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001-es BibID:BIBFORM028657
Első szerző:Fleischmann, Edith
Cím:Nitrous oxide and risk of surgical wound infection : a randomised trial / Edith Fleischmann, Rainer Lenhardt, Andrea Kurz, Friedrich Herbst, Béla Fülesdi, Robert Greif, Daniel I. Sessler, Ozan Akça, on behalf of the Outcomes Research Group
Dátum:2005
ISSN:0140-6736
Megjegyzések:Nitrous oxide inactivates vitamin B12 and methionine synthase, thereby impairing DNA formation and, consequently, new cell formation. The gas also inhibits methionine production, which can reduce scar formation and depresses chemotactic migration by monocytes. Therefore, we assessed whether nitrous oxide increases the incidence of surgical wound infection. METHODS: We recruited 418 patients aged 18-80 years, scheduled for colon resection that was expected to last more than 2 h, at three hospitals in Austria and Hungary. Patients were randomly assigned 65% intraoperative nitrous oxide (n=208) or nitrogen (n=206), with remifentanil and isoflurane. The primary outcome was the incidence of clinical postoperative wound infection, analysed by intention to treat. FINDINGS: 206 patients in the nitrous oxide group and 202 in the nitrogen group were included in the final analysis. Duration of surgery was longer in the nitrogen group (3.4 h [1.5]) than in the nitrous oxide group (3.0 h [SD 1.3]) and arterial pressure (84 mm Hg [10] vs 81 mm Hg [9]), bispectral index values (53 [9] vs 44 [8]), and end-tidal isoflurane concentration (0.64% [0.14] vs 0.56% [0.13]) were greater in patients given nitrogen than in those given nitrous oxide. Infection rate was 15% (31/206) in patients given nitrous oxide and 20% (40/202) in those given nitrogen (p=0.205). Additionally, the ASEPSIS wound healing score, wound collagen deposition, number of patients admitted to critical care unit, time to first food ingestion, duration of hospital stay, and mortality did not differ between treatment groups. INTERPRETATION: Nitrous oxide does not increase the incidence of surgical wound infection.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
külföldön készült közlemény
Megjelenés:Lancet. - 366 : 9491 (2005), p. 1101-1107. -
További szerzők:Lenhardt, Rainer Kurz, Andrea Herbst, Friedrich Fülesdi Béla (1961-) (aneszteziológus) Greif, Robert Sessler, Daniel I. Akça, Ozan Kanyári Zsolt (1964-) (orvos) Orosz László (1966-) (sebész) The Outcomes Research Group
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2.

001-es BibID:BIBFORM042432
035-os BibID:PMID:11322352
Első szerző:Kober, Alexander
Cím:Effectiveness of resistive heating compared with passive warming in treating hypothermia associated with minor trauma : a randomized trial / Alexander Kober, Thomas Scheck, Béla Fülesdi, Frank Lieba, Wolfgang Vlach, Alexander Friedman, Daniel I. Sessler
Dátum:2001
ISSN:0025-6196
Megjegyzések:OBJECTIVES:To determine the occurrence of hypothermia in patients with minor trauma, to test the hypotheses that resistive heating during transport is effective treatment for hypothermia and that this treatment reduces patients' thermal discomfort, pain, and fear, and to evaluate the accuracy of oral temperatures obtained at the scene of injury.PATIENTS AND METHODS:In December 1999 and January 2000, 100 patients with minor trauma were randomly assigned to passive warming or resistive heating. All patients were covered with a carbon-fiber resistive warming blanket and a wool blanket, but the warming blanket was activated only in those assigned to resistive heating. Core (tympanic membrane) and oral temperatures, heart rate, pain, fear, and overall satisfaction of patients were compared between the 2 groups on arrival at a hospital.RESULTS:Hypothermia was noted in 80 patients at the time of rescue. Mean initial core temperatures were 35.4 degrees C (95% confidence interval [CI], 35.2 degrees C - 35.6 degrees C) in the patients who received passive warming and 35.3 degrees C (95% CI, 35.1 degrees C - 35.5 degrees C) in those who received resistive heating. From the time of rescue until arrival at the hospital, mean core temperature decreased 0.4 degrees C/h (95% CI, 0.3 degrees C/h - 0.5 degrees C/h) with passive warming, whereas it increased 0.8 degrees C/h (95% CI, 0.7 degrees C/h - 0.9 degrees C/h) with resistive heating. Oral and tympanic membrane temperatures were similar. Mean heart rate decreased 23 beats/min in those assigned to resistive heating but remained unchanged in those assigned to passive warming. Patients in the resistive heating group felt warmer, had less pain and anxiety, and overall were more satisfied with their care.CONCLUSIONS:Oral temperatures are sufficiently accurate for field use. Hypothermia is common even in persons with minor trauma. Resistive heating during transport augments thermal comfort, increases core temperature, reduces pain and anxiety, and improves overall patient satisfaction.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Passive Warming
treating hypothermia
minor trauma
külföldön készült közlemény
Megjelenés:Mayo Clinic Proceedings. - 76 : 4 (2001), p. 369-375. -
További szerzők:Scheck, Thomas Fülesdi Béla (1961-) (aneszteziológus) Lieba, Frank Vlach, Wolfgang Friedman, Alexander Sessler, Daniel I.
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3.

