Goal-directed fluid therapy to near-maximal SV guided by ED adds no extra value to the fluid therapy using zero balance and normal BW in patients undergoing elective colorectal surgery.
Significant postoperative decrease in glycogen synthase activity in the muscle biopsies was reduced in the intervention groups, and in combination, the intervention groups had a less reduced quadriceps strength after one week (-10% vs. -16%, NS) and one month (-5% vs. -13%, P < 0.05). Minor changes in the endocrine response to surgery were found without differences between the groups, and there were no differences between the groups in ambulation time, nutritional intake or subjective measures of wellbeing.
1. The present experiments describe a role for platelet-derived growth factor-BB and cellular adhesion receptors towards extracellular matrix molecules (/1-integrins) in control of interstitial fluid pressure (Pif). and decreased to -2-50 + 0 35 mmHg (P < 0 05) and -3-88 + 1P45 mmHg (P < 0 05) at anti-a2/11 concentrations of 0-56 and 1P12 mg ml-', respectively.4. The effect of anti-a0231 was abolished when platelet-derived growth factor-BB (PDGF-BB) (200 ng ml-') was injected together with anti-ca2/1. 5. The time-and dose-responses of PDGF-BB to counteract increased negativity of Pif were studied further using dextran anaphylaxis as an experimental model inducing increased negativity of Pif in skin. Control Pif averaged -0 33 + 0A43 mmHg and fell to -4-10 + 1P47 mmHg within 10 min after dextran (P < 0-01). Subsequent subdermal injection of PDGF-BB at 200 ng ml-' normalized Pif in 10-20 min which became -1-37 + 1-23 mmHg (P < 0'01 versus dextran, P > 0.05 versus control). PDGF-BB had little or no effect at 50 ng ml-. PDGF-AA and basic fibroblast growth factor had no effect on Pif.6. The in vivo function reported for PDGF-BB has not been described previously and provides further evidence for active participation of connective tissue cells in control of Pif by altering tension on extracellular matrix structures.During the initial stage of several acute inflammatory reactions, loose connective tissues will 'actively' enhance transcapillary fluid flux and oedema formation in skin and airways, since an increased negativity of interstitial fluid pressure (Pif) from -1 to between -5 and -10 inmHg will provide an increased driving pressure for fluid filtration
Summary
The incidence of postdural puncture headache after spinal anaesthesia with two types of 26‐ and 29‐gauge needles was investigated in 149 patients less than 30 years old. Ten patients, (6.7%), six men and four women, developed typical symptoms of postdural puncture headache, while six (4.0%) developed headache of other origin. There were no headaches in the 29‐gauge group. Spinal anaesthesia in four patients (8%) was impossible to perform with the 29‐gauge needle. By using the latter, spinal anaesthesia can be given to young adults with little risk of postdural puncture headache.
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