis plane block (TAP) can be applied using different approaches, resulting in varying cutaneous analgesic distributions. This study aimed to assess the cutaneous sensory block area (CSBA) after ultrasound-guided TAP (US-TAP) using the subcostal approach. Methods: Thirty patients undergoing elective laparoscopic cholecystectomy received a subcostal US-TAP with 20 mL 2.5 mg/mL ropivacaine bilaterally. Measurements were performed 150 min after block application. The CSBA was mapped using cold sensation and a sterile marker, photodocumented, and transferred to a transparency. The area of the CSBA was calculated from the transparencies. Results: The median CSBA of the subcostal US-TAP was 174 cm2 (IQR 119-219 cm2; range 52-398 cm2). In all patients, the CSBA had a periumbilical distribution. In 42 of the 60 (70%) unilateral blocks, the CSBA had both an epigastric and infraumbilical component; in 12 of the 60 (20%) unilateral blocks, it covered only the epigastrium; and in 4 of the 60 (7%) unilateral blocks, it had only an infraumbilical distribution. No CSBA was found in 2 of the 60 (3%) unilateral blocks. In none of the patients did the CSBA cover the abdominal wall lateral to a vertical line through the anterior superior iliac spine. Conclusion: The subcostal US-TAP results in a heterogeneous non-dermatomal CSBA with varying size and distribution across the medial abdominal wall.

Published
2024

7. Collaboration for Evidence-based Practice and Research in Anaesthesia (CEPRA):A consortium initiative for perioperative research

Author

Nørskov, Anders Kehlet, Jakobsen, Janus Christian, Afshari, Arash, Bisgaard, Jannie, Geisler, Anja, Hägi-Pedersen, Daniel, Lange, Kai Henrik Wiborg, Lundstrøm, Lars Hyldborg, Lunn, Troels Haxholdt, Maagaard, Mathias, Møller, Ann Merete, Nedergaard, Helene Korvenius, Nikolajsen, Lone, Olsen, Markus Harboe, Juhl-Olsen, Peter, Rasmussen, Bodil Steen, Vested, Matias, Vester-Andersen, Morten, Wikkelsø, Anne, Mathiesen, Ole, group, The CEPRA collaboration, Nørskov, Anders Kehlet, Jakobsen, Janus Christian, Afshari, Arash, Bisgaard, Jannie, Geisler, Anja, Hägi-Pedersen, Daniel, Lange, Kai Henrik Wiborg, Lundstrøm, Lars Hyldborg, Lunn, Troels Haxholdt, Maagaard, Mathias, Møller, Ann Merete, Nedergaard, Helene Korvenius, Nikolajsen, Lone, Olsen, Markus Harboe, Juhl-Olsen, Peter, Rasmussen, Bodil Steen, Vested, Matias, Vester-Andersen, Morten, Wikkelsø, Anne, Mathiesen, Ole, and group, The CEPRA collaboration

Abstract

Evidence in perioperative care is insufficient. There is an urgent need for large perioperative research programmes, including pragmatic randomised trials, testing daily clinical treatments and unanswered question, thereby providing solid evidence for effects of interventions given to a large and growing number of patients undergoing surgery and anaesthesia. This may be achieved through large collaborations. Collaboration for Evidence-based Practice and Research in Anaesthesia (CEPRA) is a novel collaborative research network founded to pursue evidence-based answers to major clinical questions in perioperative medicine. The aims of CEPRA are to (1) improve clinical treatment and outcomes and optimise the use of resources for patients undergoing anaesthesia and perioperative care, and (2) disseminate results and inform caretakers, patients and relatives, and policymakers of evidence-based treatments in anaesthesia and perioperative medicine. CEPRA is inclusive in its concept. We aim to extend our collaboration with all relevant clinical collaborators and patient associations and representatives. Although initiated in Denmark, CEPRA seeks to develop an international network infrastructure, for example, with other Nordic countries. The work of CEPRA will follow the highest methodological standards. The organisation aims to structure and optimise any element of the research collaboration to reduce economic costs and harness benefits from well-functioning research infrastructure. This includes successive continuation of trials, harmonisation of outcomes, and alignment of data management systems. This paper presents the initiation and visions of the CEPRA network. CEPRA aims to be inclusive, patient-focused, methodologically sound, and to optimise all aspects of research logistics. This will translate into faster research conduct, reliable results, and accelerated clinical implementation of results, thereby benefiting millions of patients whilst being cost and labour-s

