Euroanaesthesia 2017 Abstract Book

451 Pages·2017·20.09 MB·English

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European Journal of Anaesthesiology
Editor-in-Chief Associate Editors Charles-Marc Samama Paris, France
Martin R. Tramèr Geneva, Switzerland Bernd W. Böttiger Cologne, Germany Francis Veyckemans Lille, France
Nicolas Bruder, Marseille, France
Michelle Chew Halmstad, Sweden Methods, Statistics, Epidemiology
Deputy Editors-in-Chief Pierre Diemunsch Strasbourg, France Malachy Columb Manchester, UK
Walid Habre Geneva, Switzerland Thomas Fuchs-Buder Nancy, France Nadia Elia Geneva, Switzerland
Bernhard Walder Geneva, Switzerland Robert Greif Berne, Switzerland
Tom Hansen, Odense, Denmark Book Reviews
Language and Technical Editors Peter Kranke Würzburg, Germany Micheal H. Nathanson Nottingham, UK
Alan Aitkenhead Nottingham, UK Patricia M. Lavand’homme Brussels, Belgium
Gordon Lyons Leeds, UK Philipp Lirk Amsterdam, Netherlands Journal Manager
Neil Morton Glasgow, UK Annelies Moerman, Ghent, Belgium Bridget M. Benn Geneva, Switzerland
Ian F. Russel Hull, UK Rolf Rossaint Aachen, Germany
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E 2017
uroanaEsthEsia
GENEVA, SWITZERLAND, 3 - 5 JUNE 2017
The European Anaesthesiology Congress
ABSTRACT PRESENTATION PROGRAMME
Please note that all abstracts are presented as poster presentations: abstract presenters do not make a formal presentation
of their abstract in a separate room, using audiovisual aids (except for the Best Abstract Prize Competition). Instead, two
chairpersons will conduct, in front of each poster, a short discussion of each abstract with the presenter and the audience,
for every abstract in that session. Poster presenters have been asked to stand by their poster at least 15 minutes before the
start of the session and 15 minutes after, to address further questions.
Date Time Reference Location Page
Best Abstract Prize Competition (BAPC)
0L4e.a0r6n.i2n0g1 7T rack 1 - General A1n4:a0e0s-1th6e:0s0io logy BAPC Room Q 1
03.06.2017 10:30-12:00 01AP01 Poster e-Board 1 3
03.06.2017 12:30-14:00 01AP02 Poster e-Board 1 7
03.06.2017 14:30-16:00 01AP03 Poster e-Board 1 10
03.06.2017 16:30-18:00 01AP04 Poster e-Board 1 15
03.06.2017 16:30-18:00 01AP05 Poster e-Board 2 18
04.06.2017 08:30-10:00 01AP06 Poster e-Board 1 22
04.06.2017 10:15-11:45 01AP07 Poster e-Board 1 25
04.06.2017 12:00-13:30 01AP08 Poster e-Board 1 28
04.06.2017 12:00-13:30 01AP09 Poster e-Board 2 31
04.06.2017 13:45-15:15 01AP10 Poster e-Board 1 34
04.06.2017 13:45-15:15 01AP11 Poster e-Board 2 38
04.06.2017 15:30-17:00 01AP12 Poster e-Board 1 42
05.06.2017 08:30-10:00 01AP13 Poster e-Board 1 45
05.06.2017 10:15-11:45 01AP14 Poster e-Board 1 48
05.06.2017 12:00-13:30 01AP15 Poster e-Board 1 52
05.06.2017 13:45-15:15 01AP16 Poster e-Board 1 56
Learning Track 2 - Ambulatory Anaesthesia
03.06.2017 10:30-12:00 02AP01 Poster e-Board 4 59
05.06.2017 10:15-11:45 02AP02 Poster e-Board 6 62
05.06.2017 13:45-15:15 02AP03 Poster e-Board 5 65
Learning Track 3 - Regional Anaesthesiology
03.06.2017 16:30-18:00 03AP01 Poster e-Board 3 68
04.06.2017 08:30-10:00 03AP02 Poster e-Board 3 72
04.06.2017 10:15-11:45 03AP03 Poster e-Board 3 76