001-es BibID:BIBFORM063308
Első szerző:Molnár Csilla (aneszteziológus)
Cím:A single preoperative dose of diclofenac reduces the intensity of acute postcraniotomy headache and decreases analgesic requirements over five postoperative days in adults: A single center, randomized, blinded trial / Molnár Csilla, Simon Éva, Kazup Ágota, Gál Judit, Molnár Levente, Novák László, Bereczki Dániel, Sessler Daniel I., Fülesdi Béla
Dátum:2015
ISSN:0022-510X
Megjegyzések:OBJECTIVE:Postcraniotomy headache causes considerable pain and can be difficult to treat. We therefore tested the hypothesis that a single 100-mg preoperative dose of diclofenac reduces the intensity of postcraniotomy headache, and reduces analgesic requirements.METHODS:200 patients having elective craniotomies were randomly assigned to diclofenac (n = 100) or control (n = 100). Pain severity was assessed by an independent observer using a 10-cm-long visual analog scale the evening of surgery, and on the 1st and 5th postoperative days. Analgesics given during the first five postoperative days were converted to intramuscular morphine equivalents. Results were compared using Mann-Whitney-tests; P < 0.05 was considered statistically significant.RESULTS:Baseline and surgical characteristics were comparable in the diclofenac and control groups. Visual analog pain scores were slightly, but significantly lower with diclofenac at all times (means and 95% confidence intervals): the evening of surgery, 2.47 (1.8-3.1) vs. 4. 37 (5.0-3.7), (P < 0.001); first postoperative day, 3.98 (3.4-4.6) vs. 5.6 (4.9-6.2) cm (P < 0.001) and 5th postoperative day: 2.8 (2.2-3.4) vs. 4.0 ? (3.3-4.7) cm (P = 0.013). Diclofenac reduced systemic analgesic requirements over the initial five postoperative days (mean and 95% CI): 3.3 (2.6-3.9) vs. 4.3 (3.5-5.1) mg morphine equivalents (P < 0.05).CONCLUSIONS:Preoperative diclofenac administration reduces postcraniotomy headache and postoperative analgesic requirements - a benefit that persisted throughout five postoperative days.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Craniotomy
Preventive analgesia
Postcraniotomy headache
Megjelenés:Journal Of The Neurological Sciences. - 353 : 1-2 (2015), p. 70-73. -
További szerzők:Simon Éva (1963-) (aneszteziológus) Kazup Ágota Gál Judit (1977-) (aneszteziológiai és ITO szakorvos) Molnár Levente Novák László (1964-) (idegsebész) Bereczki Dániel (1960-) (neurológus) Sessler, Daniel I. Fülesdi Béla (1961-) (aneszteziológus)
Pályázati támogatás:KTIA_13_NAP-A-II/5
Egyéb
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4.