Published
2023

8. Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

Author

Kahan, Brennan C., Koulenti, Desponia, Arvaniti, Kostoula, Beavis, Vanessa, Campbell, Douglas, Chan, Matthew, Moreno, Rui, Pearse, Rupert M., Pearse, Rupert M., Beattie, Scott, Clavien, Pierre-Alain, Demartines, Nicolas, Fleisher, Lee A., Grocott, Mike, Haddow, James, Hoeft, Andreas, Holt, Peter, Moreno, Rui, Pritchard, Naomi, Rhodes, Andrew, Wijeysundera, Duminda, Wilson, Matt, Ahmed, Tahania, Everingham, Kirsty, Hewson, Russell, Januszewska, Marta, Pearse, Rupert M., Phull, Mandeep-Kaur, Halliwell, Richard, Shulman, Mark, Myles, Paul, Schmid, Werner, Hiesmayr, Michael, Wouters, Patrick, de Hert, Stefan, Lobo, Suzana, Beattie, Scott, Wijeysundera, Duminda, Fang, Xiangming, Rasmussen, Lars, Futier, Emmanuel, Biais, Matthieu, Venara, Aurélien, Slim, Karem, Sander, Michael, Koulenti, Despoina, Arvaniti, Kostoula, Chan, Mathew, Kulkarni, Atul, Chandra, Susilo, Tantri, Aida, Geddoa, Emad, Abbas, Muntadhar, Della Rocca, Giorgio, Sivasakthi, Datin, Mansor, Marzida, Luna, Pastor, Bouwman, Arthur, Buhre, Wolfgang, Beavis, Vanessa, Campbell, Douglas, Short, Tim, Osinaike, Tunde, Matos, Ricardo, Grigoras, Ioana, Kirov, Mikhail, Protsenko, Denis, Biccard, Bruce, Aldecoa, Cesar, Chew, Michelle, Hofer, Christoph, Hubner, Martin, Ditai, James, Szakmany, Tamas, Fleisher, Lee, Ferguson, Marissa, MacMahon, Michael, Shulman, Mark, Cherian, Ritchie, Currow, Helen, Kanathiban, Kathirgamanathan, Gillespie, David, Pathmanathan, Edward, Phillips, Katherine, Reynolds, Jenifer, Rowley, Joanne, Douglas, Jeanene, Kerridge, Ross, Currow, Helen, Garg, Sameer, Bennett, Michael, Jain, Megha, Alcock, David, Terblanche, Nico, Cotter, Rochelle, Leslie, Kate, Stewart, Marcelle, Zingerle, Nicolette, Clyde, Antony, Hambidge, Oliver, Rehak, Adam, Cotterell, Sharon, Binh QuanHuynh, Wilson, McCulloch, Timothy, Ben-Menachem, Erez, Egan, Thomas, Cope, Jennifer, Halliwell, Richard, Fellinger, Paul, Haselberger, Simone, Holaubek, Caroline, Lichtenegger, Paul, Scherz, Florian, Schmid, Werner, Hoffer, Franz, Cakova, Veronika, Eichwalder, Andreas, Fischbach, Norbert, Klug, Reinhold, Schneider, Elisabeth, Vesely, Martin, Wickenhauser, Reinhart, Grubmueller, Karl Gernot, Leitgeb, Marion, Lang, Friedrich, Toro, Nancy, Bauer, Marlene, Laengle, Friedrich, Mayrhofer, Thomas, Buerkle, Christian, Forstner, Karin, Germann, Reinhard, Rinoesl, Harald, Schindler, Elke, Trampitsch, Ernst, Fritsch, Gerhard, Szabo, Christian, Bidgoli, Jawad, Verdoodt, Hans, Forget, Patrice, Kahn, David, Lois, Fernande, Momeni, Mona, Prégardien, Caroline, Pospiech, Audrey, Steyaert, Arnaud, Veevaete, Laurent, De Kegel, Dirk, De Jongh, Karen, Foubert, Luc, Smitz, Carine, Vercauteren, Marcel, Poelaert, Jan, Van Mossevelde, Veerle, Abeloos, Jacques, Bouchez, Stefaan, Coppens, Marc, De Baerdemaeker, Luc, Deblaere, Isabel, De Bruyne, Ann, De Hert, Stefan, Fonck, Kristine, Heyse, Bjorn, Jacobs, Tom, Lapage, Koen, Moerman, Anneliese, Neckebroek, Martine, Parashchanka, Aliaksandra, Roels, Nathalie, Van Den Eynde, Nancy, Vandenheuvel, Michael, Van Limmen, Jurgen, Vanluchene, Ann, Vanpeteghem, Caroline, Wouters, Patrick, Wyffels, Piet, Huygens, Christel, Vandenbempt, Punitha, Van de Velde, Marc, Dylst, Dimitri, Janssen, Bruno, Schreurs, Evelien, Aleixo, Fábia Berganton, Candido, Keulle, Dias Batista, Hugo, Guimarães, Mario, Guizeline, Jaqueline, Hoffmann, João, Lobo, Suzana M., Lobo, Francisco Ricardo, Nascimento, Vinícius, Nishiyama, Katia, Pazetto, Lucas, Souza, Daniela, Souza Rodrigues, Rodrigo, Vilela dos Santos, Ana Maria, Jardim, Jaquelline, Silva, Joao, do NascimentoJunior, Paulo, Baio, Thalissa Hermínia, Pereira de Castro, Gabriel Isaac, Watanabe Oliveira, Henri Roger, Amendola, Cristina Prata, Cardoso, Gutemberg, Ortega, Daniela, Brotto, Ana Flavia, De Oliveira, Mirella Cristine, Réa-Neto, Álvaro, Dias, Fernando, Azambuja, Pedro, Knibel, Marcos Freitas, Martins, Antonio, Almeida, William, Neto, Calim Neder, Tardelli, Maria Angela, Caser, Eliana, Machado, Marcio, Aguzzoli, Crisitiano, Baldisserotto, Sérgio, Beck Tabajara, Fernanda, Bettega, Fernanda, Rodrigues Júnior, La Hore Correa, de Gasperi, Julia, Faina, Lais, Nolasco, Marcos Farias, da Costa Fischer, Bruna Ferreira, de Campos Ferreira, Mariana Fosch, Hartmann, Cristina, Kliemann, Marta, Ribeiro, Gustavo LuisHubert, Fraga, Julia Merladete, Netto, Thiago Motta, Pozza, Laura Valduga, Wendling, Paulo Rafael, Azevedo, Caroline, Garcia, Juliana, Lopes, Marcel, Maia, Bernardo, Maselli, Paula, Melo, Ralph, Mendes, Weslley, Neves, Matheus, Ney, Jacqueline, Piras, Claudio, Applewhaite, Christopher, Carr, Adrienne, Chow, Lorraine, Duttchen, Kaylene, Foglia, Julena, Greene, Michael, Hinther, Ashley, Houston, Kendra, McCormick, Thomas Jared, Mikhayel, Jennifer, Montasser, Sam, Ragan, Alex, Suen, Andrew, Woolsey, Adrianna, Yu, Hai Chuan, Funk, Duane, Kowalski, Stephen, Legaspi, Regina, McDonald, Heather, Siddiqui, Faisal, Pridham, Jeremy, Rowe, Bernadette, Sampson, Sonia, Thiessen, Barton, Zbitnew, Geoff, Bernard, Andre, George, Ronald, Jones, Philip, Moor, Rita, Siddiqui, Naveed, Wolfer, Alexandra, Tran, Diem, Winch, Denyse, Dobson, Gary, Hinther, Ashley, McCormick, Thomas, Montasser, Osama, Suen, Andrew, Woolsey, Adrianna, Bernard, Andre, George, Ronald, Hall, Richard, Bernard, Andre, George, Ronald, Hall, Richard, Applewhaite, Christopher, Baghirzada, Leyla, McCormick, Thomas Jared, Suen, Andrew, Dai, Si Yuan, Hare, Gregory, Lee, Esther, Shastri, Uma, Tsui, Albert, Yagnik, Anmol, Alvares, Danielle, Choi, Stephen, Dwyer, Heather, Flores, Kathrina, McCartney, Colin, Somascanthan, Priya, Beattie, Scott, Carroll, Jo, Pazmino-Canizares, Janneth, Wijeysundera, Duminda, Wolfer, Alexandra, Ami, Noam, Chan, Vincent, Perlas, Anahi, Argue, Ruth, Lavis, Katie, Mayson, Kelly, Cao, Ying, Gao, Hong, hu, tingju, Lv, Jie, Yang, Jian, Yang, Yang, Zhong, Yi, Zhou, Jing, Zou, Xiaohua, He, Miao, Li, Xiaoying, Luo, Dihuan, Wang, Haiying, Yu, Tian, Chen, Liyong, Wang, Lijun, Cai, Yunfei, Cao, Zhongming, Li, Yanling, Lian, Jiaxin, Sun, Haiyun, Wang, Sheng, Wang, Zhipeng, Wang, Kenru, Zhu, Yi, Du, Xindan, Fan, Hao, Fu, Yunbin, Huang, Lixia, Huang, Yanming, Hwan, Haifang, Luo, Hong, Qu, Pi-Sheng, Tao, Fan, Wang, Zhen, Wang, Guoxiang, Wang, Shun, Zhang, Yan, Zhang, Xiaolin, Chen, Chao, Wang, Weixing, Liu, Zhengyuan, Fan, Lihua, Tang, Jing, Chen, Yijun, Chen, Yongjie, Han, Yangyang, Huang, Changshun, Liang, Guojin, Shen, Jing, Wang, Jun, Yang, Qiuhong, Zhen, Jungang, Zhou, Haidong, Chen, Junping, Chen, Zhang, Li, Xiaoyu, Meng, Bo, Ye, Haiwang, Zhang, Xiaoyan, Bi, Yanbing, Cao, Jianqiao, Guo, Fengying, Lin, Hong, Liu, Yang, Lv, Meng, Shi, Pengcai, Song, Xiumei, Sun, Chuanyu, Sun, Yongtao, Wang, Yuelan, Wang, Shenhui, Zhang, Min, Chen, Rong, Hou, Jiabao, Leng, Yan, Meng, Qing-tao, Qian, Li, Shen, Zi-ying, Xia, Zhong-yuan, Xue, Rui, Zhang, Yuan, Zhao, Bo, Zhou, Xian-jin, Chen, Qiang, Guo, Huinan, Guo, Yongqing, Qi, Yuehong, Wang, Zhi, Wei, Jianfeng, Zhang, Weiwei, Zheng, Lina, Bao, Qi, Chen, Yaqiu, Chen, Yijiao, Fei, Yue, Hu, Nianqiang, Hu, Xuming, Lei, Min, Li, Xiaoqin, Lv, Xiaocui, Lv, Jie, Miao, Fangfang, Ouyang, Lingling, Qian, Lu, Shen, Conyu, Sun, Yu, Wang, Yuting, Wang, Dong, Wu, Chao, Xu, Liyuan, Yuan, Jiaqi, Zhang, Lina, Zhang, Huan, Zhang, Yapping, Zhao, Jinning, Zhao, Chong, Zhao, Lei, Zheng, Tianzhao, Zhou, Dachun, Zhou, Haiyan, Zhou, Ce, Lu, Kaizhi, Zhao, Ting, He, Changlin, Chen, Hong, Chen, Shasha, Cheng, Baoli, He, Jie, Jin, Lin, Li, Caixia, Li, Hui, Pan, Yuanming, Shi, Yugang, Wen, Xiao Hong, Wu, Shuijing, Xie, Guohao, Zhang, Kai, Zhao, Bing, Lu, Xianfu, Chen, Feifei, Liang, Qisheng, Lin, Xuewu, Ling, Yunzhi, Liu, Gang, Tao, Jing, Yang, Lu, Zhou, Jialong, Chen, Fumei, Feng, Yunlin, Hou, Benchao, Lin, Jiamei, Liu, Mei, Luo, Foquan, Shi, Xiaoyun, Xiong, Yingfen, Xu, Lin, Yang, Shuangjia, Zhang, Qin, Zhang, Huaigen, Zhao, Weihong, Zhao, Weilu, Bai, Yun, Chen, Linbi, Chen, Sijia, Dai, Qinxue, Geng, Wujun, Han, Kunyuan, He, Xin, Huang, Luping, Ji, Binbin, Jia, Danyun, Jin, Shenhui, Li, Qianjun, Liang, Dongdong, Luo, Shan, Lwang, Lulu, Mo, Yunchang, Pan, Yuanyuan, Qi, Xinyu, Qian, Meizi, Qin, Jinling, Ren, Yelong, Shi, Yiyi, Wang, Junlu, Wang, Junkai, Wang, Leilei, Xie, Junjie, Yan, Yixiu, Yao, Yurui, Zhang, Mingxiao, Zhao, Jiashi, Zhuang, Xiuxiu, Ai, Yanqiu, Du, Fang, He, Long, Huang, Ledan, Li, Zhisong, Li, Huijuan, Li, Yetong, Li, Liwei, Meng, Su, Yuan, Yazhuo, Zhang, Enman, Zhang, Jie, Zhao, Shuna, Ji, Zhenrong, Pei, Ling, Wang, Li, Chen, Chen, Dong, Beibei, Li, Jing, Miao, Ziqiang, Mu, Hongying, Qin, Chao, Su, Lin, Wen, Zhiting, Xie, Keliang, Yu, Yonghao, Yuan, Fang, Hu, Xianwen, Zhang, Ye, Xiao, Wangpin, Zhu, Zhipeng, Dai, Qingqing, Fu, Kaiwen, Hu, Rong, Hu, Xiaolan, Huang, Song, Li, Yaqi, Liang, Yingping, Yu, Shuchun, Guo, Zheng, Jing, Yan, Tang, Na, Wu, Jie, Yuan, Dajiang, Zhang, Ruilin, Zhao, Xiaoying, Li, Yuhong, Bai, Hui-Ping, Liu, Chun-Xiao, Liu, Fei-Fei, Ren, Wei, Wang, Xiu-Li, Xu, Guan-Jie, Hu, Na, Li, Bo, Ou, Yangwen, Tang, Yongzhong, Yao, Shanglong, Zhang, Shihai, Kong, Cui-Cui, Liu, Bei, Wang, Tianlong, Xiao, Wei, Lu, Bo, Xia, Yanfei, Zhou, Jiali, Cai, Fang, Chen, Pushan, Hu, Shuangfei, Wang, Hongfa, Wu, Jie, Xu, Qiong, Hu, Liu, Jing, Liang, Li, Jing, Li, Bin, Liu, Qiang, Liu, Yuejiang, Lu, Xinjian, Peng, Zhen