04.06.2017 12:00-13:30 03AP04 Poster e-Board 3 80
04.06.2017 13:45-15:15 03AP05 Poster e-Board 3 82
04.06.2017 15:30-17:00 03AP06 Poster e-Board 3 85
05.06.2017 08:30-10:00 03AP07 Poster e-Board 3 87
05.06.2017 10:15-11:45 03AP08 Poster e-Board 3 90
05.06.2017 12:00-13:30 03AP09 Poster e-Board 3 93
05.06.2017 13:45-15:15 03AP10 Poster e-Board 3 96
Learning Track 4 - Obstetric Anaesthesiology
03.06.2017 12:30-14:00 04AP01 Poster e-Board 4 100
03.06.2017 14:30-16:00 04AP02 Poster e-Board 4 104
03.06.2017 16:30-18:00 04AP03 Poster e-Board 4 108
04.06.2017 08:30-10:00 04AP04 Poster e-Board 4 112
04.06.2017 12:00-13:30 04AP05 Poster e-Board 4 116
04.06.2017 13:45-15:15 04AP06 Poster e-Board 4 118
05.06.2017 08:30-10:00 04AP07 Poster e-Board 4 122
05.06.2017 10:15-11:45 04AP08 Poster e-Board 4 125
Learning Track 5 - Paediatric Anaesthesiology
03.06.2017 14:30-16:00 05AP01 Poster e-Board 2 129
04.06.2017 10:15-11:45 05AP02 Poster e-Board 2 131
04.06.2017 15:30-17:00 05AP03 Poster e-Board 2 133
05.06.2017 08:30-10:00 05AP04 Poster e-Board 2 136
05.06.2017 10:15-11:45 05AP05 Poster e-Board 2 139
05.06.2017 12:00-13:30 05AP06 Poster e-Board 2 140
05.06.2017 13:45-15:15 05AP07 Poster e-Board 2 143
Learning Track 6 - Neuroanaesthesiology
03.06.2017 12:30-14:00 06AP01 Poster e-Board 3 148
03.06.2017 14:30-16:00 06AP02 Poster e-Board 3 152
04.06.2017 08:30-10:00 06AP03 Poster e-Board 2 154
04.06.2017 10:15-11:45 06AP04 Poster e-Board 4 160
04.06.2017 12:00-13:30 06AP05 Poster e-Board 8 162
05.06.2017 08:30-10:00 06AP06 Poster e-Board 9 167
Learning Track 7 - Cardiac, Thoracic and Vascular Anaesthesiology
03.06.2017 10:30-12:00 07AP01 Poster e-Board 5 170
03.06.2017 12:30-14:00 07AP02 Poster e-Board 5 174
03.06.2017 14:30-16:00 07AP03 Poster e-Board 5 177
03.06.2017 16:30-18:00 07AP04 Poster e-Board 5 180
04.06.2017 08:30-10:00 07AP05 Poster e-Board 5 184
04.06.2017 10:15-11:45 07AP06 Poster e-Board 5 187
04.06.2017 12:00-13:30 07AP07 Poster e-Board 5 191
04.06.2017 13:45-15:15 07AP08 Poster e-Board 5 194
04.06.2017 15:30-17:00 07AP09 Poster e-Board 5 197
05.06.2017 08:30-10:00 07AP10 Poster e-Board 5 201
05.06.2017 10:15-11:45 07AP11 Poster e-Board 5 204
05.06.2017 12:00-13:30 07AP12 Poster e-Board 5 207
Learning Track 8 - Acute Pain Management
03.06.2017 14:30-16:00 08AP01 Poster e-Board 10 209
03.06.2017 16:30-18:00 08AP02 Poster e-Board 10 213
04.06.2017 08:30-10:00 08AP03 Poster e-Board 9 215
04.06.2017 10:15-11:45 08AP04 Poster e-Board 10 219
04.06.2017 15:30-17:00 08AP05 Poster e-Board 8 223
05.06.2017 10:15-11:45 08AP06 Poster e-Board 10 227
05.06.2017 13:45-15:15 08AP07 Poster e-Board 10 230
Learning Track 9 - Chronic Pain and Palliative Medicine
03.06.2017 10:30-12:00 09AP01 Poster e-Board 3 232
03.06.2017 16:30-18:00 09AP02 Poster e-Board 9 235
04.06.2017 12:00-13:30 09AP03 Poster e-Board 10 238
04.06.2017 15:30-17:00 09AP04 Poster e-Board 6 242
05.06.2017 08:30-10:00 09AP05 Poster e-Board 10 244
Learning Track 10 - Critical Emergency Medicine - Trauma and Resuscitation
03.06.2017 10:30-12:00 10AP01 Poster e-Board 6 248
03.06.2017 12:30-14:00 10AP02 Poster e-Board 10 251
04.06.2017 13:45-15:15 10AP03 Poster e-Board 10 253
