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Henrik Linde Vilhelmas Bartusevicius Åke Norberg Fredrik Klevebro Jonathan Grip 《Acta anaesthesiologica Scandinavica》2023,67(3):277-283
Background
Esophagectomy is a major surgical intervention and a cornerstone in the treatment of esophageal cancer. There is clinical experience that blood lactate concentration often is elevated in the period following esophagectomy, but the incidence and clinical consequences are sparsely studied.Methods
We extracted data from all patients undergoing esophagectomy at Karolinska University Hospital 2016–2018, n = 153. Most were performed with minimally invasive technique, n = 130. Blood lactate values directly after surgery, highest value during the first night, and morning level on postoperative day one were recorded. Primary outcome was hospital length of stay and secondary outcome was a composite of postoperative infection, additional surgery, or intensive care during the hospital stay. Development of anastomotic leak was analyzed separately.Results
Postoperative hyperlactatemia was common as 93% of patients had peak lactate concentration >1.6 mmol/L and 27% >3.5 mmol/L in the first night following operation. Median hospital length of stay was 14 days. Blood lactate showed a weak correlation to hospital stay and intensive care the morning following surgery, but not at arrival to postoperative ward. There were no statistical differences between those with and without anastomotic leak at any of the time points. Elevated lactate in the first 12–16 h postoperatively was related to surgical factors (open technique, surgery time, and perioperative bleeding) but not to patient related factors (ASA-class, Charlson comorbidity index, sex, age) or cumulative fluid balance.Conclusion
In conclusion, elevated blood lactate in the immediate time following esophagectomy showed a weak association to intensive care and length of stay but not anastomotic leak. 相似文献3.
Andreas Glenthj Lasse H. Jakobsen Henrik Sengelv Syed A. Ahmad Kristian Qvist Annika Rewes Christian B. Poulsen Ulrik M. Overgaard Ingolf Mlle Marianne T. Severinsen Casper N. Strandholdt Jack Maibom Annette R. Kodahl Jesper Ryg Pernille Ravn Isik S. Johansen Sren N. Hels Sren Jensen‐Fangel Jacek Kisielewicz Lothar Wiese Marie Helleberg Ole Kirk Michael R. Clausen Henrik Frederiksen 《European journal of haematology》2021,106(1):72-81
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Familial risk and heritability of intellectual disability: a population-based cohort study in Sweden
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Marianne Torp Stensvehagen Berit Arnesveen Bronken Lars Lien Gerry Larsson 《Scandinavian journal of caring sciences》2019,33(2):487-497
The impact of stress on health can depend on factors such as frequency, heightening of stress during a given period or the presence of one or a few repeated hassles of psychological importance. The aim of this study was to gain a deeper understanding of how adult women experience and cope with daily hassles after sexual abuse. Ten interviews were analysed using the grounded theory method. The theoretical model of ‘protecting armor in daily life’ emerged. The aftermath of sexual abuse related coping with daily stress can be understood as a three‐phase process: (1) avoiding and escaping—coping after experiencing sexual abuse; (2) accepting and disclosing—starting a process of recovery; and (3) reconciling and repossessing—living with the experience in the present. The model contributes to a deeper understanding of the everyday life of women who have experienced sexual abuse. Increased knowledge of coping behaviours that can be used to deal with daily hassles may also serve as a tool for health professionals, other helpers and family to help these women rebuild a good life. 相似文献
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