Dan, Qiu, Xiaodong, Ren, Quan, Tong, Youliang, Wang, Zhen, Wang, Jin, Wen, Yazhou, Wu, Qiong, Xia, Jiangyan, Xie, Jue, Xiong, Xiapei, Xu, Shixia, Yang, Tianqin, Ye, Hui, Yin, Ning, Yuan, Jing, Zeng, Qiuting, Zhang, Baoling, Zheng, Kang, Cang, Jing, Chen, Shiyu, Du, Fang, Fan, Yu, Fu, Shuying, Ge, Xiaodong, Guo, Baolei, Huang, Wenhui, Jiang, Linghui, Jiang, Xinmei, Jin, Lin, Liu, Yi, Pan, Yan, Ren, Yun, Shan, Qi, Wang, Jiaxing, Wang, Fei, Wu, Chi, Zhang, Xiaoguang, Christiansen, Ida Cecilie, Granum, Simon Nørgaard, Rasmussen, Bodil Steen, Daugaard, Morten, Gambhir, Rajiv, Steingrímsdóttir, Guðný Erla, Jensen-Gadegaard, Peter, Olsen, Karsten Skovgaard, Siegel, Hanna, Zwicky Eskildsen, Katrine, Gätke, Mona Ring, Wibrandt, Ida, Heintzelmann, Simon Bisgaard, Lange, Kai Henrik Wiborg, Lundsgaard, Rune Sarauw, Amstrup-Hansen, Louise, Hovendal, Claus, Larsen, Michael, Lenstrup, Mette, Kobborg, Tina, Larsen, Jens Rolighed, Pedersen, Anette Barbre, Larsen, Jens Rolighed, Smith, Søren Hübertz, Oestervig, Rebecca Monett, Rasmussen, Lars, Afshari, Arash, Andersen, Cheme, Ekelund, Kim, Secher, Erik Lilja, Brandsborg, Birgitte, Beloeil, Helene, Lasocki, Sigismond, Venara, Aurélien, Biais, Matthieu, Ouattara, Alexandre, Sineus, Marlene, Molliex, Serge, Legouge, Marie Lim, Wallet, Florent, Tesniere, Antoine, Gaudin, Christophe, Lehur, Paul, Forsans, Emma, de Rudnicki, Stéphane, Serra Maudet, Valerie, Mutter, Didier, Sojod, Ghassan, Ouaissi, Mehdi, Regimbeau, Jean-Marc, Futier, Emmanuel, Desbordes, Jacques, Comptaer, Nicolas, elManser, Diae, Ethgen, Sabine, Lebuffe, Gilles, Auer, Patrick, Härtl, Christine, Deja, Maria, Legashov, Kirill, Sonnemann, Susanne, Wiegand-Loehnert, Carola, Falk, Elke, Habicher, Marit, Angermair, Stefan, Laetsch, Beatrix, Schmidt, Katrin, Sonnemann, Susanne, Von Heymann, Christian, Ramminger, Axel, Jelschen, Florian, Pabel, Svenja, Weyland, Andreas, Czeslick, Elke, Gille, Jochen, Malcharek, Michael, Sablotzki, Armin, Lueke, Katharina, Wetzel, Peter, Weimann, Joerg, Lenhart, Franz-Peter, Reichle, Florian, Schirmer, Frederike, Hüppe, Michael, Klotz, Karl, Nau, Carla, Schön, Julika, Mencke, Thomas, Wasmund, Christina, Bankewitz, Carla, Baumgarten, Georg, Fleischer, Andreas, Guttenthaler, Vera, Hack, Yvonne, Hoeft, Andreas, Kirchgaessner, Katharina, Männer, Olja, Schurig-Urbaniak, Marlen, Struck, Rafael, vanZyl, Rebekka, Wittmann, Maria, Goebel, Ulrich, Harris, Sarah, Veit, Siegfried, Andreadaki, Evangelia, Souri, Flora, Katsiadramis, Ioannis, Skoufi, Anthi, Vasileiou, Maria, Aimoniotou-Georgiou, Eleni, Katsourakis, Anastasios, Veroniki, Fotini, Vlachogianni, Glyceria, Petra, Konstantina, Chlorou, Dimitra, Oloktsidou, Eirini, Ourailoglou, Vasileios, Papapostolou, Konstantinos, Tsaousi, Georgia, Daikou, Panagoula, Dedemadi, Georgia, Kalaitzopoulos, Ioannis, Loumpias, Christos, Bristogiannis, Sotirios, Dafnios, Nikolaos, Gkiokas, Georgios, Kontis, Elissaios, Kozompoli, Dimitra, Papailia, Aspasia, Theodosopoulos, Theodosios, Bizios, Christol, Koutsikou, Anastasia, Moustaka, Aleaxandra, Plaitakis, Ioannis, Armaganidis, Apostolos, Christodoulopoulou, Theodora, Lignos, Mihail, Theodorakopoulou, Maria, Asimakos, Andreas, Ischaki, Eleni, Tsagkaraki, Angeliki, Zakynthinos, Spyros, Antoniadou, Eleni, Koutelidakis, Ioannis, Lathyris, Dimitrios, Pozidou, Irene, Voloudakis, Nikolaos, Dalamagka, Maria, Gkonezou, Elena, Chronis, Christos, Manolakaki, Dimitra, Mosxogiannidis, Dimitris, Slepova, Tatiana, Tsakiridou, Isaia–sissy, Lampiri, Claire Lampiri, Vachlioti, Anastasia Vachlioti, Panagiotakis, Christos Panagiotakis, Sfyras, Dimitrios Sfyras, Tsimpoukas, FotiosTsimpoukas, Tsirogianni, Athanasia, Axioti, Elena, Filippopoulos, Andreas, Kalliafa, Elli, Kassavetis, George, Katralis, Petros, Komnos, Ioannis, Pilichos, Georgios, Ravani, Ifigenia, Totis, Antonis, Apagaki, Eymorfia, Efthymiadi, Andromachi, Kampagiannis, Nikolaos, Paraforou, Theoniki, Tsioka, Agoritsa, Georgiou, Georgios, Vakalos, Aristeidis, Bairaktari, Aggeliki, Charitos, Efthimios, Markou, George, Niforopoulou, Panagiota, Papakonstantinou, Nikolaos, Tsigou, Evdoxia, Xifara, Archontoula, Zoulamoglou, Menelaos, Gkioni, Panagiota, Karatzas, Stylianos, Kyparissi, Aikaterini, Mainas, Efstratios, Papapanagiotou, Ioannis, Papavasilopoulou, Theonymfi, Fragandreas, George, Georgopoulou, Eleni, Katsika, Eleni, Psarras, Kyriakos, Synekidou, Eirini, Verroiotou, Maria, Vetsiou, Evangelia, Zaimi, Donika, Anagnou, Athina, Apostolou, Konstantinos, Melissopoulou, Theodora, Rozenberg, Theophilos, Tsigris, Christos, Boutsikos, Georgios, Kalles, Vasileios, Kotsalas, Nikolaos, Lavdaiou, Christina, Paikou, Fotini, Panagou, Georgia-Laura, Spring, Anna, Arvaniti, Kostoula, Botis, Ioannis, Drimala, Maria, Georgakakis, Georgios, Kiourtzieva, Ellada, Ntouma, Panagiota, Prionas, Apostolos, Xouplidis, Kyriakos, Dalampini, Eleftheria, Giannaki, Chrysavgi, Iasonidou, Christina, Ioannidis, Orestis, Lavrentieva, Athina, Lavrentieva, Athena, Papageorgiou, George, Kokkinoy, Maria, Stafylaraki, Maria, Gaitanakis, Stylianos, Karydakis, Periclis, Paltoglou, Josef, Ponireas, Panagiotis, Chaloulis, Panagiotis, Provatidis, Athanasios, Sousana, Anisoglou, Gardikou, Varvara Vanessa, Konstantivelli, Maria, Lataniotou, Olga, Lisari, Elisavet, Margaroni, Maria, Stamatiou, Konstantinos, Nikolaidis, Edouardos, Pnevmatikos, Ioannis, Sertaridou, Eleni, Andreou, Alexandros, Arkalaki, Eleni, Athanasakis, Elias, Chaniotaki, Fotini, Chatzimichali, Aikaterini, Christofaki, Maria, Dermitzaki, Despina, Fiorentza, Klara, Frantzeskos, Georgios, Geromarkaki, Elisavet, Kafkalaki, Kalliopi, Kalogridaki, Marina, Karydi, Konstyllia, Kokkini, Sofia, Kougentakis, Georgios, Lefaki, Tatiana, Lilitsis, Emmanouhl, Makatounaki, Aikaterini, Malliotakis, Polychronis, Michelakis, Dimosthenis, Neonaki, Maria, Nyktari, Vasileia, Palikyra, Iliana, Papadakis, Eleftherios, Papaioannou, Alexandra, Sfakianakis, Konstantinos, Sgouraki, Maria, Souvatzis, Xenia, Spartinou, Anastasia, Stefanidou, Nefeli, Syrogianni, Paulina, Tsagkaraki, Georgia, Arnaoutoglou, Elena, Arnaoutoglou, Christina, Bali, Christina, Bouris, Vasilios, Doumos, Rodamanthos, Gkini, Konstantia-Paraskevi, Kapaktsi, Clio, Koulouras, Vasilios, Lena, Arian, Lepida, Dimitra, Michos, Evangelos, Papadopoulos, Dimitrios, Paschopoulos, Minas, Rompou, Vaia Aliki, Siouti, Ioanna, Tsampalas, Stavros, Ververidou, Ourania, Zilis, Georgios, Charlalampidoy, Alexandra, Christodoulidis, Gregory, Flossos, Andreas, Stamoulis, Konstantinos, Chan, Matthew, Tsang, Man Shing Caleb, Tsang, Man Shing, Lai, Man Ling, Yip, Chi Pang, Chan, Hey Man Heymans, Law, Bassanio, Li, Wing Sze, Chu, Hiu Man, Koo, Emily Gar Yee, Lam, Chi Cheong Joe, Cheng, Ka Ho, Chan, Matthew, 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Ramona–Mihaela, Sandu, Gigel, Bruma, Dana, Corneci, Dan, Dutu, Madalina, Krepil, Adriana, Copaciu, Elena, Dumitrascu, Clementina Oana, Jemna, Ramona, Mihaescu, Florentina, Petre, Raluca, Tudor, Cristina, Ursache, Elena, Kulikov, Alexander, Lubnin, Andrey, Grigoryev, Evgeny, Pugachev, Stanislav, Protsenko, Denis, Tolmasov, Alexander, Hussain, Ayyaz, Ilyina, Yana, Kirov, Mikhail, Roshchina, Anna, Iurin, Aleksandr, Chazova, Elena, Dunay, Artem, Karelov, Alexey, Khvedelidze, Irina, Voldaeva, Olga, Belskiy, Vladislav, Dzhamullaev, Parvin, Grishkowez, Elena, Kretov, Vladimir, Levin, Valeriy, Molkov, Aleksandr, Puzanov, Sergey, Samoilenko, Aleksandr, Tchekulaev, Aleksandr, Tulupova, Valentina, Utkin, Ivan, Allorto, Nikki Leigh, Bishop, David Gray, Builu, Pierre Monji, Cairns, Carel, Dasrath, Ashish, de Wet, Jacques, denHoedt, Marielle, Grey, Ben, Hayes, Morgan Philip, Küsel, Belinda Senta, Shangase, Nomcebo, Wise, Robert, Cacala, Sharon, Farina, Zane, Govindasamy, Vishendran, Kruse, 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Amir, Shekar, Priya, Harden, Catherine, Hollands, Heidi, King, Angela, March, Linda, Minto, Gary, Patrick, Abigail, Waugh, Darren, Kumara, Paramesh, Simeson, Karen, Yarwood, Jamie, Browning, Julie, Hatton, Jonathan, Julian, Howes, Mitra, Atideb, Newton, Maria, Pernu, Pawan, Wilson, Alison, Commey, Thelma, Foot, Helen, Glover, Lyn, Gupta, Ajay, Lancaster, Nicola, Levin, Jill, Mackenzie, Felicity, Mestanza, Claire, Nofal, Emma, Pout, Lauren, Varden, Rosanna, Wild, Jonathan, Jones, Stephanie, Moreton, Sarah, Pulletz, Mark, Davies, Charlotte, Martin, Matthew, Thomas, Sian, Burns, Karen, McArthur, Carol, Patel, Panna, Lau, Gary, Rich, Natalie, Davis, Fiona, Self, James, Lyons, Rachel, Port, Beth, Prout, Rachel, Smith, Christopher, Adelaja, Yemi, Bennett, Victoria, Bidd, Heena, Dumitrescu, Alexandra, Murphy, Jacqui