Learning Track 11 - Respiration and Airway Management
03.06.2017 12:30-14:00 11AP01 Poster e-Board 6 257
03.06.2017 14:30-16:00 11AP02 Poster e-Board 6 260
04.06.2017 08:30-10:00 11AP03 Poster e-Board 6 264
04.06.2017 12:00-13:30 11AP04 Poster e-Board 6 267
04.06.2017 13:45-15:15 11AP05 Poster e-Board 6 271
05.06.2017 08:30-10:00 11AP06 Poster e-Board 6 274
05.06.2017 12:00-13:30 11AP07 Poster e-Board 6 277
05.06.2017 13:45-15:15 11AP08 Poster e-Board 6 281
Learning Track 12 - Transfusion, Haemostasis and Thrombosis
03.06.2017 10:30-12:00 12AP01 Poster e-Board 2 284
03.06.2017 12:30-14:00 12AP02 Poster e-Board 2 286
03.06.2017 16:30-18:00 12AP03 Poster e-Board 6 290
04.06.2017 15:30-17:00 12AP04 Poster e-Board 4 293
05.06.2017 12:00-13:30 12AP05 Poster e-Board 4 296
Learning Track 13 - Intensive Care Medicine
03.06.2017 10:30-12:00 13AP01 Poster e-Board 7 300
03.06.2017 12:30-14:00 13AP02 Poster e-Board 7 303
03.06.2017 14:30-16:00 13AP03 Poster e-Board 7 306
03.06.2017 16:30-18:00 13AP04 Poster e-Board 7 308
04.06.2017 08:30-10:00 13AP05 Poster e-Board 7 312
04.06.2017 10:15-11:45 13AP06 Poster e-Board 7 315
04.06.2017 12:00-13:30 13AP07 Poster e-Board 7 318
04.06.2017 13:45-15:15 13AP08 Poster e-Board 7 321
04.06.2017 15:30-17:00 13AP09 Poster e-Board 7 324
05.06.2017 08:30-10:00 13AP10 Poster e-Board 7 327
05.06.2017 10:15-11:45 13AP11 Poster e-Board 7 330
05.06.2017 12:00-13:30 13AP12 Poster e-Board 7 334
05.06.2017 13:45-15:15 13AP13 Poster e-Board 7 336
Learning Track 14 - Perioperative Medicine
03.06.2017 10:30-12:00 14AP01 Poster e-Board 8 339
03.06.2017 12:30-14:00 14AP02 Poster e-Board 8 343
03.06.2017 14:30-16:00 14AP03 Poster e-Board 8 346
03.06.2017 16:30-18:00 14AP04 Poster e-Board 8 349
04.06.2017 08:30-10:00 14AP05 Poster e-Board 8 353
04.06.2017 10:15-11:45 14AP06 Poster e-Board 8 357
04.06.2017 13:45-15:15 14AP07 Poster e-Board 8 360
05.06.2017 08:30-10:00 14AP08 Poster e-Board 8 364
05.06.2017 10:15-11:45 14AP09 Poster e-Board 8 367
05.06.2017 12:00-13:30 14AP10 Poster e-Board 8 371
Learning Track 15 - Geriatric Anaesthesiology
03.06.2017 10:30-12:00 15AP01 Poster e-Board 9 375
04.06.2017 10:15-11:45 15AP02 Poster e-Board 6 377
Learning Track 16 - Patient Safety
03.06.2017 12:30-14:00 16AP01 Poster e-Board 9 380
03.06.2017 14:30-16:00 16AP02 Poster e-Board 9 383
04.06.2017 10:15-11:45 16AP03 Poster e-Board 9 388
04.06.2017 12:00-13:30 16AP04 Poster e-Board 9 391
04.06.2017 13:45-15:15 16AP05 Poster e-Board 9 395
05.06.2017 10:15-11:45 16AP06 Poster e-Board 9 397
05.06.2017 12:00-13:30 16AP07 Poster e-Board 9 401
05.06.2017 13:45-15:15 16AP08 Poster e-Board 9 405
Learning Track 17 - Education
04.06.2017 15:30-17:00 17AP01 Poster e-Board 10 408
05.06.2017 12:00-13:30 17AP02 Poster e-Board 10 411
Subject Index 416
Author Index 424
The abstracts published in this Supplement have been typeset from electronic submissions and camera-ready copies
prepared by the authors. Every effort has been made to reproduce faithfully the abstracts as submitted. These abstracts
have been prepared in accordance with the requirements of the European Society of Anaesthesiology and have not been
