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Biomedical subjects

S Rosenberg-Adamsen

Publications and source records attributed to S Rosenberg-Adamsen.

9 recordsLinked to original sources
PubMed2004

Relationship between nocturnal hypoxaemia, tachycardia and myocardial ischaemia after major abdominal surgery.

BACKGROUND: Episodic hypoxaemia, cardiac arrhythmias, and myocardial ischaemia may be related after major abdominal surgery. METHODS: We studied 52 patients on the second and third nights after major abdominal operations, using continuous pulse oximetry and Holter ECG. We recorded the amount of time spent with oxygen saturation values less than 90, 85, and 80% during the night, and noted episodes of hypoxaemia, tachycardia, bradycardia, and ST-segment changes. RESULTS: In 87 study nights there were 2403 (individual range 1-229) episodes of hypoxaemia, 3509 (individual range 1-234) episodes of tachycardia, and 265 (individual range 1-73) episodes of ST segment deviation. Of the 52 patients, 50 had episodes of hypoxaemia and tachycardia, and 19 patients had one or more episodes of ST segment deviation. For 38% of the episodes of ST deviation, there was an episode of hypoxaemia at the same time and in 16% there was an episode of tachycardia. ST deviation was only noted in 4% of the episodes of hypoxaemia and in 1% of the episodes of tachycardia. CONCLUSION: Episodes of hypoxaemia and tachycardia frequently occur together after surgery but are rarely associated with ST deviation. Hypoxaemia or tachycardia is often present at the same time as ST deviation occurs.

Abdomen↗
PubMed2001

Laparoscopic cholecystectomy causes less sleep disturbance than open abdominal surgery.

BACKGROUND: The aim of this study was to examine subjective sleep quality before and after laparoscopic vs open abdominal surgery. METHODS: Twelve patients undergoing laparoscopic cholecystectomy and 15 patients undergoing laparotomy were evaluated with the aid of a sleep questionnaire from 4 days before until 4 weeks after surgery. RESULTS: Following laparoscopic surgery, total sleep time increased during the 1st week after the operation compared with preoperative values (p = 0.02), whereas sleep duration during weeks 2, 3, and 4 did not differ from the times reported preoperatively. Following laparotomy, sleep duration increased during the 1st, 3rd, and 4th weeks after the operation compared with preoperative values (p < 0.05). All patients experienced postoperative circadian sleep disturbance, with significantly more sleep during the daytime compared with preoperative values; the disturbance was present 1 week after laparoscopy and 4 weeks after laparotomy. CONCLUSIONS: After laparotomy, total sleep time increased and there was a change in diurnal sleep distribution. These sleep alterations were less pronounced after laparoscopic cholecystectomy. Thus, sleep architecture was disturbed for ?4 weeks after major abdominal surgery but for only 1 week after laparoscopic cholecystectomy.

Abdomen↗
PubMed1999

Effect of oxygen treatment on heart rate after abdominal surgery.

BACKGROUND: Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate. METHODS: The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. RESULTS: The median arterial oxygen saturation rate increased significantly from 96% to 99% (P < 0.0001) and the heart rate decreased significantly from 85 beats/min to 81 beats/min (P < 0.0001) during oxygen supplementation compared with air administered by a binasal catheter. The greatest decrease in heart rate occurred in patients with the lowest oxygen saturation or the highest heart rate values before oxygen supplementation. Overall, 73% of this unselected group of patients responded with decreased heart rate during supplemental oxygen therapy. No significant differences in changes in heart rate after oxygen supplementation were found between patients with or without an epidural catheter or between the postoperative day studied. CONCLUSION: Postoperative oxygen therapy increased arterial oxygen saturation and decreased heart rate after uncomplicated abdominal surgery in a consecutive unselected group of patients who received routine postoperative care.

Abdomen↗
PubMed1997

Validation of pulse oximetry for monitoring of hypoxaemic episodes in the late postoperative period.