Fox, Keen, Abigail, Mguni, Nhlanhla, Ong, Cheng, Adams, George, Boshier, Piers, Brown, Richard, Butryn, Izabella, Chatterjee, Jayanta, Freethy, Alexander, Lockwood, Geoffrey, Tsakok, Maria, Tsiligiannis, Sophia, Peat, William, Stephenson, Lorraine, Bradburn, Mike, Pick, Sara, Cunha, Pedro, Olagbaiye, Olufemi, Tayeh, Salim, Abernethy, Caroline, Balasubramaniam, Madhu, Bennett, Rachael, Bolton, David, Martinson, Victoria, Naylor, Charde, Smith, Neil, Bell, Stephanie, Heather, Blaylock, Kushakovsky, Vlad, Alcock, Liam, Alexander, Hazel, Anderson, Colette, Baker, Paul, Brookes, Morag, Cawthorn, Louise, Cirstea, Emanuel, Colling, Kerry, Coulter, Ian, Das, Suparna, Haigh, Kathryn, Hamdan, Alhafidz, Hugill, Keith, Kottam, Lucksy, Lisseter, Emily, Mawdsley, Matthew, McGivern, Julie, Padala, Krishnaveni, Phelps, Victoria, kumar, Vineshykaa Ramesh, Stewart, Kirsten, Towse, Kayley, Tregonning, Julie, Vahedi, Ali, Walker, Alycon, Baines, Duncan, Bilolikar, Anjali, Chande, Shiv, Copley, Edward, Dunk, Nigel, Kulkarni, Raghavendra, Kumar, Pawan, Metodiev, Yavor, Ncomanzi, Dumisani, Raithatha, Bhavesh, Raymode, Parizade, Szafranski, Jan, Twohey, Linda, Watt, Philip, Weatherall, Lucie, Weatherill, J., Whitman, Zoe, Wighton, Elinor, Abayasinghe, Chamika, Chan, Alexander, Darwish, Sharif, Gill, James, Glasgow, Emma, Hadfield, Daniel, Harris, Clair, Kochhar, Arun, Mellis, Clare, Pool, Andrew, Riozzi, Paul, Selman, Andrew, Smith, Emma-Jane, Vele, Liana, Gercek, Yuksel, Guy, Kramer, Holden, Douglas, Watson, Nicholas, Whysall, Karen, Andreou, Prematie, Hales, Dawn, Thompson, Jonathan, Bowrey, Sarah, McDonald, Shara, Thompson, Jonathan, Gilmore, Jemma, Hills, Vicky, Kelly, Chan, Kelly, Sinead, Lloyd, Geraint, Abbott, Tom, Gall, Lewis, Torrance, Hew, Vivian, Mark, Berntsen, Emer, Nolan, Tracey, Turner, Angus, Vohra, Akbar, Brown, Andrew, Clark, Richard, Coughlan, Elaine, Daniel, Conway, Patvardhan, Chinmay, Pearson, Rachel, Predeep, Sheba, Saad, Hesham, Shanmugam, Mohanakrishnan, Varley, Simon, Vohra, Akbar, Wylie, Katharine, Cooper, Lucy, Makowski, Arystarch, Misztal, Beata, Moldovan, Eliza, Pegg, Claire, Donovan, Andrew, Foot, Jayne, Large, Simon, Claxton, Andrew, Netke, Bhagyashree, Armstrong, Richard, Calderwood, Claire, Kwok, Andy, Mohr, Otto, Oyeniyi, Peter, Patnaik, Lisa, Post, Benjamin, Ali, Sarah, Arshad, Homa, Baker, Gerard, Brenner, Laura, Brincat, Maximilian, Brunswicker, Annemarie, Cox, Hannah, Cozar, Octavian Ionut, Durst, Alexander, Fengas, Lior, Flatt, Jim, Glister, Georgina, Narwani, Vishal, Photi, Evangelos, Rankin, Adeline, Rosbergen, Melissa, Tan, Mark, Beaton, Ceri, Horn, Rachel, Hunt, Jane, Rousseau, Guy, Stancombe, Lucia, Absar, Mohammed, Allsop, Joanne, Drinkwater, Zoe, Hodgkiss, Tracey, Smith, Kirsty, Brown, Jamie, Pick, Sara, Alexander-Sefre, Farhad, Campey, Lorraine, Dudgeon, Lucy, Hall, Kathryn, Hitchcock, Rachael, James, Lynne, Smith, Kate, Winstone, Ulrika, Ahmad, Norfaizan, Bauchmuller, Kris, Harrison, Jonathan, Jeffery, Holly, Miller, Duncan, Pinder, Angela, Pothuneedi, Sailaja, Rosser, Jonathan, Sanghera, Sumayer, Swift, Diane, Walker, Rachel, Bester, Delia, Cavanagh, Sarah, Cripps, Heather, Daniel, Harvey, Lynch, Julie, Paton, Alison, Pyke, Shirley, Scholefield, John, Whitworth, Helen, Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O’Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Simeson, Karen, Smith, Annie, Varma, Sandeep, Ward, Jackie, Simeson, Karen, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewis, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al ‘Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, James, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Ip, Peter, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chris, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chris, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, James, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Macalister Hall, Andrew, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Ratcliffe, Anna, Robbins, James, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Donna, Alison, Smith, Frances, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chris, Marques de Araujo, Daniela, Martin, Daniel, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Szakmany, Tamas, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Pothuneedi, Sailaja, Walker, Rachel, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Wrey Brown, Caroline, Docherty, Philip, Gillies, Michael, McGregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thais, Everingham, Kirsty, Fowler, Alexander, Hewson, Russ, Ijuo, Eke, Januszewska, Marta, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, McLean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thomas, Tripathi, Shiva, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, White, Stuart, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, McCrossan, Roopa, Nesbitt, Vanessa, O’connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Vohra, Akbar, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, Jansen van Vuuren, Amanda, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nicholas, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Mitra, Atideb, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Onie Hove, Mazvangu, khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, James, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, MacGregor, Mark, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Bidd, Heena, Cifra, Elna, Cooper, Mariese, Dragnea, Dragos, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Salvana, Abegail, Watson, Anthony, Ali, Hani, Campbell, Gill, Critchley, Rebecca, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, James, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Vohra, Akbar, Berntsen, Emer, Nolan, Tracey, Turner, Angus, Alexander, Maini, Arrich, James, Arumugam, Swarna, Blackwood, Douglas, Boggiano, Victoria, Brown, Robyn, Lam Chan, Yik, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, CoxwellMatthewman, Madeline, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charles, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Carys, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thomas, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephens, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Hernandez, Miguel, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, Wilson, Debbie, Al-Soudaine, Yassr, Baldwin, Matthew, Cornish, Julie, Davies, Zoe, Davies, Leigh, Edwards, Marc, Frewer, Natasha, Gallard, Sian, Glasbey, James, Harries, Rhiannon, Hopkins, Luke, Kim, Taeyang, Koompirochana, Vilavan, Lawson, Simon, Lewis, Megan, Makzal, Zaid, Scourfield, Sarah, Ahmad, Yousra, Bates, Sarah, Blackwell, Clare, Bryant, Helen, Coulter, Suzanne, Cruickshank, Ross, Daniel, Sonya, Daubeny, Thomas, Edwards, Mark, Golder, Kim, Hawkins, Lesley, Helen, Bryant, Hinxman, Honor, Levett, Denny, Skinner, Ben, Walsgrove, Joseph, Bradburn, Mike, Dickson, Jane, Constantin, Kathryn, Karen, Markwell, O’Brien, Peter, O’Donohoe, Lynn, Payne, Hannah, Sundayi, Saul, Walker, Elaine, Brooke, Jenny, Cardy, Jon, Humphreys, Sally, Kessack, Laura, Kubitzek, Christiane, Kumar, Suhas, Cotterill, Donna, Hodzovic, Emil, Hosdurga, Gurunath, Miles, Edward, Saunders, Glenn, Campbell, Marta, Chan, Peter, Jemmett, Kim, Raj, Ashok, Naik, Aditi, Ramamoorthy, Rajarajan, Shah, Nimesh, Sylvan, Axel, Blyth, Katharine, Burtenshaw, Andrew, Freeman, David, Johnson, Emily, Lo, Philip, Martin, Terry, Plunkett, Emma, Wollaston, Julie, Allison, Joanna, Carroll, Christine, Craw, Nicholas, Craw, Sarah, Pitt-Kerby, Tressy, Rowland-Axe, Rebecca, Spurdle, Katie, McDonald, Andrew, Simon, Davies, Sinha, Vivek, Smith, Thomas, Banner-Goodspeed, Valerie, Boone, Myles, Campbell, Kathleen, Lu, Fengxin, Scannell, Joseph, Sobol, Julia, Balajonda, Naraida, Clemmons, Karen, Conde, Carlos, Funk, Bonita, Hall, Roger, Hopkins, Thomas, Olaleye, Omowunmi, Omer, Omer, Pender, Michelle, Porto, Angelo, Stevens, Alice, Waweru, Peter, Yeh, Erlinda, Bodansky, Daniella, Evans, Adam, Kleopoulos, Steven, Maril, Robert, Mathney, Edward, Sanchez, Angela, Tinuoye, Elizabeth, Bateman, Brian, Eng, Kristen, Jiang, Ning, Ladha, Karim, Needleman, Joseph, Chen, Lee-lynn, Chen, Lee-lynn, Lane, Rondall, Robinowitz, David, Ghushe, Neil, Irshad, Mariam, Patel, Samir, Takemoto, Steven, Wallace, Art, Mazzeffi, Michael, Rock, Peter, Wallace, Karin, Zhu, Xiaomao, Chua, Pandora, Fleisher, Lee, Mattera, Matthew, Sharar, Rebecca, Thilen, Stephan, Treggiari, Miriam, Morgan, Angela, Sofjan, Iwan, Subramaniam, Kathirvel, Avidan, Michael, Maybrier, Hannah, Muench, Maxwell, Wildes, Troy, and The International Surgical Outcomes Study (ISOS) group