subjected to review nor editing by the European Journal of Anaesthesiology. However, no responsibility is assumed by the
organisers or publisher for any injury and/or damage to persons or property as a matter of products liability, negligence
or otherwise, or from any use or operation of methods, products, instructions or ideas contained in the material herein.
Because of the rapid advances in medical sciences, we recommend that independent verification of diagnoses and drug
doses should be made.

Call for abstracts
The ESA solicits the submission of abstracts for the
Euroanaesthesia 2018 Congress
Copenhagen, Denmark
2 - 4 June 2018
All abstracts must be submitted online via the ESA Website
www.esahq.org
The submission module will be available to submitters
November - December 2017
Submission Conditions
When submitting your abstract, you will be prompted to accept the
sub mission conditions that will be made available on the ESA website
at least one month before the submission starts.
ESA Best Abstract Prize Competition (BAPC) 1
ESA Best Abstract Prize Competition (BAPC)
BAPC-1
Effectiveness of personalised physical training intervention
opioid in a wide variety of pediatric surgical patients. The aim of this study is
(prehabilitation) in high-risk patients undergoing elective major tMo euthndoedrss:t and the effect of age on the PK of oxycodone and its metabolites
abdominal surgery: a randomised controlled trial (oxymorphone and noroxycodone).
This prospective study was approved by the hospital investiga-
tional review board. A total of 45 opioid-naive children, aged 0-5 years have
been consented. Blood samples were collected for the assay of oxycodone
1 1 2 2 3
Ubré M., Risco R., Barberan-Garcia A., Roca J., de Lacy A.M., and its main metabolites, as well as for CYP3A4 and CYP2D6 genotyping.
1Hospital Clínic o1f Barcelona, Dept of Anaesthesiology & Intensive
Oxycodone, oxymorphone, and noroxycodone levels at 10 time points were
Martinez-Pallí G.
Care, Barcelona, Spain, 2Hospital Clinic de Barcelona, Department aRsessauyletsd: using liquid chromatography- mass spectrometry (UPLC/MS/MS)
of Respiratory Medicine, Barcelona, Spain, 3Hospital Clínic of and single-dose pharmacokinetics parameters were determined.
Barcelona, Dept of Surgery, Barcelona, Spain The concentration data revealed a substantial interpatient PK. We
divided patient into 4 age groups (n = 7; 0 - 0.5 years, n = 10; 0.5 - 1 years;
Background: n = 14, 1 - 2 years; n = 14, 2 - 6 years). Our data demonstrates that all 4 age
groups appear to have same onset of absorption (2-5 hours). It seems that
Based on the notion that preoperative functional reserve and patients age 0 - 0.5 years old have higher peak plasma oxycodone concentra-
cardiopulmonary fitness are predictors of postoperative morbidity, preha- tion (mean ~10 ng/mL) compare to older patient age 2-6 years (mean ~8 ng/
bilitation, defined as the process of enhancing the functional capacity of the mL). All the groups except age 0.5-1 years group tend to have higher plasma
iGnodiavli doufa Sl, tuadpyp:ears as highly promising preventive intervention to optimise noroxycodone level compare to oxymorphone level at the same time point.
preoperatively the patient’s physical condition.
