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Hedenstierna, GöranORCID iD iconorcid.org/0000-0002-2923-6012
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Publications (10 of 192) Show all publications
Bergmann, A., Jovanovska, E., Schilling, T., Hedenstierna, G., Follner, S., Schreiber, J. & Hachenberg, T. (2020). Early and late effects of remote ischemic preconditioning on spirometry and gas exchange in healthy volunteers. Respiratory Physiology & Neurobiology, 271, Article ID 103287.
Open this publication in new window or tab >>Early and late effects of remote ischemic preconditioning on spirometry and gas exchange in healthy volunteers
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2020 (English)In: Respiratory Physiology & Neurobiology, ISSN 1569-9048, E-ISSN 1878-1519, Vol. 271, article id 103287Article in journal (Refereed) Published
Abstract [en]

Purpose: Remote ischemic preconditioning (RIP) may protect remote organs from ischemia-reperfusion-injury (IRI) in surgical and non-surgical patients. There are few data available on RIP and lung function, especially not in healthy volunteers. The null-hypothesis was tested that RIP does not have an effect on pulmonary function when applied on healthy volunteers that were breathing spontaneously and did not experience any intervention. After approval of the Ethics Committee and informed consent of the study subjects, 28 healthy non-smoking volunteers were included and randomized in either the RIP group (n = 13) or the control group (n = 15). In the RIP group, lower limb ischemia was induced by inflation of a blood pressure cuff to a pressure 20 mmHg above the systolic blood pressure. After five minutes the blood pressure cuff was released for five minutes rest. The procedure was repeated three times resulting in 40 min ischemia and reperfusion. Capillary blood samples were taken, and lung function tests were performed at baseline (T1) and 60 min (T2) and 24 h (T3) after RIP. The control group was treated in the same fashion, but the RIP procedure was replaced by a sham protocol.

Results: 60 min after RIP capillary pO(2) decreased significantly and returned to baseline level after 24 h in the RIP group. This did not occur in the control group. Capillary pCO(2), variables of lung function tests and pulmonary capillary blood volume remained unchanged throughout the experiment in both groups.

Conclusion: Oxygenation is impaired early after RIP which is possibly induced by transient ventilation-perfusion inequality. No late effects of RIP were observed. The null hypothesis has to be rejected that RIP has no effect on respiratory variables in healthy volunteers.

Keywords
Remote ischemic preconditioning, Pulmonary function, Diffusion capacity, Pulmonary capillary volume, Gas exchange
National Category
Physiology Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-402012 (URN)10.1016/j.resp.2019.103287 (DOI)000500384200004 ()31494306 (PubMedID)
Available from: 2020-01-13 Created: 2020-01-13 Last updated: 2020-03-18Bibliographically approved
Hedenstierna, G., Tokics, L., Reinius, H., Rothen, H. U., Östberg, E. & Öhrvik, J. (2020). Higher age and obesity limit atelectasis formation during anaesthesia: an analysis of computed tomography data in 243 subjects. British Journal of Anaesthesia, 124(3), 336-344
Open this publication in new window or tab >>Higher age and obesity limit atelectasis formation during anaesthesia: an analysis of computed tomography data in 243 subjects
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2020 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 124, no 3, p. 336-344Article in journal (Refereed) Published
Abstract [en]

Background: General anaesthesia is increasingly common in elderly and obese patients. Greater age and body mass index (BMI) worsen gas exchange. We assessed whether this is related to increasing atelectasis during general anaesthesia.

Methods: This primary analysis included pooled data from previously published studies of 243 subjects aged 18-78 yr, with BMI of 18-52 kg m(-2). The subjects had no clinical signs of cardiopulmonary disease, and they underwent computed tomography (CT) awake and during anaesthesia before surgery after preoxygenation with an inspired oxygen fraction (FIO2) of >0.8, followed by mechanical ventilation with FIO2 of 0.3 or higher with no PEEP. Atelectasis was assessed by CT.