Published
2017
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10. Collaboration for Evidence‐based Practice and Research in Anaesthesia (CEPRA): A consortium initiative for perioperative research.

Author

Nørskov, Anders Kehlet, Jakobsen, Janus Christian, Afshari, Arash, Bisgaard, Jannie, Geisler, Anja, Hägi‐Pedersen, Daniel, Lange, Kai Henrik Wiborg, Lundstrøm, Lars Hyldborg, Lunn, Troels Haxholdt, Maagaard, Mathias, Møller, Ann Merete, Nedergaard, Helene Korvenius, Nikolajsen, Lone, Olsen, Markus Harboe, Juhl‐Olsen, Peter, Rasmussen, Bodil Steen, Vested, Matias, Vester‐Andersen, Morten, Wikkelsø, Anne, and Mathiesen, Ole

Subjects
CONSORTIA, ANESTHESIA, PERIOPERATIVE care, INFRASTRUCTURE (Economics), COMMUNICATION infrastructure
Abstract

Evidence in perioperative care is insufficient. There is an urgent need for large perioperative research programmes, including pragmatic randomised trials, testing daily clinical treatments and unanswered question, thereby providing solid evidence for effects of interventions given to a large and growing number of patients undergoing surgery and anaesthesia. This may be achieved through large collaborations. Collaboration for Evidence‐based Practice and Research in Anaesthesia (CEPRA) is a novel collaborative research network founded to pursue evidence‐based answers to major clinical questions in perioperative medicine. The aims of CEPRA are to (1) improve clinical treatment and outcomes and optimise the use of resources for patients undergoing anaesthesia and perioperative care, and (2) disseminate results and inform caretakers, patients and relatives, and policymakers of evidence‐based treatments in anaesthesia and perioperative medicine. CEPRA is inclusive in its concept. We aim to extend our collaboration with all relevant clinical collaborators and patient associations and representatives. Although initiated in Denmark, CEPRA seeks to develop an international network infrastructure, for example, with other Nordic countries. The work of CEPRA will follow the highest methodological standards. The organisation aims to structure and optimise any element of the research collaboration to reduce economic costs and harness benefits from well‐functioning research infrastructure. This includes successive continuation of trials, harmonisation of outcomes, and alignment of data management systems. This paper presents the initiation and visions of the CEPRA network. CEPRA aims to be inclusive, patient‐focused, methodologically sound, and to optimise all aspects of research logistics. This will translate into faster research conduct, reliable results, and accelerated clinical implementation of results, thereby benefiting millions of patients whilst being cost and labour‐saving. [ABSTRACT FROM AUTHOR]

Published
2023
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11. Ultrasound-guided peripheral nerve blocks for preoperative pain management in hip fractures:a systematic review

Author

Exsteen, Oskar Wilborg, Svendsen, Christine Nygaard, Rothe, Christian, Lange, Kai Henrik Wiborg, Lundstrøm, Lars Hyldborg, Exsteen, Oskar Wilborg, Svendsen, Christine Nygaard, Rothe, Christian, Lange, Kai Henrik Wiborg, and Lundstrøm, Lars Hyldborg

Abstract

Systematic reviews associate peripheral nerve blocks based on anatomic landmarks or nerve stimulation with reduced pain and need for systemic analgesia in hip fracture patients. We aimed to investigate the effect of ultrasound-guided nerve blocks compared to conventional analgesia for preoperative pain management in hip fractures. Five databases were searched until June 2021 to identify randomised controlled trials. Two independent authors extracted data and assessed risk of bias. Data was pooled for meta-analysis and quality of evidence was evaluated using Grades of Recommendation Assessment, Development and Evaluation (GRADE). We included 12 trials (976 participants) comparing ultrasound-guided nerve blocks to conventional systemic analgesia. In favour of ultrasound, pain measured closest to two hours after block placement decreased with a mean difference of -2.26 (VAS 0 to 10); (p < 0.001) 95% CI [–2.97 to –1.55]. In favour of ultrasound, preoperative analgesic usage of iv. morphine equivalents in milligram decreased with a mean difference of –5.34 (p=0.003) 95% CI [–8.11 to –2.58]. Time from admission until surgery ranged from six hours to more than three days. Further, ultrasound-guided nerve blocks may be associated with a lower frequency of delirium: risk ratio 0.6 (p = 0.03) 95% CI [0.38 to 0.94], fewer serious adverse events: risk ratio 0.33 (p = 0.006) 95% CI [0.15 to 0.73] and higher patient satisfaction: mean difference 25.9 (VAS 0 to 100) (p < 0.001) 95% CI [19.74 to 32.07]. However, the quality of evidence was judged low or very low. In conclusion, despite low quality of evidence, ultrasound-guided blocks were associated with benefits compared to conventional systemic analgesia.