To evaluate the effectiveness of a personalised preoperative
pMreethhaobdilsit:a tion intervention on postoperative outcomes in high-risk patients
undergoing major abdominal surgery.
Randomised double-blind controlled trial. 144 high-risk patients
(>70 yrs-old and/or ASA III/IV) planned for elective major abdominal sur-
gery were randomised to prehabilitation program or standard preoperative
care. The intervention encompassed three steps: i) motivational interview; ii)
personalized program to promote physical activity; and, iii) supervised en-
durance training program. The main outcome of study was the proportion
of patients suffering from postoperative complications. Secondary outcome
variables were: i) hospital and intensive care unit (ICU) days of stay; and, ii)
endurance time measured by a cycling2 constant work-rate exercise testing.
CRoesmupltasr:is ons have been done using chi or Fisher’s exact tests for categorical
variables, and Student’s or Wilcoxon tests for numerical variables.
125 patients (prehabilitation group n=62 and control group n=63)
(71±10 yrs-old, 75% male) were finally included in the intention-to-treat analy-
sis. At program discharge [duration 6 (2) weeks], the prehabilitation group
showed an improvement of 135 (218) % in the endurance time (p<0.001)
meanwhile the· control grou·p r·emained unchanged. The intervention group
showed 20% less of patients with postoperative complications compared with
controls (RR 05, 95% CI [03-08]; p=0.001). The intervention group showed
shorter in-hospital stay, although no statistical significant showed up [8 (8) vs.
13 (20) days (p=0.078)]. A sensitivity analysis including only those patients
aCdomncitltuesdi oinn tsh:e ICU (n=44), showed a significant reduction of ICU stay in the
intervention group [3 (2) vs. 12 (20) days; p=0.046].
Prehabilitation is effective reducing morbidity rates in high-risk
patients undergoing major abdominal surgery. Easier alternatives based on
moderate-intensity exercise programs and the role of including nutritional and
psychological support should be investigated in future research. Supported
by ESA Grant.
BAPC-2
The effect of age on oral liquid oxycodone pharmacokinetics
in pediatric patients
1Boston Chi1ldren’s Ho2spital - Harv2ard Medica1l School, De1pt of
Sriswasdi P. , Dube C., Pereira L., Berde C., Goobie S.
Anaesthesiology & Pain Medicine, Boston, United States, 2Boston
Childrens Hospital, Dept of Anaesthesiology & Pain Medicine,
Boston, United States
Background:
Despite oxycodone marked pharmacokinetics (PK) variation [Plasma Oxycodone and its metabolites by age groups]
among the children, we generally prescribe same oral oxycodone dose of 0.1
mg/kg. Most oxycodone (80%) breakdown by the enzyme cytochrome P450 Conclusion:
(CYP) 3A4 into noroxycodone, up to 11% of the metabolism occurs through
CYP2D6 into oxymorphone. The developmental changes and CYP3A4&2D6 A trend appears to exist with age contributing to the variability
maturation could potentially alter the bioavailability and metabolic pathways of PK of oxycodone. This justifies the need for its consideration in the dosing
of oral oxycodone. optimization of Oxycodone based on individual age. It is possible that oxyco-
This suggests the need to rationalize oxycodone dosing regimens in children. done metabolism might be different in pediatric population when compare
Understanding oral oxycodone PK favors the safe and effective use of this to adult.
2 ESA Best Abstract Prize Competition (BAPC)
BAPC-3
Influence of xenon on pulmonary mechanics and tidal volume
<100 mmHg. Following a lung recruitment maneuver and a decremental
distribution PEEP trial (26 cmH2O - 6 cmH2O) respiratory system mechanics and regional
TP was determined for each PEEP level. The best-PEEP level was defined
as the lowest PEEP yielding positive end-expiratory TP in all lung regions.