Results: Atelectasis area of up to 39 cm(2) in a transverse scan near the diaphragm was seen in 90% of the subjects during anaesthesia. The log of atelectasis area was related to a quadratic function of (age+age(2)) with the most atelectasis at similar to 50 yr (r(2)=0.08; P<0.001). Log atelectasis area was also related to a broken-line function of the BMI with the knee at 30 kg m(-2) (r(2)=0.06; P<0.001). Greater atelectasis was seen in the subjects receiving FIO2 of 1.0 than FIO2 of 0.3-0.5 (12.8 vs 8.1 cm(2); P<0.001). A multiple regression analysis, including a quadratic function of age, a broken-line function of the BMI, and dichotomised FIO2 (0.3-0.5/1.0) adjusting for ventilatory frequency, strengthened the association (r(2)= 0.23; P<0.001). PaO2 decreased with both age and BMI.

Conclusions: Atelectasis during general anaesthesia increased with age up to 50 yr and decreased beyond that. Atelectasis increased with BMI in normal and overweight patients, but showed no further increase in obese subjects (BMI >= 30 kg m(-2)). Therefore, greater age and obesity appear to limit atelectasis formation during general anaesthesia.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2020
Keywords
age, atelectasis, general anaesthesia, inspired oxygen, mechanical ventilation, obesity, pulmonary complications
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-407516 (URN)10.1016/j.bja.2019.11.026 (DOI)000514166800045 ()31918847 (PubMedID)
Available from: 2020-03-25 Created: 2020-03-25 Last updated: 2020-03-25Bibliographically approved
Cronin, J. N., Crockett, D. C., Farmery, A. D., Hedenstierna, G., Larsson, A., Camporota, L. & Formenti, F. (2020). Mechanical Ventilation Redistributes Blood to Poorly Ventilated Areas in Experimental Lung Injury*. Critical Care Medicine, 48(3), E200-E208
Open this publication in new window or tab >>Mechanical Ventilation Redistributes Blood to Poorly Ventilated Areas in Experimental Lung Injury*
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2020 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 48, no 3, p. E200-E208Article in journal (Refereed) Published
Abstract [en]

Objectives: Determine the intra-tidal regional gas and blood volume distributions at different levels of atelectasis in experimental lung injury. Test the hypotheses that pulmonary aeration and blood volume matching is reduced during inspiration in the setting of minimal tidal recruitment/derecruitment and that this mismatching is an important determinant of hypoxemia.

Design: Preclinical study.

Setting: Research laboratory.

Subjects: Seven anesthetized pigs 28.7 kg (sd, 2.1 kg).

Interventions: All animals received a saline-lavage surfactant depletion lung injury model. Positive end-expiratory pressure was varied between 0 and 20 cm H2O to induce different levels of atelectasis.

Measurements and Main Results: Dynamic dual-energy CT images of a juxtadiaphragmatic slice were obtained, gas and blood volume fractions within three gravitational regions calculated and normalized to lung tissue mass (normalized gas volume and normalized blood volume, respectively). Ventilatory conditions were grouped based upon the fractional atelectatic mass in expiration (< 20%, 20-40%, and >= 40%). Tidal recruitment/derecruitment with fractional atelectatic mass in expiration greater than or equal to 40% was less than 7% of lung mass. In this group, inspiration-related increase in normalized gas volume was greater in the nondependent (818 mu L/g [95% CI, 729-908 mu L/g]) than the dependent region (149 mu L/g [120-178 mu L/g]). Normalized blood volume decreased in inspiration in the nondependent region (29 mu L/g [12-46 mu L/g]) and increased in the dependent region (39 mu L/g [30-48 mu L/g]). Inspiration-related changes in normalized gas volume and normalized blood volume were negatively correlated in fractional atelectatic mass in expiration greater than or equal to 40% and 20-40% groups (r(2) = 0.56 and 0.40), but not in fractional atelectatic mass in expiration less than 20% group (r(2) = 0.01). Both the increase in normalized blood volume in the dependent region and fractional atelectatic mass in expiration negatively correlated with Pao(2)/Fio(2) ratio (rho = -0.77 and -0.93, respectively).