Published
2022

14. Additional file 1 of Ultrasound-guided peripheral nerve blocks for preoperative pain management in hip fractures: a systematic review

Author

Exsteen, Oskar Wilborg, Svendsen, Christine Nygaard, Rothe, Christian, Lange, Kai Henrik Wiborg, and Lundstrøm, Lars Hyldborg

Abstract

Additional file 1: Supplementary Figure 1. Prevalence of serious adverse events. Supplementary Figure 2. Patient satisfaction. Supplementary Figure 3. Prevalence of delirium. Supplementary Figure 4. Length of stay. Supplementary Figure 5. Mortality.

Published
2022
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16. Optimal peripheral nerve block after minimally invasive colon surgery – a study protocol for a randomised trial

Author

Salmonsen, Christopher Blom, Lange, Kai Henrik Wiborg, Kleif, Jakob, Bertelsen, Claus Anders, Salmonsen, Christopher Blom, Lange, Kai Henrik Wiborg, Kleif, Jakob, and Bertelsen, Claus Anders

Abstract

INTRODUCTION Transversus abdominis plane (TAP) blocks are used for post-operative pain management, but their efficacy remains unclear. We aim to investigate the effect of two TAP block methods in minimally invasive colon surgery. METHODS This will be a double-blind, randomised and controlled multicentre trial including 360 adults who are planned for elective minimally invasive colon surgery with curative intent for colon neoplasia. The participants are randomised to one of three arms: active ultrasound-guided TAP (US-TAP) and placebo laparoscopic assisted TAP (L-TAP), placebo US-TAP and active L-TAP, or placebo US-TAP and placebo L-TAP. The primary outcome is morphine dose equivalents administered during the first 24 hours after surgery. Secondary outcomes are pain on the first post-operative day, length of stay, post-operative nausea and vomiting, and quality of recovery measured using the Quality of Recovery 15 questionnaire. Statistical analysis will determine any superiority of US-TAP and L-TAP versus placebo, and any non-inferiority of L-TAP compared with US-TAP. The latter will only be tested if superiority to placebo is shown. Primary and secondary outcomes will be analysed as intention-to-treat regarding superiority and as intention-to-treat and per protocol regarding non-inferiority. CONCLUSION This will be the first ever blinded multicentre trial comparing L-TAP, US-TAP and placebo in daily clinical practice. The study has the potential to determine the role of the TAP in minimally invasive colon surgery. FUNDING A & JC Tvergaards Fond, Helen Rudes Fond, Fru Olga Bryde Nielsens Fond, Aage og Johanne Louis-Hansen Fond, Medicine & Treatment Research Fund of the Danish Regions and a Research Grant from Copenhagen University Hospital – North Zealand Hospital. TRIAL REGISTRATION ClinicalTrials.gov: NCT04311099.

Published
2021

17. Effects of 2 wk of GH administration on 24-h indirect calorimetry in young, healthy, lean men

Author

Hansen, Mette, Morthorst, Rikke, Larsson, Benny, Flyvbjerg, Allan, Rasmussen, Michael Hojby, Orskov, Hans, Astrup, Arne, Kjaer, Michael, and Lange, Kai Henrik Wiborg

Subjects
Fat metabolism -- Research, Calorimetry -- Usage, Somatotropin -- Research, Biological sciences
Abstract

The present study was designed as a randomized, double-blind placebo (Plc)-controlled study to determine the effect of 2 wk of growth hormone administration (GH-adm.) on energy expenditure (EE) and substrate oxidation in healthy humans. Sixteen young healthy men were divided into two groups. The study consisted of two 24-h measurements (indirect calorimetry), separated by 2 wk of either Plc or GH injections (6 IU/day). At baseline, no significant differences were observed between the two groups in any of the measured anthropometric, hormonal, or metabolic parameters, neither did the parameters change over time in the Plc group. GH-adm. resulted in a 4.4% increase in 24-h EE (P < 0.05) and an increase in fat oxidation by 29% (P < 0.05). However, a decrease in the respiratory quotient was only observed in the postabsorptive phase after an overnight fast (0.84 [+ or -] 0.1 to 0.79 [+ or -] 0.1, P < 0.05). Furthermore, lean body mass (LBM) was increased by GH-adm. only [62.8 [+ or -] 2.5 kg (baseline) vs. 64.7 [+ or -] 2.4 kg (after), P < 0.001]. In conclusion, GH-adm. increases 24-h EE, which may be partly explained by increased LBM. Furthermore, GH-adm. stimulates fat combustion, especially in the postabsorptive state. energy expenditure; fat oxidation; growth hormone; insulin-like growth factor 1; metabolism

Published
2005

18. Longitudinal neural exposure to local anesthetic and nerve block duration:A retrospective analysis of experimental data from healthy volunteer trials

Author

Madsen, Mikkel Herold, Christiansen, Claus Behrend, Rothe, Christian, Lundstrøm, Lars Hyldborg, Lange, Kai Henrik Wiborg, Madsen, Mikkel Herold, Christiansen, Claus Behrend, Rothe, Christian, Lundstrøm, Lars Hyldborg, and Lange, Kai Henrik Wiborg

Abstract

Background and objectives Characteristics of a nerve block depend on the distribution of local anesthetic (LA) close to the nerve. The relationship between longitudinal distribution of LA and nerve block characteristics has not been investigated in viv o, but one in vitro study showed decrements in action potential amplitudes with increasing exposure length. We describe the influence of longitudinal neural exposure to LA on nerve block duration adjusted for other likely influential factors. Methods We analyzed data from an ethical board approved prospective consecutive collected dataset of 180 healthy volunteers with a common peroneal nerve block (2.5-20 mL, 5-40 mg of ropivacaine). Data were retrieved from three independent randomized controlled trials. The longitudinal neural exposure to LA in millimeters was evaluated using ultrasound. Interventional covariates and demographics were retrieved. Nerve block duration, the dependent variable in the primary assessment, was defined as time of insensitivity to a cold stimulus and was evaluated blinded to all other covariates. Using a multiple linear mixed-effects model, we explored the association between neural exposure to LA and nerve block duration. Results We found a significant positive association between longitudinal neural exposure to LA and block duration (p<0.01). A 10% increase in longitudinal exposure resulted in an 8.7 (2.5; 15) min increase in block duration. LA dose was associated to block duration (p<0.001) but LA volume had no impact (p=0.93). Conclusions Longitudinal neural exposure to LA was significantly associated with nerve block duration. LA dose was the strongest determinant for block duration whereas LA volume had no influence.

Published
2020

19. Intraindividual variation of the transversus abdominis plane block:an exploratory study in healthy volunteers

Author

Juhl, Christian Svendsen, Rothe, Christian, Støving, Kion, Aasvang, Eske K., Rosenstock, Charlotte V., Lange, Kai Henrik Wiborg, Lundstrøm, Lars Hyldborg, Juhl, Christian Svendsen, Rothe, Christian, Støving, Kion, Aasvang, Eske K., Rosenstock, Charlotte V., Lange, Kai Henrik Wiborg, and Lundstrøm, Lars Hyldborg

Abstract

Introduction The transversus abdominis plane block is widely used in postoperative pain management after abdominal surgery. However, large interindividual variation in the cutaneous distribution area of the block has been demonstrated. The purpose of the present study was to explore the reproducibility of the block by determining the intraindividual variation when repeating the block on two separate days. Methods Ultrasound-guided posterior transversus abdominis plane blocks were performed in 16 healthy volunteers and repeated after at least 2 days. Cutaneous sensory block areas and distributions, thresholds for mechanical stimulation, abdominal muscle thicknesses at rest and during maximal contraction, waist circumferences and block duration times were measured on both days. Outcome measurements from the 2 days were compared using a one-sample t-test and intraclass correlation coefficients were calculated for each parameter. Agreement was evaluated visually using Bland-Altman plots. Results None of the mean values of the outcome measurements differed significantly between the 2 days. Intraclass correlation coefficient was 0.75 (moderate-to-good reliability) for lateral abdominal muscle thickness during maximal contraction, but ranges from-0.07 to 0.67 were found for all other outcome measurements (poor-to-moderate reliability). Conclusion We found a moderate-to-good reproducibility for lateral abdominal muscle thickness during maximal voluntary contraction, but a moderate-to-poor reproducibility for all other block characteristics. However, the cutaneous distribution of the block was still located primarily inferior to a horizontal line through the umbilicus and lateral relative to a vertical line through the anterior superior iliac spine.