We monitored 12 patients undergoing major abdominal surgery using a pulse oximeter (Nellcor N-200) and a transcutaneous oxygen tension monitor (TINA, Radiometer A/S) on the second or third night after operation. Of the shortest hypoxaemic episodes measured with the pulse oximeter (< or = 30 s duration), 78% also occurred in the transcutaneous oxygen tension measurement. Episodes of longer duration (> or = 1 min duration on the pulse oximeter) were, in 95% of cases, reflected in the transcutaneous oxygen tension measurement also. Thus postoperative episodic desaturations lasting > or = 1 min are at least 95% likely to be a real phenomenon.

Abdomen↗
PubMed1997

Body position and late postoperative nocturnal hypoxaemia.

Thirteen patients were monitored for nocturnal body position (supine vs. side) and arterial oxygen saturation pre-operatively and on the second postoperative night after major abdominal surgery. The number of positional changes were significantly decreased after operation (p < 0.05) with a trend towards more time spent in the supine position (p = 0.1). Individual mean arterial oxygen saturation decreased postoperatively (p < 0.05) but without a difference between the supine and side positions (p = 0.9). Pre-operatively, episodic desaturations were significantly more frequent in the supine position than on the side (p < 0.05) but not postoperatively. Pain was the most frequent reason for decreased nocturnal movements.

Adult↗
PubMed1996

Sleep after laparoscopic cholecystectomy.

The sleep pattern and oxygenation of 10 patients undergoing laparoscopic cholecystectomy were studied on the night before operation and the first night after operation. Operations were performed during general anaesthesia and postoperative analgesia was achieved without the administration of opioids. There were no significant changes in the total time awake or the number of arousals on the postoperative night compared with the night before operation. During the postoperative night, we found a decrease (P = 0.02) in slow wave sleep (SWS) with a corresponding increase in stage 2 sleep (P = 0.01). SWS was absent in four of the patients after operation, whereas in six patients it was within the normal range (5-20% of the night). The proportion of rapid eye movement (REM) sleep was not significantly changed after operation. There were no changes in arterial oxygen saturation on the postoperative compared with the preoperative night. Comparison of our results with previous studies on SWS and REM sleep disturbances after open laparotomy, suggests that the magnitude of surgery or administration of opioids, or both, may be important factors in the development of postoperative sleep disturbances.

Adult↗
PubMed1995

Comparison of three devices for oxygen administration in the late postoperative period.

We have evaluated three different devices for oxygen administration in the surgical ward, the Hudson face mask (oxygen 3 litre min-1, air 12 litre min-1), the nasal prong (oxygen 3 litre min-1) and the binasal catheter (oxygen 3 litre min-1). We evaluated the three devices in random order for periods of 30 min each in 25 patients with postoperative hypoxaemia (SpO2 < or = 94%). Arterial oxygen saturation was measured by continuous pulse oximetry and comfort was evaluated with a questionnaire after each treatment period. The three systems increased arterial oxygen saturation to similar levels, but the highest degree of comfort was found with the binasal catheter. Use of the binasal catheter is recommended for oxygen administration in the late postoperative period.

Adult↗
PubMed1995

Post-operative sleep disturbance: causes, factors and effects on outcome.

Post-operative sleep disturbance, with suppression of rapid eye movement sleep and slow wave sleep followed by a subsequent rebound, seems to be related to the magnitude of trauma and thereby to the surgical stress response. In this context, cortisol, autonomic stimulation, and certain cytokines may lead to abnormal sleep. Furthermore, the environment, pain and the administration of analgesics seem to be important factors in the precipitation of sleep abnormalities. Post-operative sleep disturbance may contribute to the development of episodic hypoxaemia, haemodynamic instability and altered mental status, all of which have an influence on post-operative morbidity and mortality. Prevention or reduction of the post-operative sleep disturbance may be achieved by minimizing surgical trauma, changing the conventional nursing procedures, avoiding opioids and treating pain with non-opioid analgesics, although none of these methods has been thoroughly studied. Post-operative sleep disturbance represents an important research field, since it may have a significant adverse impact on post-operative outcome.

Humans↗