University Hospital Düsseldorf, Dept of Anaesthesiology, Animals were then randomly assigned to airway pressure release ventilation
Schaefer M.S., Gauch J., Treschan T.A., Kienbaum P. with best PEEP + 4 cmH2O (Group 1, “high PEEP”, n=5) or best PEEP - 4
Düsseldorf, Germany
cmH2O (Group 2, “low PEEP”, n=5). SB was induced (proportion of SB be-
ing 40 to 60% of total minute ventilation) gas exchange, hemodynamics and
Background:
lung mechanics were assessed for a time period of 12 hours. At the end lung
The anaesthetic xenon has organ protective properties [1] and iRneflasmulmtsa atniodn Dwisacsu dsestieornm: ined as the specific uptake rate (Ki,S) of Fluor-18-
might attenuate ventilator-induced lung injury in perioperative patients, as well deoxyglucose using PET (Patlak model).
as patients suffering from ARDS. Due to its high viscosity, xenon adminis- There were no significant differences in bodyweight
tration increases maximum airway pressure (Pmax) in mechanically ventilated and age. A two tailed Mann Whitney U test showed a significantly lower Ki,S
patients [2]. However, it is unknown whether barotrauma-associated transpul- for the high PEEP group (median 0.031, interquartile range 0.038-0.026) com-
monary pressure (Ptp), is also affected. Also, it is unclear to what extent xenon pared to the low PEEP group (median 0.048; interquartile range 0.070-0.039)
influences aeration of the lungs. Thus, we investigated the influence of xenon (p=0.032). Repeated measures two-way ANOVA showed no differences be-
aMpeptlhicoadtiso:n on pulmonary mechanics, as well as distribution of tidal volume in tween groups for hemodynamics, gas exchange and lung mechanics. The
mechanically ventilated patients. bCeosnt-c lPuEsEioPn :l evel did not differ significantly from the PEEP level resulting in
Following ethical approval (#5161R, 29/09/15) and written informed lowest lung elastance.
consent, 20 patients with healthy lungs undergoing surgery with xenon-based In a model of severe ARDS in pigs, assisted SB with titrated posi-
general anaesthesia were included in this prospective observational study. tive end-expiratory TP levels in all lung regions, attenuated lung inflammation.
During volume-controlled ventilation (8ml/kg predicted body weight, PEEP
5mbar), Ptp was calculated from plateau pressure and esophageal pressure
(balloon catheter). Additionally, static (Cstat) and dynamic (Cdyn) lung compli- BAPC-5
ance were measured. Further, using electrical impedance tomography (EIT, Effects of dexamethasone on cognitive dysfunction following
PulmoVista 500, Draeger), dorsoventral distribution of tidal volume was quan- cardiac surgery
tified (center of gravity index, CGI), and homogeneity of lung aeration was
measured (inhomogeneity index, IH). Measurements were taken:
1. during awake spontaneous breathing (EIT-derived parameters);
1University1 Hospital of S2plit, Dept of An1aesthesiology & Intensive
2S.t aatfistetirc sin duction of general anaesthesia (FiO2 >0.9), as well as; Glumac S., Kardum G., Karanovic N.
Care, Split, Croatia, 2University of Split, Faculty of Humanities and
3. during subsequent inhalation of xenon (FiXe 0.6).
Results: Paired t-test/Repeated measures ANOVA (Dunn sidak post-hoc test), Social Sciences, Department of Psychology, Split, Croatia
p<0.05.
Xenon application had no impact on Ptp (1.5±-41 vs 2.0±4, p=0.15). Background and Goal of Study:
While xenon reduced Cdyn (33.4±6 vs 30.8±6m-l1*mbar , p<0.001), Cstat re-
Postoperative cognitive dysfunction (POCD)
mained unchanged (43.2±9 vs 43.1±10ml*mbar , p=0.98).
is a very common complication after cardiac surgery. We focused on the role
The ventral shift of tidal volume and increased inhomogeneity of ventila-
of the inflammatory response to a surgical procedure as a potential factor
tion during mechanical ventilation (CGI 0.53±0,03 vs 0.60±0.03, p<0.05;
involved in the pathogenesis of POCD. The use of prophylactic corticosteroids
HCIo n0.c3l5u±si0o.n0:2 vs 0.38±0.03, p<0.05), remained unchanged by xenon (CGI
0.60±0.03, p=0.29; HI 0.37±0.03, p=0.99). tMo aattetreinaul aatned th Me einthflaomdsm:atory response was hypothesised to reduce the risk
The xenon-associated increase in Pmax is not associated with an of POCD.