Published
2020

28. Growth hormone enhances effects of endurance training on oxidative muscle metabolism in elderly women

Author

LANGE, KAI HENRIK WIBORG, ISAKSSON, FREDRIK, JUUL, ANDERS, RASMUSSEN, MICHAEL HOJBY, BULOW, JENS, and KJAER, MICHAEL

Subjects
Somatotropin -- Physiological aspects, Energy metabolism -- Physiological aspects, Insulin-like growth factor 1 -- Physiological aspects, Exercise -- Physiological aspects, Body composition -- Analysis, Biological sciences
Abstract

Lange, Kai Henrik Wiborg, Fredrik Isaksson, Anders Juul, Michael Hojby Rasmussen, Jens Bulow, and Michael Kjaer. Growth hormone enhances effects of endurance training on oxidative muscle metabolism in elderly women. Am J Physiol Endocrinol Metab 279: E989-E996, 2000.--The present study investigated whether recombinant human (rh) growth hormone (GH) combined with endurance training would have a larger effect on oxidative capacity metabolism, and body fat than endurance training alone. Sixteen healthy, elderly women, aged 75 yr, performed closely monitored endurance training on a cycle ergometer over 12 wk. rhGH was given in a randomized, double-blinded, placebo-controlled design in addition to the training program. GH administration resulted in a doubling of serum insulin-like growth factor I levels. With endurance training, peak oxygen uptake increased by -18% in both groups, whereas the marked increase in muscle citrate synthase activity was 50% larger in the GH group compared with the placebo group. In addition, only the GH group revealed an increase in muscle L-3-hydroxyacyl-CoA dehydrogenase activity. Body weight remained unchanged in both groups, but the GH group showed significant changes in body composition with a decrease in fat mass and an increase in lean body mass. Twenty-four-hour indirect calorimetry performed in four subjects showed a marked increase in energy expenditure with increased relative and absolute fat combustion in the two subjects receiving rhGH. In conclusion, rhGH adds to the effects of endurance training on muscle oxidative enzymes and causes a reduction in body fat in elderly women. insulin-like growth factor I; enzymes; exercise; calorimetry; body composition

Published
2000

29. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group

Author

Ahmad, T, Bouwman, RA, Grigoras, I, Aldecoa, C, Hofer, C, Hoeft, A, Holt, P, Fleisher, LA, Buhre, W, Pearse, RM, Ferguson, Marissa, MacMahon, Michael, Shulman, Mark, Cherian, Ritchie, Currow, Helen, Kanathiban, Kathirgamanathan, Gillespie, David, Pathmanathan, Edward, Phillips, Katherine, Reynolds, Jenifer, Rowley, Joanne, Douglas, Jeanene, Kerridge, Ross, Garg, Sameer, Bennett, Michael, Jain, Megha, Alcock, David, Terblanche, Nico, Cotter, Rochelle, Leslie, Kate, Stewart, Marcelle, Zingerle, Nicolette, Clyde, Antony, Hambidge, Oliver, Rehak, Adam, Cotterell, Sharon, Huynh, Wilson Binh Quan, McCulloch, Timothy, Ben-Menachem, Erez, Egan, Thomas, Cope, Jennifer, Halliwell, Richard, Fellinger, Paul, Haisjackl, Markus, Haselberger, Simone, Holaubek, Caroline, Lichtenegger, Paul, Scherz, Florian, Schmid, Werner, Hoffer, Franz, Cakova, Veronika, Eichwalder, Andreas, Fischbach, Norbert, Klug, Reinhold, Schneider, Elisabeth, Vesely, Martin, Wickenhauser, Reinhart, Grubmueller, Karl Gernot, Leitgeb, Marion, Lang, Friedrich, Toro, Nancy, Bauer, Marlene, Laengle, Friedrich, Haberl, Claudia, Mayrhofer, Thomas, Trybus, Christoph, Buerkle, Christian, Forstner, Karin, Germann, Reinhard, Rinoesl, Harald, Schindler, Elke, Trampitsch, Ernst, Bogner, Gerhard, Dankl, Daniel, Duenser, Martin, Fritsch, Gerhard, Gradwohl-Matis, Ilse, Hartmann, Andreas, Hoelzenbein, Thomas, Jaeger, Tarkan, Landauer, Franz, Lindl, Gregor, Lux, Michael, Steindl, Johannes, Stundner, Ottokar, Szabo, Christian, Bidgoli, Jawad, Verdoodt, Hans, Forget, Patrice, Kahn, David, Lois, Fernande, Momeni, Mona, Pregardien, Caroline, Pospiech, Audrey, Steyaert, Arnaud, Veevaete, Laurent, De Kegel, Dirk, De Jongh, Karen, Foubert, Luc, Smitz, Carine, Vercauteren, Marcel, Poelaert, Jan, Van Mossevelde, Veerle, Abeloos, Jacques, Bouchez, Stefaan, Coppens, Marc, De Baerdemaeker, Luc, Deblaere, Isabel, De Bruyne, Ann, De Hert, Stefan, Fonck, Kristine, Heyse, Bjorn, Jacobs, Tom, Lapage, Koen, Moerman, Anneliese, Neckebroek, Martine, Parashchanka, Aliaksandra, Roels, Nathalie, Van Den Eynde, Nancy, Vandenheuvel, Michaël, van Limmen, Jurgen, Vanluchene, Ann, Vanpeteghem, Caroline, Wouters, Patrick, WYFFELS, PIET, Huygens, Christel, Vandenbempt, Punitha, Van de Velde, Marc, Dylst, Dimitri, Janssen, Bruno, Schreurs, Evelien, Aleixo, Fabia Berganton, Candido, Keulle, Batista, Hugo Dias, Guimaraes, Mario, Guizeline, Jaqueline, Hoffmann, Joao, Lobo, Suzana, Marques Lobo, Francisco Ricardo, Nascimento, Vinicius, Nishiyama, Katia, Pazetto, Lucas, Souza, Daniela, Rodrigues, Rodrigo Souza, Vilela dos Santos, Ana Maria, Jardim, Jaquelline, Sa Malbouisson, Luiz Marcelo, Silva, Joao, do Nascimento Junior, Paulo, Baio, Thalissa Herminia, Pereira de Castro, Gabriel Isaac, Watanabe Oliveira, Henri Roger, Amendola, Cristina Prata, Cardoso, Gutemberg, Ortega, Daniela, Brotto, Ana Flavia, De Oliveira, Mirella Cristine, Rea-Neto, Alvaro, Dias, Fernando, Travi, Maria Eduarda, Zerman, Luiza, Azambuja, Pedro, Knibel, Marcos Freitas, Martins, Antonio, Almeida, William, Neder Neto, Calim, Tardelli, Maria Angela, Caser, Eliana, Machado, Marcio, Aguzzoli, Crisitiano, Baldisserotto, Sergio, Tabajara, Fernanda Beck, Bettega, Fernanda, Rodrigues Junior, La Hore Correa, de Gasperi, Julia, Faina, Lais, Nolasco, Marcos Farias, da Costa Fischer, Bruna Ferreira, de Campos Ferreira, Mariana Fosch, Hartmann, Cristina, Kliemann, Marta, Ribeiro, Gustavo Luis Hubert, Fraga, Julia Merladete, Netto, Thiago Motta, Pozza, Laura Valduga, Wendling, Paulo Rafael, Azevedo, Caroline, Garcia, Juliana, Lopes, Marcel, Maia, Bernardo, Maselli, Paula, Melo, Ralph, Mendes, Weslley, Neves, Matheus, Ney, Jacqueline, Piras, Claudio, Applewhaite, Christopher, Carr, Adrienne, Chow, Lorraine, Duttchen, Kaylene, Foglia, Julena, Greene, Michael, Hinther, Ashley, Houston, Kendra, McCormick, Thomas Jared, Mikhayel, Jennifer, Montasser, Sam, Ragan, Alex, Suen, Andrew, Woolsey, Adrianna, Yu, Hai Chuan, Funk, Duane, Kowalski, Stephen, Legaspi, Regina, McDonald, Heather, Siddiqui, Faisal, Pridham, Jeremy, Rowe, Bernadette, Sampson, Sonia, Thiessen, Barton, Zbitnew, Geoff, Bernard, Andre, George, Ronald, Jones, Philip, Moor, Rita, Siddiqui, Naveed, Wolfer, Alexandra, Tran, Diem, Winch, Denyse, Dobson, Gary, McCormick, Thomas, Montasser, Osama, Hall, Richard, Baghirzada, Leyla, Curley, Gerard, Dai, Si Yuan, Hare, Gregory, Lee, Esther, Shastri, Uma, Tsui, Albert, Yagnik, Anmol, Alvares, Danielle, Choi, Stephen, Dwyer, Heather, Flores, Kathrina, McCartney, Colin, Somascanthan, Priya, Beattie, Scott, Carroll, Jo, Pazmino-Canizares, Janneth, Wijeysundera, Duminda, Ami, Noam, Chan, Vincent, Perlas, Anahi, Argue, Ruth, Huang, Yang, Lavis, Katie, Mayson, Kelly, Cao, Ying, Gao, Hong, Hu, Tingju, Lv, Jie, Yang, Jian, Yang, Yang, Zhong, Yi, Zhou, Jing, Zou, Xiaohua, He, Miao, Li, Xiaoying, Luo, Dihuan, Wang, Haiying, Yu, Tian, Chen, Liyong, Wang, Lijun, Cai, Yunfei, Cao, Zhongming, Li, Yanling, Lian, Jiaxin, Sun, Haiyun, Wang, Sheng, 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Xuming, Lei, Min, Li, Xiaoqin, Lv, Xiaocui, Miao, Fangfang, Ouyang, Lingling, Qian, Lu, Shen, Conyu, Sun, Yu, Wang, Yuting, Wang, Dong, Wu, Chao, Xu, Liyuan, Yuan, Jiaqi, Zhang, Lina, Zhang, Huan, Zhang, Yapping, Zhao, Jinning, Zhao, Chong, Zhao, Lei, Zheng, Tianzhao, Zhou, Dachun, Zhou, Haiyan, Zhou, Ce, Lu, Kaizhi, Zhao, Ting, He, Changlin, Chen, Hong, Chen, Shasha, Cheng, Baoli, He, Jie, Jin, Lin, Li, Caixia, Li, Hui, Pan, Yuanming, Shi, Yugang, Wen, Xiao Hong, Wu, Shuijing, Xie, Guohao, Zhang, Kai, Zhao, Bing, Lu, Xianfu, Chen, Feifei, Liang, Qisheng, Lin, Xuewu, Ling, Yunzhi, Liu, Gang, Tao, Jing, Yang, Lu, Zhou, Jialong, Chen, Fumei, Cheng, Zhonggui, Dai, Hanying, Feng, Yunlin, Hou, Benchao, Gong, Haixia, Hu, Chun Hua, Huang, Haijin, Huang, Jian, Jiang, Zhangjie, Li, Mengyuan, Lin, Jiamei, Liu, Mei, Liu, Weicheng, Liu, Zhen, Liu, Zhiyi, Luo, Foquan, Ma, Longxian, Min, Jia, Shi, Xiaoyun, Song, Zhiping, Wan, Xianwen, Xiong, Yingfen, Xu, Lin, Yang, Shuangjia, Zhang, Qin, Zhang, Hongyan, Zhang, Huaigen, Zhang, Xuekang, Zhao, Lili, Zhao, Weihong, Zhao, Weilu, Zhu, Xiaoping, Bai, Yun, Chen, Linbi, Chen, Sijia, Dai, Qinxue, Geng, Wujun, Han, Kunyuan, He, Xin, Huang, Luping, Ji, Binbin, Jia, Danyun, Jin, Shenhui, Li, Qianjun, Liang, Dongdong, Luo, Shan, Lwang, Lulu, Mo, Yunchang, Pan, Yuanyuan, Qi, Xinyu, Qian, Meizi, Qin, Jinling, Ren, Yelong, Shi, Yiyi, Wang, Junlu, Wang, Junkai, Wang, Leilei, Xie, Junjie, Yan, Yixiu, Yao, Yurui, Zhang, Mingxiao, Zhao, Jiashi, Zhuang, Xiuxiu, Ai, Yanqiu, Du, Fang, He, Long, Huang, Ledan, Li, Zhisong, Li, Huijuan, Li, Yetong, Li, Liwei, Meng, Su, Yuan, Yazhuo, Zhang, Enman, Zhang, Jie, Zhao, Shuna, Ji, Zhenrong, Pei, Ling, Wang, Li, Chen, Chen, Dong, Beibei, Li, Jing, Miao, Ziqiang, Mu, Hongying, Qin, Chao, Su, Lin, Wen, Zhiting, Xie, Keliang, Yu, Yonghao, Yuan, Fang, Hu, Xianwen, Zhang, Ye, Xiao, Wangpin, Zhu, Zhipeng, Dai, Qingqing, Fu, Kaiwen, Hu, Rong, Hu, Xiaolan, Huang, Song, Li, Yaqi, Liang, Yingping, Yu, Shuchun, Guo, Zheng, Jing, Yan, Tang, Na, Wu, Jie, Yuan, Dajiang, Zhang, Ruilin, Zhao, Xiaoying, Li, Yuhong, Bai, Hui-Ping, Liu, Chun-Xiao, Liu, Fei-Fei, Ren, Wei, Wang, Xiu-Li, Xu, Guan-Jie, Hu, Na, Li, Bo, Ou, Yangwen, Tang, Yongzhong, Yao, Shanglong, Zhang, Shihai, Kong, Cui-Cui, Liu, Bei, Wang, Tianlong, Xiao, Wei, Lu, Bo, Xia, Yanfei, Zhou, Jiali, Cai, Fang, Chen, Pushan, Hu, Shuangfei, Wang, Hongfa, Xu, Qiong, Hu, Liu, Jing, Liang, Li, Bin, Liu, Qiang, Liu, Yuejiang, Lu, Xinjian, Peng, Zhen Dan, Qiu, Xiaodong, Ren, Quan, Tong, Youliang, Wang, Jin, Wen, Yazhou, Wu, Qiong, Xia, Jiangyan, Xie, Jue, Xiong, Xiapei, Xu, Shixia, Yang, Tianqin, Ye, Hui, Yin, Ning, Yuan, Jing, Zeng, Qiuting, Zhang, Baoling, Zheng, Kang, Cang, Jing, Chen, Shiyu, Fan, Yu, Fu, Shuying, Ge, Xiaodong, Guo, Baolei, Huang, Wenhui, Jiang, Linghui, Jiang, Xinmei, Liu, Yi, Pan, Yan, Ren, Yun, Shan, Qi, Wang, Jiaxing, Wang, Fei, Wu, Chi, Zhang, Xiaoguang, Christiansen, Ida Cecilie, Granum, Simon Norgaard, Rasmussen, Bodil Steen, Daugaard, Morten, Gambhir, Rajiv, Brandsborg, Birgitte, Steingrimsdottir, Guony Erla, Jensen-Gadegaard, Peter, Olsen, Karsten Skovgaard, Siegel, Hanna, Eskildsen, Katrine Zwicky, Gatke, Mona Ring, Wibrandt, Ida, Heintzelmann, Simon Bisgaard, Lange, Kai Henrik Wiborg, Lundsgaard, Rune Sarauw, Amstrup-Hansen, Louise, Hovendal, Claus, Larsen, Michael, Lenstrup, Mette, Kobborg, Tina, Larsen, Jens Rolighed, Pedersen, Anette Barbre, Smith, Soren Hubertz, Oestervig, Rebecca Monett, Rasmussen, Lars, Afshari, Arash, Andersen, Cheme, Ekelund, Kim, Secher, Erik Lilja, Beloeil, Helene, Lasocki, Sigismond, Venara, Aurelien, Biais, Matthieu, Ouattara, Alexandre, Sineus, Marlene, Molliex, Serge, Legouge, Marie Lim, Wallet, Florent, Tesniere, Antoine, Gaudin, Christophe, Lehur, Paul, Forsans, Emma, de Rudnicki, Stephane, Maudet, Valerie Serra, Mutter, Didier, Sojod, Ghassan, Ouaissi, Mehdi, Regimbeau, Jean-Marc, Futier, Emmanuel, Desbordes, Jacques, Comptaer, Nicolas, el Manser, Diae, Ethgen, Sabine, Lebuffe, Gilles, Auer, Patrick, Haertl, Christine, Deja, Maria, Legashov, Kirill, Sonnemann, Susanne, Wiegand-Loehnert, Carola, Falk, Elke, Habicher, Marit, Angermair, Stefan, Laetsch, Beatrix, Schmidt, Katrin, Von Heymann, Christian, Ramminger, Axel, Jelschen, Florian, Pabel, Svenja, Weyland, Andreas, Czeslick, Elke, Gille, Jochen, Malcharek, Michael, Sablotzki, Armin, Lueke, Katharina, Wetzel, Peter, Weimann, Joerg, Lenhart, Franz-Peter, Reichle, Florian, Schirmer, Frederike, Hueppe, Michael, Klotz, Karl, Nau, Carla, Schoen, Julika, Mencke, Thomas, Wasmund, Christina, Bankewitz, Carla, Baumgarten, Georg, Fleischer, Andreas, Guttenthaler, Vera, Hack, Yvonne, Hoeft, Andreas, Kirchgaessner, Katharina, Maenner, Olja, Schurig-Urbaniak, Marlen, Struck, Rafael, van Zyl, Rebekka, Wittmann, Maria, Goebel, Ulrich, Harris, Sarah, Veit, Siegfried, Andreadaki, Evangelia, Souri, Flora, Katsiadramis, Ioannis, Skoufi, Anthi, Vasileiou, Maria, Aimoniotou-Georgiou, Eleni, Katsourakis, Anastasios, 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Denham, Samuel, Griffiths, Ewen, Ip, Peter, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Reynolds, Tim, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Ben Burston, Ben Burston, Davies, Kirsty, Edwards, Jayne, Evans, Chris, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chris, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, James, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Hall, Andrew Macalister, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Paddle, Jonathan, Ratcliffe, Anna, Robbins, James, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Potter, Alison, Smith, Frances, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chris, de Araujo, Daniela Marques, Martin, Daniel, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Szakmany, Tamas, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Brown, Caroline Wrey, Docherty, Philip, Gillies, Michael, McGregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thais, Everingham, Kirsty, Fowler, Alexander, Hewson, Russ, Ijuo, Eke, Januszewska, Marta, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, McLean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thomas, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, Harper, Mark, White, Stuart, Jack, James, Ridley, Carrie, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, McCrossan, Roopa, Nesbitt, Vanessa, O'connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, van Vuuren, Amanda Jansen, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nicholas, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Hove, Mazvangu Onie, khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Hanna, George, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, James, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Dragos, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Ramessur, Suneil, Salvana, Abegail, Watson, Anthony, Ali, Hani, Campbell, Gill, Critchley, Rebecca, Endersby, Simon, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, James, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, James, Arumugam, Swarna, Blackwood, Douglas, Boggiano, Victoria, Brown, Robyn, Chan, Yik Lam, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Matthewman, Madeline Coxwell, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charles, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Carys, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thomas, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Stephens, Robert, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Hernandez, Miguel, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, Wilson, Debbie, Al-Soudaine, Yassr, Baldwin, Matthew, Cornish, Julie, Davies, Zoe, Davies, Leigh, Edwards, Marc, Frewer, Natasha, Gallard, Sian, Glasbey, James, Harries, Rhiannon, Hopkins, Luke, Kim, Taeyang, Koompirochana, Vilavan, Lawson, Simon, Lewis, Megan, Makzal, Zaid, Scourfield, Sarah, Ahmad, Yousra, Bates, Sarah, Blackwell, Clare, Bryant, Helen, Collins, Hannah, Coulter, Suzanne, Cruickshank, Ross, Daniel, Sonya, Daubeny, Thomas, Edwards, Mark, Golder, Kim, Hawkins, Lesley, Helen, Bryant, Hinxman, Honor, Levett, Denny, Salmon, Karen, Seaward, Leanne, Skinner, Ben, Tyrell, Bryony, Wadams, Beverley, Walsgrove, Joseph, Dickson, Jane, Constantin, Kathryn, Karen, Markwell, O'Brien, Peter, O'Donohoe, Lynn, Payne, Hannah, Sundayi, Saul, Walker, Elaine, Brooke, Jenny, Cardy, Jon, Humphreys, Sally, Kessack, Laura, Kubitzek, Christiane, Kumar, Suhas, Cotterill, Donna, Hodzovic, Emil, Hosdurga, Gurunath, Miles, Edward, Saunders, Glenn, Campbell, Marta, Chan, Peter, Jemmett, Kim, Raj, Ashok, Naik, Aditi, Oshowo, Ayo, Ramamoorthy, Rajarajan, Shah, Nimesh, Sylvan, Axel, Blyth, Katharine, Burtenshaw, Andrew, Freeman, David, Johnson, Emily, Lo, Philip, Martin, Terry, Plunkett, Emma, Wollaston, Julie, Allison, Joanna, Carroll, Christine, Craw, Nicholas, Craw, Sarah, Pitt-Kerby, Tressy, Rowland-Axe, Rebecca, Spurdle, Katie, McDonald, Andrew, Simon, Davies, Sinha, Vivek, Smith, Thomas, Banner-Goodspeed, Valerie, Boone, Myles, Campbell, Kathleen, Lu, Fengxin, Scannell, Joseph, Sobol, Julia, Balajonda, Naraida, Clemmons, Karen, Conde, Carlos, Elgasim, Magdi, Funk, Bonita, Hall, Roger, Hopkins, Thomas, Olaleye, Omowunmi, Omer, Omer, Pender, Michelle, Porto, Angelo, Stevens, Alice, Waweru, Peter, Yeh, Erlinda, Bodansky, Daniella, Evans, Adam, Kleopoulos, Steven, Maril, Robert, Mathney, Edward, Sanchez, Angela, Tinuoye, Elizabeth, Bateman, Brian, Eng, Kristen, Jiang, Ning, Ladha, Karim, Needleman, Joseph, Chen, Lee-lynn, Lane, Rondall, Robinowitz, David, Ghushe, Neil, Irshad, Mariam, O'Connor, John, Patel, Samir, Takemoto, Steven, Wallace, Art, Mazzeffi, Michael, Rock, Peter, Wallace, Karin, Zhu, Xiaomao, Chua, Pandora, Fleisher, Lee, Mattera, Matthew, Sharar, Rebecca, Thilen, Stephan, Treggiari, Miriam, Morgan, Angela, Sofjan, Iwan, Subramaniam, Kathirvel, Avidan, Michael, Maybrier, Hannah, Muench, Maxwell, and Wildes, Troy