Conclusions: In experimental atelectasis with minimal tidal recruitment/derecruitment, mechanical inspiratory breaths redistributed blood volume away from well-ventilated areas, worsening Pao(2)/Fio(2).

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2020
Keywords
pulmonary circulation, respiratory distress syndrome, adult, tomography, x-ray computed, ventilation-perfusion ratio, ventilator-induced lung injury, swine
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-408532 (URN)10.1097/CCM.0000000000004141 (DOI)000518037000003 ()31809278 (PubMedID)
Funder
Swedish Heart Lung FoundationWellcome trust, HMRXGK00
Available from: 2020-04-09 Created: 2020-04-09 Last updated: 2020-04-09Bibliographically approved
Borges, J. B., Cronin, J. N., Crockett, D. C., Hedenstierna, G., Larsson, A. & Formenti, F. (2020). Real-time effects of PEEP and tidal volume on regional ventilation and perfusion in experimental lung injury. Intensive Care Medicine Experimental, 8(1), Article ID 10.
Open this publication in new window or tab >>Real-time effects of PEEP and tidal volume on regional ventilation and perfusion in experimental lung injury
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2020 (English)In: Intensive Care Medicine Experimental, ISSN 1646-2335, E-ISSN 2197-425X, Vol. 8, no 1, article id 10Article in journal (Refereed) Published
Abstract [en]

Background Real-time bedside information on regional ventilation and perfusion during mechanical ventilation (MV) may help to elucidate the physiological and pathophysiological effects of MV settings in healthy and injured lungs. We aimed to study the effects of positive end-expiratory pressure (PEEP) and tidal volume (V-T) on the distributions of regional ventilation and perfusion by electrical impedance tomography (EIT) in healthy and injured lungs. Methods One-hit acute lung injury model was established in 6 piglets by repeated lung lavages (injured group). Four ventilated piglets served as the control group. A randomized sequence of any possible combination of three V-T (7, 10, and 15 ml/kg) and four levels of PEEP (5, 8, 10, and 12 cmH(2)O) was performed in all animals. Ventilation and perfusion distributions were computed by EIT within three regions-of-interest (ROIs): nondependent, middle, dependent. A mixed design with one between-subjects factor (group: intervention or control), and two within-subjects factors (PEEP and V-T) was used, with a three-way mixed analysis of variance (ANOVA). Results Two-way interactions between PEEP and group, and V-T and group, were observed for the dependent ROI (p = 0.035 and 0.012, respectively), indicating that the increase in the dependent ROI ventilation was greater at higher PEEP and V-T in the injured group than in the control group. A two-way interaction between PEEP and V-T was observed for perfusion distribution in each ROI: nondependent (p = 0.030), middle (p = 0.006), and dependent (p = 0.001); no interaction was observed between injured and control groups. Conclusions Large PEEP and V-T levels were associated with greater pulmonary ventilation of the dependent lung region in experimental lung injury, whereas they affected pulmonary perfusion of all lung regions both in the control and in the experimental lung injury groups.

Place, publisher, year, edition, pages
SPRINGEROPEN, 2020
Keywords
Respiratory distress syndrome, Adult, Mechanical ventilation, Electrical impedance tomography, Pulmonary circulation, Ventilation-perfusion ratio
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-407604 (URN)10.1186/s40635-020-0298-2 (DOI)000515332600001 ()32086632 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20170531Swedish Research Council, K2015-99X-2273101-4
Available from: 2020-04-06 Created: 2020-04-06 Last updated: 2020-04-06Bibliographically approved
Crockett, D. C., Tran, M. C., Formenti, F., Cronin, J. N., Hedenstierna, G., Larsson, A., . . . Farmery, A. D. (2020). Validating the inspired sinewave technique to measure the volume of the 'baby lung' in a porcine lung-injury model. British Journal of Anaesthesia, 124(3), 345-353
Open this publication in new window or tab >>Validating the inspired sinewave technique to measure the volume of the 'baby lung' in a porcine lung-injury model
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2020 (English)In: British Journal of Anaesthesia, ISSN 0007-0912, E-ISSN 1471-6771, Vol. 124, no 3, p. 345-353Article in journal (Refereed) Published
Abstract [en]