001-es BibID:BIBFORM120123
035-os BibID:(scopus)85189692529
Első szerző:Szamos Katalin
Cím:One-lung ventilation with fixed and variable tidal volumes on oxygenation and pulmonary outcomes : a randomized trial / Szamos Katalin, Balla Boglárka, Pálóczi Balázs, Enyedi Attila, Sessler Daniel I., Fülesdi Béla, Végh Tamás
Dátum:2024
ISSN:0952-8180
Megjegyzések:A B S T R A C T Objective: Test the hypothesis that one-lung ventilation with variable tidal volume improves intraoperative oxygenation and reduces postoperative pulmonary complications after lung resection. Background: Constant tidal volume and respiratory rate ventilation can lead to atelectasis. Animal and human ARDS studies indicate that oxygenation improves with variable tidal volumes. Since one-lung ventilation shares characteristics with ARDS, we tested the hypothesis that one-lung ventilation with variable tidal volume improves intraoperative oxygenation and reduces postoperative pulmonary complications after lung resection. Design: Randomized trial. Setting: Operating rooms and a post-anesthesia care unit. Patients: Adults having elective open or video-assisted thoracoscopic lung resection surgery with general anesthesia were randomly assigned to intraoperative ventilation with fixed (n = 70) or with variable (n = 70) tidal volumes. Interventions: Patients assigned to fixed ventilation had a tidal volume of 6 ml/kgPBW, whereas those assigned to variable ventilation had tidal volumes ranging from 6 ml/kg PBW ? 33% which varied randomly at 5-min intervals. Measurements: The primary outcome was intraoperative oxygenation; secondary outcomes were postoperative pulmonary complications, mortality within 90 days of surgery, heart rate, and SpO2/FiO2 ratio. Results: Data from 128 patients were analyzed with 65 assigned to fixed-tidal volume ventilation and 63 to variable-tidal volume ventilation. The time-weighted average PaO2 during one-lung ventilation was 176 (86) mmHg in patients ventilated with fixed-tidal volume and 147 (72) mmHg in the patients ventilated with variable-tidal volume, a difference that was statistically significant (p < 0.01) but less than our pre-defined clinically meaningful threshold of 50 mmHg. At least one composite complication occurred in 11 (17%) of patients ventilated with variable-tidal volume and in 17 (26%) of patients assigned to fixed-tidal volume ventilation, with a relative risk of 0.67 (95% CI 0.34?1.31, p = 0.24). Atelectasis in the ventilated lung was less common with variable-tidal volumes (4.7%) than fixed-tidal volumes (20%) in the initial three postoperative days, with a relative risk of 0.24 (95% CI 0.01?0.8, p = 0.02), but there were no significant late postoperative differences. No other secondary outcomes were both statistically significant and clinically meaningful.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Thoracic anesthesia
One-lung ventilation
Tidal volume
Postoperative pulmonary complications
Intraoperative oxygenation
Variable ventilation
Megjelenés:Journal Of Clinical Anesthesia. - 95 (2024), p. 1-9. -
További szerzők:Balla Boglárka Pálóczi Balázs Enyedi Attila (1975-) (sebész) Sessler, Daniel I. Fülesdi Béla (1961-) (aneszteziológus) Végh Tamás (1975-) (aneszteziológus, intenzív terápiás szakorvos)
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5.

001-es BibID:BIBFORM047381
Első szerző:Végh Tamás (aneszteziológus, intenzív terápiás szakorvos)
Cím:Reply to "Further studies should compare the different tidal volume with adjusted PEEP levels at the same time of anesthesia / T. Végh, M. Juhász, Sz. Szatmári, A. Enyedi, D. I. Sessler., L. L. Szegedi, B. Fülesdi
Dátum:2013
ISSN:0375-9393 1827-1596
Tárgyszavak:Orvostudományok Klinikai orvostudományok levél
Megjelenés:Minerva Anestesiologica. - 79 : 6 (2013), p. 696. -
További szerzők:Juhász Marianna (1975-) (aneszteziológus) Szatmári Szilárd (1984-) (aneszteziológus) Enyedi Attila (1975-) (sebész) Sessler, Daniel I. Szegedi László (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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6.

001-es BibID:BIBFORM047387
Első szerző:Végh Tamás (aneszteziológus, intenzív terápiás szakorvos)
Cím:A magas és alacsony légzési térfogat hatása az artériás oxigenizációra és intrapulmonális shunt frakcióra egytüdős lélegeztetés során: randomizált crossover vizsgálat / Végh T., Juhász M., Szatmári Sz., Enyedi A., D. I. Sessler, Szegedi L. L., Fülesdi B.
Dátum:2012
Tárgyszavak:Orvostudományok Klinikai orvostudományok magyar nyelvű folyóiratközlemény hazai lapban
Megjelenés:Aneszteziológia és Intenzív Terápia. - 42 : 2 (2012), p. 85-89. -
További szerzők:Juhász Marianna (1975-) (aneszteziológus) Szatmári Szilárd (1984-) (aneszteziológus) Enyedi Attila (1975-) (sebész) Sessler, Daniel I. Szegedi László (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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7.

