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001-es BibID:	BIBFORM042435
Első szerző:	Csépány Tünde (neurológus, pszichiáter)
Cím:	Cerebral systemic lupus erythematosus / Tünde Csépány, Attila Valikovics, Bela Fülesdi, Emese Kiss, Gyula Szegedi, László Csiba
Dátum:	1994
ISSN:	0140-6736
Megjegyzések:	Korrekcót nyújtottak be a Lancet (1994), 343 : 1512. oldalán, mert a szerzők neve rosszul szerepel a Lancet (1994), 343 : 1103-1104. közleményen.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok levél Arterial redistribution egyetemen (Magyarországon) készült közlemény
Megjelenés:	Lancet. - 343 : 8905 (1994), p. 1103-1104. -
További szerzők:	Valikovics Attila Fülesdi Béla (1961-) (aneszteziológus) Kiss Emese (1960-) (belgyógyász, immunológus) Szegedi Gyula (1936-2013) (belgyógyász, immunológus) Csiba László (1952-) (neurológus, pszichiáter)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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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. (1980-) (kutatóorvos) Akça, Ozan Kanyári Zsolt (1964-) (orvos) Orosz László (1966-) (sebész) The Outcomes Research Group
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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001-es BibID:	BIBFORM133516
035-os BibID:	(scopus)105022127725
Első szerző:	PROTHOR Collaborative Group
Cím:	Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR) : a multicentre, international, randomised, controlled, phase 3 trial / PROTHOR Collaborative Group
Dátum:	2025
ISSN:	2213-2600
Megjegyzések:	Background The effect of higher positive end-expiratory pressure (PEEP) and recruitment manoeuvres aimed at lung expansion as compared with lower PEEP without recruitment manoeuvres aimed at permissive atelectasis on postoperative pulmonary complications (PPCs) in patients undergoing one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to determine the contribution of an intraoperative lung expansion strategy to preventing PPCs. Methods In this multicentre, randomised, controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in 28 countries, we enrolled adult patients (aged ?18 years) with a BMI of less than 35 kg/m? who were scheduled for open thoracic or video-assisted thoracoscopic surgery under general anaesthesia requiring one-lung ventilation with a double-lumen tube, with a planned operative time of more than 60 min, and an expected duration of one-lung ventilation longer than that of two-lung ventilation. Patients were randomly assigned (1:1), using permuted blocks of random size (4, 6, and 8) and stratified by study site, to receive one-lung ventilation with either a higher PEEP of 10 cm H?O and periodic lung recruitment manoeuvres (high PEEP group) or a lower PEEP of 5 cm H?O without routine recruitment manoeuvres (low PEEP group). All patients received protective tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation and 7 mL/kg predicted body weight during two-lung ventilation. Postoperative assessors were masked to treatment allocation. The primary outcome was a composite of PPCs during the first 5 postoperative days, including aspiration pneumonia, moderate or severe respiratory failure, acute respiratory distress syndrome (ARDS), pulmonary infection, atelectasis, cardiopulmonary oedema, pleural effusion, non-operative pneumothorax, pulmonary infiltrates, prolonged air leak, purulent pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified intention-to-treat analysis was performed, with patients analysed according to their assigned treatment group, except in cases of withdrawal of informed consent, cancellation of surgery, and or loss to follow-up. This trial is registered with ClinicalTrials.gov (NCT02963025) and is completed. Findings Between Jan 3, 2017, and Feb 12, 2024, 2200 patients were randomly allocated: 1099 to the high PEEP group and 1101 to the low PEEP group. 43 patients in the high PEEP group and 33 in the low PEEP group were excluded from the modified intention-to-treat analysis after randomisation. The primary outcome occurred in 555 (53?6%) of 1036 patients in the high PEEP group and 592 (56?4%) of 1049 patients in the low PEEP group (absolute risk difference ?2?68 percentage points [95% CI ?6?36 to 1?01]; p=0?155). Intraoperative complications occurred in 484 (49?8%) of 972 patients in the high PEEP group and in 305 (31?3%) of 974 patients in the low PEEP group (absolute risk difference 18?09 percentage points [95% CI 14?41?21?77]), among which hypotension (360 [37?3%] of 966 patients in the high PEEP group vs 140 [14?3%] of 978 in the low PEEP group) and new arrhythmias (89 [9?9%] of 899 vs 37 [3?9%] of 956) were more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres were more frequent in the low PEEP group (29 [3?3%] of 888 vs 86 [8?8%] of 982). The proportions of patients with extrapulmonary postoperative complications (110 [10?6%] of 1036 vs 107 [10?2%] of 1049 patients), and the numbers of adverse events (209 vs 204 events), did not differ between groups. Interpretation In patients with a BMI of less than 35 kg/m? undergoing thoracic surgery, one-lung ventilation using higher PEEP with recruitment manoeuvres, compared with lower PEEP without recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative lung expansion or permissive atelectasis should take the individual gas-exchange and haemodynamic conditions into account, which might vary during the intraoperative period.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk thoracic anesthesia one-lung ventilation positive end-expiratory pressure
Megjelenés:	The Lancet Respiratory Medicine. - [Epub ahead of print] (2025). -
További szerzők:	Végh Tamás (1975-) (aneszteziológus, intenzív terápiás szakorvos)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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