Subjects
surgery, postoperative care/methods, cohort studies, operative/mortality, data, postoperative care/statistics and numerical, Medicine and Health Sciences, critical care/utilisation, surgical procedures
Abstract

Background: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. Results: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with amedian hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. Conclusions: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care.

Published
2016

30. Routine blood tests are associated with short term mortality and can improve emergency department triage: a cohort study of >12,000 patients

Author

Kristensen, Michael, primary, Iversen, Anne Kristine Servais, additional, Gerds, Thomas Alexander, additional, Østervig, Rebecca, additional, Linnet, Jakob Danker, additional, Barfod, Charlotte, additional, Lange, Kai Henrik Wiborg, additional, Sölétormos, György, additional, Forberg, Jakob Lundager, additional, Eugen-Olsen, Jesper, additional, Rasmussen, Lars Simon, additional, Schou, Morten, additional, Køber, Lars, additional, and Iversen, Kasper, additional

Published
2017
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31. Routine blood tests are associated with short term mortality and can improve emergency department triage:a cohort study of >12,000 patients

Author

Kristensen, Michael, Iversen, Anne Kristine Servais, Gerds, Thomas Alexander, Østervig, Rebecca, Linnet, Jakob Danker, Barfod, Charlotte, Lange, Kai Henrik Wiborg, Sölétormos, György, Forberg, Jakob Lundager, Eugen-Olsen, Jesper, Rasmussen, Lars Simon, Schou, Morten, Køber, Lars, Iversen, Kasper, Kristensen, Michael, Iversen, Anne Kristine Servais, Gerds, Thomas Alexander, Østervig, Rebecca, Linnet, Jakob Danker, Barfod, Charlotte, Lange, Kai Henrik Wiborg, Sölétormos, György, Forberg, Jakob Lundager, Eugen-Olsen, Jesper, Rasmussen, Lars Simon, Schou, Morten, Køber, Lars, and Iversen, Kasper

Abstract

BACKGROUND: Prioritization of acutely ill patients in the Emergency Department remains a challenge. We aimed to evaluate whether routine blood tests can predict mortality in unselected patients in an emergency department and to compare risk prediction with a formalized triage algorithm.METHODS: A prospective observational cohort study of 12,661 consecutive admissions to the Emergency Department of Nordsjælland University Hospital during two separate periods in 2010 (primary cohort, n = 6279) and 2013 (validation cohort, n = 6383). Patients were triaged in five categories by a formalized triage algorithm. All patients with a full routine biochemical screening (albumin, creatinine, c-reactive protein, haemoglobin, lactate dehydrogenase, leukocyte count, potassium, and sodium) taken at triage were included. Information about vital status was collected from the Danish Central Office of Civil registration. Multiple logistic regressions were used to predict 30-day mortality. Validation was performed by applying the regression models on the 2013 validation cohort.RESULTS: Thirty-day mortality was 5.3%. The routine blood tests had a significantly stronger discriminative value on 30-day mortality compared to the formalized triage (AUC 88.1 [85.7;90.5] vs. 63.4 [59.1;67.5], p < 0.01). Risk stratification by routine blood tests was able to identify a larger number of low risk patients (n = 2100, 30-day mortality 0.1% [95% CI 0.0;0.3%]) compared to formalized triage (n = 1591, 2.8% [95% CI 2.0;3.6%]), p < 0.01.CONCLUSIONS: Routine blood tests were strongly associated with 30-day mortality in acutely ill patients and discriminatory ability was significantly higher than with a formalized triage algorithm. Thus routine blood tests allowed an improved risk stratification of patients presenting in an emergency department.

Published
2017

32. Endurance training and GH administration in elderly women: effects on abdominal adipose tissue lipolysis

Author

LANGE, KAI HENRIK WIBORG, LORENTSEN, JEANNE, ISAKSSON, FREDRIK, JUUL, ANDERS, RASMUSSEN, MICHAEL HOJBY, CHRISTENSEN, NIELS JUEL, BULOW, JENS, and KJAER, MICHAEL

Subjects
Physical fitness -- Evaluation, Women -- Physiological aspects, Adipose tissues -- Physiological aspects, Lipid metabolism -- Research, Biological sciences
Abstract

In the present study, the effect of endurance training alone and endurance training combined with recombinant human growth hormone (rhGH) administration on subcutaneous abdominal adipose tissue lipolysis was investigated. Sixteen healthy women [age 75 [+ or -] 2 yr (mean [+ or -] SE)] underwent a 12-wk endurance training program on a cycle ergometer. rhGH was administered in a randomized, double-blinded, placebo-controlled design in addition to the training program. Subcutaneous abdominal adipose tissue lipolysis was estimated by means of microdialysis combined with measurements of subcutaneous abdominal adipose tissue blood flow (ATBF; [sup.133]Xe washout). Whole body fat oxidation was estimated simultaneously by indirect calorimetry. Before and after completion of the training program, measurements were performed both at rest and during 60 min of continuous cycling at a workload corresponding to 60% of pretraining peak oxygen uptake. Endurance training alone did not affect subcutaneous abdominal adipose tissue lipolysis either at rest or during exercise, as reflected by identical levels of interstitial adipose tissue glycerol, subcutaneous abdominal ATBF, and plasma nonesterified fatty acids before and after completion of the training program. Similarly, no effect on subcutaneous abdominal adipose tissue lipolysis was observed when combining endurance training with rhGH administration. However, in both the placebo and the GH groups, fat oxidation was significantly increased during exercise performed at the same absolute workload after completion of the training program. We conclude that the changed lipid metabolism during exercise observed after endurance training alone or after endurance training combined with rhGH administration is not due to alterations in subcutaneous abdominal adipose tissue metabolism in elderly women. adipose tissue blood flow; catecholamines; fat metabolism; microdialysis; body composition

Published
2001

33. Fatalt forløb ved in vitro-fertilisation

Author

Sørensen, Martin Kryspin, Møller-Sørensen, Hasse, Svane, Christian, Jensen, Carsten Huus, Lange, Kai Henrik Wiborg, Tybjaerg-Hansen, Anne, Sørensen, Martin Kryspin, Møller-Sørensen, Hasse, Svane, Christian, Jensen, Carsten Huus, Lange, Kai Henrik Wiborg, and Tybjaerg-Hansen, Anne

Abstract

Chylomicronaemia syndrome is a rare disorder primarily caused by a genetic defect which increases triglycerides, combined with a secondary inducing factor. We describe the fatal course of a 33-year-old, pregnant woman with known dyslipidaemia who had been treated with in vitro fertilisation and developed chylomicronaemia syndrome with severe hypertriglyceridaemia, hypertriglyceridaemia-induced acute pancreatitis and septic shock. Appropriate treatment including close monitoring, severe restriction of dietary fat intake and early plasmapheresis is emphasized - especially during pregnancy.

Published
2010

34. Venous blood lactate on admission is a predictor for in-hospital cardiac arrest—An observational cohort study

Author

Barfod, Charlotte, primary, Lundstrøm, Lars Hyldborg, additional, Lauritzen, Marlene Mauson Pankoke, additional, Danker, Jakob Klim, additional, Sölétormos, György, additional, Forberg, Jakob Lundager, additional, Berlac, Peter Anthony, additional, Lippert, Freddy, additional, Antonsen, Kristian, additional, and Lange, Kai Henrik Wiborg, additional

Published
2012
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35. Lipolysis in human adipose tissue during exercise:comparison of microdialysis and a-v measurements

Author

Lange, Kai Henrik Wiborg, Lorentsen, Jeanne, Isaksson, Fredrik, Simonsen, Lene, Bülow, Jens, Kjaer, Michael, Lange, Kai Henrik Wiborg, Lorentsen, Jeanne, Isaksson, Fredrik, Simonsen, Lene, Bülow, Jens, and Kjaer, Michael

Abstract

Subcutaneous adipose tissue lipolysis was studied in vivo by Fick's arteriovenous (a-v) principle using either calculated (microdialysis) or directly measured (catheterization) adipose tissue venous glycerol concentration. We compared results during steady-state (rest and prolonged continuous exercise), as well as during non-steady-state (onset of exercise and early exercise) experimental settings. Fourteen healthy women [age: 74 +/- 1 (SE) yr] were studied at rest and during 60-min continuous bicycling at 60% of peak O(2) uptake. Calculated and measured subcutaneous abdominal adipose tissue venous glycerol concentrations increased substantially from rest to exercise but were similar both at rest and during later stages of exercise. In contrast, during the initial approximately 40 min of exercise, calculated glycerol concentration was significantly lower (approximately 40%) than measured adipose tissue venous glycerol concentration. Despite several methodological limitations inherent to both techniques, the results strongly suggest that microdialysis and catheterization provide similar estimates of subcutaneous adipose tissue lipolysis in steady-state experimental settings like rest and continuous prolonged exercise. However, during shorter periods of exercise (<40 min), the results from the two techniques may differ quantitatively in the studied subjects. Caution should, therefore, be taken when lipolysis is evaluated, based on results obtained by the two techniques under non-steady-state conditions.

Published
2002

37. Review Fat metabolism in exercise – with special reference to training and growth hormone administration.

Author

Lange, Kai Henrik Wiborg

Subjects
*FAT, *OXIDATION, *LIFESTYLES, *METABOLISM, *ANIMALS, *EXERCISE, *SOMATOTROPIN
Abstract

Despite abundance of fat, exclusive dependency on fat oxidation can only sustain a metabolic rate corresponding to 50–60% of VO2max in humans. This puzzling finding has been subject to intense research for many years. Lately, it has gained renewed interest as a consequence of increased obesity and physical inactivity imposed by Western lifestyle. Why are humans so poor at metabolizing fat? Can fat metabolism be manipulated by exercise, training, diet and hormones? And why is fat stored in specialized adipose tissue and not just as lipid droplets inside muscle cells? In the present review, human fat metabolism is discussed in relation to how human fat metabolism is designed. Limitations in this design are explored and examples of different designs for fat metabolism from animal physiology are included to illustrate these limitations. Various means of manipulating fat metabolism are discussed with special emphasis on exercise, training, growth hormone (GH) physiology and GH administration. It is concluded that fat stores, non-esterified fatty acids (NEFAs) availability and enzymes for fat oxidation can be increased substantially. However, it is almost impossible to increase fat oxidation during endurance exercise at higher intensities. It seems that, for some reason, the human being is far from optimally designed for fat oxidation during exercise. Acute GH administration has several unexpected effects on fat and carbohydrate metabolism during aerobic exercise, and future research in this area is likely to provide valuable information with respect to GH physiology and the regulation of fat and carbohydrate metabolism during aerobic exercise. [ABSTRACT FROM AUTHOR]

Published
2004
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39. Effects of blood flow restriction during moderate-intensity eccentric knee extensions.

Author

Behringer, Michael, Heinke, Lars, Leyendecker, Jannik, and Mester, Joachim

Abstract

We investigated if blood flow restriction (BFR, cuff pressure 20 mmHG below individual occlusion pressure) increases metabolic stress, hormonal response, release of muscle damage markers, and muscle swelling induced by moderate-intensity eccentric contractions. In a randomized, matched-pair design, 20 male subjects (25.3 ± 3.3 years) performed four sets of unilateral eccentric knee extensions (75% 1RM) to volitional failure with (IG) or without (CG) femoral BFR. Despite significant differences of performed repetitions between IG (85.6 ± 15.4 repetitions) and CG (142.3 ± 44.1 repetitions), peak values of lactate (IG 7.0 ± 1.4 mmol l−1, CG 6.9 ± 2.7 mmol l−1), growth-hormone (IG 4.9 ± 4.8 ng ml−1, CG 5.2 ± 3.5 ng ml−1), insulin-like growth factor 1 (IG 172.1 ± 41.9 ng ml−1, CG 178.7 ± 82.1 ng ml−1), creatine-kinase (IG 625.5 ± 464.8 U l−1, CG 510.7 ± 443.5 U l−1), the absolute neutrophil count (IG 7.9 ± 1.3 103 µl−1, CG 8.7 ± 2.0 103 µl−1), induced muscle swelling of rectus femoris and vastus lateralis and perceived pain did not differ. The present data indicate that BFR is suitable to intensify eccentric exercises. [ABSTRACT FROM AUTHOR]

Published
2018
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