001-es BibID:BIBFORM047398
Első szerző:Végh Tamás (aneszteziológus, intenzív terápiás szakorvos)
Cím:A constant-flow technique for determining the lower inflection point of the pressure-volume curve and volumetric capnography for optimizing oxygenation during one-lung ventilation (O-66) / Tamás Végh, Marianna Juhász, Attila Enyedi, Daniel I. Sessler, László L. Szegedi, Béla Fülesdi
Dátum:2012
Tárgyszavak:Orvostudományok Klinikai orvostudományok idézhető absztrakt
Megjelenés:Applied Cardiopulmonary Pathophysiology. - 16 : Suppl. 1 (2012), p. 220. -
További szerzők:Juhász Marianna (1975-) (aneszteziológus) Enyedi Attila (1975-) (sebész) Sessler, Daniel I. Szegedi László (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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8.

001-es BibID:BIBFORM041902
Első szerző:Végh Tamás (aneszteziológus, intenzív terápiás szakorvos)
Cím:Effects of different tidal volumes for one-lung ventilation on oxygenation with open chest condition and surgical manipulation : a randomised cross-over trial / T. Végh, M. Juhász, S. Szatmári, A. Enyedi, D. I. Sessler, L. L. Szegedi, B. Fülesdi
Dátum:2013
Megjegyzések:Background. The ideal tidal volume (TV) during one-lung ventilation (OLV) remains controversial. High TVs mayincrease the incidence of postoperative lung injury after thoracic surgery. There is nonetheless little evidence thatthe use of low TV during OLV will fail to provide adequate arterial oxygenation. We evaluated the influence of low(5 mL/kg-1) and high (10 mL/kg-1) TV on arterial oxygenation during one-lung ventilation in clinical conditions.Methods. A hundred patients scheduled for lung surgery were studied. Patients were randomly assigned to either30 minutes of one-lung ventilation with a TV of 10 mL/kg-1 at a rate of 10 breaths/minute (Group 10, N.=50) or aTV of 5 mL/kg-1 with 5 cmH2O PEEP at a rate of 20 breaths/minute (Group 5, N.=50). According to the rules ofcrossover design during the subsequent 30 minutes, each patient received the alternative management. Arterial bloodpartial pressures, hemodynamic responses, and ventilatory parameters were recorded. Results are presented as means? SDs; P<0.05 was considered statistically significant.Results. PaO2 was unaffected by TV (10 mL/kg-1: 218?106 versus 5 mL/kg-1: 211?119 mmHg, P=0.29). Calculatedintrapulmonary shunt fraction was also similar with each TV during OLV (5 mL/kg-1: 25?9% versus 10 mL/kg-1: 24?8%, p=0.14). In contrast, low TV significantly increased PaCO2 (10 mL/kg-1: 39?6 versus 5 mL/kg-1:44?8 mmHg, P<0.001). There were significant differences both in peak (10 mL/kg-1: 27?6 versus 5 mL/kg-1: 21?5cmH2O, P<0.001) and plateau airway pressure values (10 mL/kg-1: 22?6 versus 5 mL/kg-1: 18?5 cmH2O, P<0.001)during OLV.Conclusion. Low TV (5 mL/kg-1) accompanied by 5 cmH2O PEEP provides comparable arterial oxygenation andintrapulmonary shunt fraction during one-lung ventilation as higher TV (10 mL/kg-1) without PEEP.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Tidal volume
One lung ventilation
Oxygenation
Anesthesia
Megjelenés:Minerva Anestesiologica. - 79 : 1 (2013), p. 24-32. -
További szerzők:Juhász Marianna (1975-) (aneszteziológus) Szatmári Szilárd (1984-) (aneszteziológus) Enyedi Ágnes Sessler, Daniel I. Szegedi László (aneszteziológus) Fülesdi Béla (1961-) (aneszteziológus)
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