Background: Bedside lung volume measurement could personalise ventilation and reduce driving pressure in patients with acute respiratory distress syndrome (ARDS). We investigated a modified gas-dilution method, the inspired sinewave technique (IST), to measure the effective lung volume (ELV) in pigs with uninjured lungs and in an ARDS model. Methods: Anaesthetised mechanically ventilated pigs were studied before and after surfactant depletion by saline lavage. Changes in PEEP were used to change ELV. Paired measurements of absolute ELV were taken with IST (ELVIST) and compared with gold-standard measures (sulphur hexafluoride wash in/washout [ELVSF6] and computed tomography (CT) [ELVCT]). Measured volumes were used to calculate changes in ELV (Delta ELV) between PEEP levels for each method (Delta ELVIST, Delta ELVSF6, and Delta ELVCT). Results: The coefficient of variation was <5% for repeated ELVIST measurements (n=13 pigs). There was a strong linear relationship between ELVIST and ELVSF6 in uninjured lungs (r(2)=0.97), and with both ELVSF6 and ELVCT in the ARDS model (r(2)=0.87 and 0.92, respectively). ELVIST had a mean bias of -12 to 13% (95% limits=+/- 17 - 25%) compared with ELVSF6 and ELVCT. Delta ELVIST was concordant with Delta ELVSF6 and Delta ELVCT in 98-100% of measurements, and had a mean bias of -73 to -77 ml (95% limits=+/- 128 - 186 ml) compared with Delta ELVSF6 and -1 ml (95% limits +/- 333 ml) compared with Delta ELVCT. Conclusions: IST provides a repeatable measure of absolute ELV and shows minimal bias when tracking PEEP-induced changes in lung volume compared with CT in a saline-lavage model of ARDS.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2020
Keywords
ARDS, computed tomography, inspired sinewave technique, lung volume measurement, method comparison
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-407607 (URN)10.1016/j.bja.2019.11.030 (DOI)000514166800046 ()31952649 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20170531Swedish Research Council, K2015-99X-2273101-4
Available from: 2020-04-01 Created: 2020-04-01 Last updated: 2020-04-01Bibliographically approved
Marchesi, S., Ortiz-Nieto, F., Ahlgren, K. M., Roneus, A., Feinstein, R., Lipcsey, M., . . . Hedenstierna, G. (2019). Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study. American Journal of Physiology - Gastrointestinal and Liver Physiology, 316(1), G187-G196
Open this publication in new window or tab >>Abdominal organ perfusion and inflammation in experimental sepsis: a magnetic resonance imaging study
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2019 (English)In: American Journal of Physiology - Gastrointestinal and Liver Physiology, ISSN 0193-1857, E-ISSN 1522-1547, Vol. 316, no 1, p. G187-G196Article in journal (Refereed) Published
Abstract [en]

Diffusion-weighted magnetic resonance imaging (DW-MRI) uses water as contrast and enables the study of perfusion in many organs simultaneously in situ. We used DW-MRI in a sepsis model, comparing abdominal organs perfusion with global hemodynamic measurements and inflammation. Sixteen anesthetized piglets were randomized into 3 groups: HighMAP (mean arterial pressure, MAP > 65 mmHg), LowMAP (MAP between 50 and 60 mmHg) and Healthy Controls (HC). Sepsis was obtained with endotoxin and the desired MAP maintained with noradrenaline. After 6 hours DW-MRI was performed. Acute inflammation was assessed with IL-6 and TNFα in abdominal organs, ascites, and blood and by histology of intestine (duodenum). Perfusion of abdominal organs was reduced in the LowMAP group compared to the HighMAP group and HC. Liver perfusion was still reduced by 25% in the HighMAP group compared with HC. Intestinal perfusion did not differ significantly between the study groups. Cytokines concentration were generally higher in the LowMAP group but did not correlate with global hemodynamics. However, cytokines correlated with regional perfusion and, for liver and intestine, also with intra-abdominal pressure. Histopathology of intestine worsened with decreasing perfusion. In conclusion, although a low MAP (≤60 mmHg) indicated impeded abdominal perfusion in experimental sepsis, it did not predict inflammation, nor did other global measures of circulation. Decreased abdominal perfusion predicted partially inflammation but intestine, occupying most of the abdomen, and liver, were also affected by intra-abdominal pressure.