This randomised, double-blind, placebo-controlled
increase in transpulmonary pressure, nor does xenon have any influence on
tidal volume distribution or homogeneity of ventilation. Hence, we could not trial enrolled 169 patients undergoing elective cardiac- 1surgery. Patients were
randomised to receive a single IV bolus of 0.1 mg kg dexamethasone (n =
identify any mechanisms potentially harming the lungs during xenon admin-
85) or placebo (n = 84) 10 hours before the surgery. The primary outcome
istration.
measure was the incidence of POCD on the 6th day after surgery. We used a
1. Anesthesiology 2015;122:1312-26 [2] Acta Anaesth Scand 1999;43:1060-4
validated battery of eight neuropsychological tests to assess cognitive func-
tions. POCD in an individual is defined as an Reliable Change Index equal to
BAPC-4 or less than -1.96 on at least one test.
We also evaluated the effect of dexamethasone on the incidence of systemic
Distribution of lung inflammation during assisted mechanical
iRneflasmulmtsa atonrdy D riesscpuosnssieo ns:y ndrome (SIRS), and postoperative C-reactive pro-
ventilation with titrated end-expiratory transpulmonary
tein (CRP) levels.
pressures in experimental acute respiratory distress syndrome The dexamethasone group showed statistically sig-
nificant reductions in the incidence of POCD (RR, 0.43; 95% CI, 0.21 to 0.89;
P = 0.02), the incidence of SIRS (30.0% vs. 58.0%, P <0.001), and postopera-
1 1 1 2 1 tive CRP levels (P <0.001). At the 6th day of follow-up, 9 of the 80 patients in
Kiss T., Bluth T., Braune A., Vivona L., Huhle R., the dexamethasone group (11.3%) and 21 of the 81 patients in the placebo
1Dresden University1, Dept of Anaesthesiology & Intensive Care,
Gama de Abreu M. group (25.9%) fulfilled the criteria fore Pt OaCl.D. Postoperative CRP levels are pre-
Dresden, Germany, 2University of Naples “Federico II”, Dept of
sented in Table.
Anaesthesiology & Intensive Care, Naples, Italy Contrary to the findings of Ottens our study found a beneficial effect
of preoperative administration of dexamethasone on the incidence of POCD.
Background and Goal of Study: Because corticosteroids may adversely affect cognitive function and to re-
duce inflammatory response in time, only a single low-dose of dexametha-
Evidence of lung injury due to spontane-
sone was used 10 hours before the surgery.
ous breathing activity (SB) in acute respiratory lung injury (ARDS) has been Dexamethasone group Placebo group
obtained during inappropriate settings of positive end-expiratory pressure
(PEEP) and artificially high respiratory drive.
In this study, we investigated the correlation between a PEEP setting based Serum
on transpulmonary pressure (TP) and assisted SB in experimental severe biomarker POD 1 POD 2 POD 3 POD 1 POD 2 POD 3
adult respiratory distress syndrome (ARDS) in pigs. (mg/L)
We hypothesized that in severe ARDS, 12 hours of assisted SB with titrated 53.6 176.6 220.7 87.9 241.8 255.8
positive end-expiratory TP levels in all lung regions, compared to a group with [CCRRPP lleevveells in th(e2 9d.e3x)ametha(s6o6n.1e) and pla(c6e9b.0o) groups(]38.6) (60.4) (63.6)
nMeagtaetriivael TaPn dv amlueetsh, ordesd:u ces lung inflammation measured by positron emis-
sion tomography (PET). Conclusion:
In 10 anesthetized pigs, custom-made intrapleural
Preoperative administration of dexamethasone reduced the in-
pressure sensors were placed in non-dependent and dependent lung regions
flammatory response and therefore decreased the risk of early POCD after
by video-assisted thoracoscopy. Experimental ARDS was induced by saline
lung lavage and injurious high tidal volume mechanical ventilation, until PaO2 cardiac surgery.