Keywords
Abdominal organs, inflammation, magnetic resonance, perfusion, sepsis
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-364356 (URN)10.1152/ajpgi.00151.2018 (DOI)000455670700012 ()30335473 (PubMedID)
Funder
Swedish Heart Lung FoundationSwedish Research Council
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-02-05Bibliographically approved
Cronin, J. N., Borges, J. B., Crockett, D. C., Farmery, A. D., Hedenstierna, G., Larsson, A., . . . Formenti, F. (2019). Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury. Intensive Care Medicine Experimental, 7(1), Article ID 59.
Open this publication in new window or tab >>Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury
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2019 (English)In: Intensive Care Medicine Experimental, ISSN 1646-2335, E-ISSN 2197-425X, Vol. 7, no 1, article id 59Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Dynamic single-slice CT (dCT) is increasingly used to examine the intra-tidal, physiological variation in aeration and lung density in experimental lung injury. The ability of dCT to predict whole-lung values is unclear, especially for dual-energy CT (DECT) variables. Additionally, the effect of inspiration-related lung movement on CT variables has not yet been quantified.

METHODS: Eight domestic pigs were studied under general anaesthesia, including four following saline-lavage surfactant depletion (lung injury model). DECT, dCT and whole-lung images were collected at 12 ventilatory settings. Whole-lung single energy scans images were collected during expiratory and inspiratory apnoeas at positive end-expiratory pressures from 0 to 20 cmH2O. Means and distributions of CT variables were calculated for both dCT and whole-lung images. The cranio-caudal displacement of the anatomical slice was measured from whole-lung images.

RESULTS: Mean CT density and volume fractions of soft tissue, gas, iodinated blood, atelectasis, poor aeration, normal aeration and overdistension correlated between dCT and the whole lung (r2 0.75-0.94) with agreement between CT density distributions (r 0.89-0.97). Inspiration increased the matching between dCT and whole-lung values and was associated with a movement of 32% (SD 15%) of the imaged slice out of the scanner field-of-view. This effect introduced an artefactual increase in dCT mean CT density during inspiration, opposite to that caused by the underlying physiology.

CONCLUSIONS: Overall, dCT closely approximates whole-lung aeration and density. This approximation is improved by inspiration where a decrease in CT density and atelectasis can be interpreted as physiological rather than artefactual.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Acute lung injury, Artificial, Contrast media, Respiration, Swine, Tomography, X-ray computed
National Category
Anesthesiology and Intensive Care Radiology, Nuclear Medicine and Medical Imaging
Research subject
Physiology
Identifiers
urn:nbn:se:uu:diva-405361 (URN)10.1186/s40635-019-0273-y (DOI)000515113800001 ()31676929 (PubMedID)
Funder
Swedish Heart Lung Foundation, 20170531Swedish Research Council, K2015-99X-2273101-4
Available from: 2020-02-27 Created: 2020-02-27 Last updated: 2020-03-25Bibliographically approved
Broche, L., Pisa, P., Porra, L., Degrugilliers, L., Bravin, A., Pellegrini, M., . . . Bayat, S. (2019). Individual Airway Closure Characterized In Vivo by Phase-Contrast CT Imaging in Injured Rabbit Lung. Critical Care Medicine, 47(9), E774-E781
Open this publication in new window or tab >>Individual Airway Closure Characterized In Vivo by Phase-Contrast CT Imaging in Injured Rabbit Lung
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2019 (English)In: Critical Care Medicine, ISSN 0090-3493, E-ISSN 1530-0293, Vol. 47, no 9, p. E774-E781Article in journal (Refereed) Published
Abstract [en]

Objectives: Airway closure is involved in adverse effects of mechanical ventilation under both general anesthesia and in acute respiratory distress syndrome patients. However, direct evidence and characterization of individual airway closure is lacking. Here, we studied the same individual peripheral airways in intact lungs of anesthetized and mechanically ventilated rabbits, at baseline and following lung injury, using high-resolution synchrotron phase-contrast CT.

Design: Laboratory animal investigation.

Setting: European synchrotron radiation facility.

Subjects: Six New-Zealand White rabbits.

Interventions: The animals were anesthetized, paralyzed, and mechanically ventilated in pressure-controlled mode (tidal volume, 6 mL/kg; respiratory rate, 40; Fio(2), 0.6; inspiratory:expiratory, 1:2; and positive end-expiratory pressure, 3 cm H2O) at baseline. Imaging was performed with a 47.5 x 47.5 x 47.5 mu m voxel size, at positive end-expiratory pressure 12, 9, 6, 3, and 0 cm H2O. The imaging sequence was repeated after lung injury induced by whole-lung lavage and injurious ventilation in four rabbits. Cross-sections of the same individual airways were measured.

Measurements and Main Results: The airways were measured at baseline (n = 48; radius, 1.7 to 0.21 mm) and after injury (n = 32). Closure was observed at 0 cm H2O in three of 48 airways (6.3%; radius, 0.350.08 mm at positive end-expiratory pressure 12) at baseline and five of 32 (15.6%; radius, 0.28 +/- 0.09 mm) airways after injury. Cross-section was significantly reduced at 3 and 0 cm H2O, after injury, with a significant relation between the relative change in cross-section and airway radius at 12 cm H2O in injured, but not in normal lung (R = 0.60; p < 0.001).

Conclusions: Airway collapsibility increases in the injured lung with a significant dependence on airway caliber. We identify "compliant collapse" as the main mechanism of airway closure in initially patent airways, which can occur at more than one site in individual airways.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2019
Keywords
airway closure, mechanical ventilation, phase-contrast imaging, respiratory distress syndrome, adult, tomography, x-ray computed, ventilator-induced lung injury
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-394204 (URN)10.1097/CCM.0000000000003838 (DOI)000484224200007 ()31162202 (PubMedID)
Available from: 2019-10-04 Created: 2019-10-04 Last updated: 2019-10-04Bibliographically approved
Hedenstierna, G., Meyhoff, C. S., Perchiazzi, G., Larsson, A., Wetterslev, J. & Rasmussen, L. S. (2019). Modification of the World Health Organization Global Guidelines for Prevention of Surgical Site Infection Is Needed. Anesthesiology, 131(4), 765-768
Open this publication in new window or tab >>Modification of the World Health Organization Global Guidelines for Prevention of Surgical Site Infection Is Needed
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2019 (English)In: Anesthesiology, ISSN 0003-3022, E-ISSN 1528-1175, Vol. 131, no 4, p. 765-768Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-396468 (URN)10.1097/ALN.0000000000002848 (DOI)000489733000004 ()31246605 (PubMedID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-14Bibliographically approved
Hedenstierna, G. & Meyhoff, C. S. (2019). Oxygen toxicity in major emergency surgery-anything new?. Intensive Care Medicine, 45(12)
Open this publication in new window or tab >>Oxygen toxicity in major emergency surgery-anything new?
2019 (English)In: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 45, no 12Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2019
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:uu:diva-401996 (URN)10.1007/s00134-019-05787-8 (DOI)000503066300005 ()31599335 (PubMedID)
Available from: 2020-01-10 Created: 2020-01-10 Last updated: 2020-01-10Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0002-2923-6012

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