TY - JOUR AU - Appleton, Jason P. AU - Woodhouse, Lisa J. AU - Bereczki, Dániel AU - Berge, Eivind AU - Christensen, Hanne K. AU - Collins, Rónán AU - Gommans, John AU - Ntaios, George AU - Ozturk, Serefnur AU - Szatmári, Szilárd Attila AU - Wardlaw, Joanna M. AU - Sprigg, Nikola AU - Rothwell, Peter M. AU - Bath, Philip M. TI - Effect of Glyceryl Trinitrate on Hemodynamics in Acute Stroke JF - STROKE J2 - STROKE VL - 50 PY - 2019 IS - 2 SP - 405 EP - 412 PG - 8 SN - 0039-2499 DO - 10.1161/STROKEAHA.118.023190 UR - https://m2.mtmt.hu/api/publication/30688072 ID - 30688072 LA - English DB - MTMT ER - TY - JOUR AU - Vaskó, Attila AU - Siró, Péter AU - László, István AU - Szatmári, Szilárd Attila AU - Molnár, Levente AU - Fülesdi, Béla AU - Molnár, Csilla TI - Assessment of cerebral tissue oxygen saturation in septic patients during acetazolamide provocation — A near infrared spectroscopy study JF - ACTA PHYSIOLOGICA HUNGARICA J2 - ACTA PHYSIOL HUNG VL - 101 PY - 2014 IS - 1 SP - 32 EP - 39 PG - 8 SN - 0231-424X DO - 10.1556/APhysiol.101.2014.1.4 UR - https://m2.mtmt.hu/api/publication/2558242 ID - 2558242 AB - Sepsis-associated encephalopathy is a multifactorially determined process of the brain parenchyma. Among other factors, vasogenic causes have been shown to play a role in its development. The aim of the present work was to assess whether cerebral tissue oxygen saturation is influenced by administration of acetazolamide in septic patients compared to controls. LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Véghné Juhász, Marianna Beáta AU - Szatmári, Szilárd Attila AU - Enyedi, Attila AU - Sessler, Daniel I. AU - Szegedi, László AU - Fülesdi, Béla TI - Reply to "Further studies should compare the different tidal volume with adjusted PEEP levels at the same time of anesthesia JF - MINERVA ANESTESIOLOGICA J2 - MINERVA ANESTESIOL VL - 79 PY - 2013 IS - 6 SP - 696 EP - 696 PG - 1 SN - 0375-9393 UR - https://m2.mtmt.hu/api/publication/30460483 ID - 30460483 N1 - 172206 LA - English DB - MTMT ER - TY - JOUR AU - Pongrácz, Adrienn AU - Szatmári, Szilárd Attila AU - Nemes, Réka AU - Fülesdi, Béla AU - Tassonyi, Edömér TI - Reversal of Neuromuscular Blockade with Sugammadex at the Reappearance of Four Twitches to Train-of-four Stimulation JF - ANESTHESIOLOGY J2 - ANESTHESIOLOGY VL - 119 PY - 2013 IS - 1 SP - 36 EP - 42 PG - 7 SN - 0003-3022 DO - 10.1097/ALN.0b013e318297ce95 UR - https://m2.mtmt.hu/api/publication/2319024 ID - 2319024 AB - Abstract Background: Doses of sugammadex required to reverse deep, moderate, and shallow rocuronium-induced neuromuscular blockade have been established. However, no adequate doses for the reversal of reappearance of four twitches of train-of-four (TOF) stimulation (threshold TOF-count-four) have been established. Methods: This single-center, randomized, controlled, double- blind, four-groups parallel-arm study included 80 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and rocuronium. Neuromuscular monitoring was performed with calibrated acceleromyography. Once rocuronium-induced neuromuscular blockade recovered spontaneously to threshold TOF- count-four, patients randomly received 0.5, 1.0, 2.0 mg/kg of sugammadex or 0.05 mg/kg of neostigmine. The time between study drug injection and reversal of TOF ratios to 1.0 was measured. Rapid reversal (<=2.0 min average, upper limit of 5.0 min) was the primary endpoint and slower reversal (<=5.0 min average, upper limit of 10 min) was the secondary endpoint of the study. Results: Sugammadex, in doses of 1.0 and 2.0 mg/kg, reversed threshold TOF-count-four to TOF ratios of 1.0 in 2.1 +/- 0.8 min (mean +/- SD) and 1.8 +/- 0.9 min, respectively. Sugammadex, 0.5 mg/kg, induced a similar degree of reversal in 4.1 +/- 1.9 min (P < 0.001 vs. 1.0 and 2.0 mg/kg). Neostigmine, 0.05 mg/kg, reversed TOF ratios to 1.0 in 8.5 +/- 3.5 min (P < 0.001 vs. sugammadex groups). Conclusion: Sugammadex, 1.0 mg/kg, rapidly and effectively reverses rocuronium-induced block that has recovered spontaneously to a threshold TOF-count-four. A dose of 0.5 mg/kg was equally effective, but satisfactory antagonism took as long as 8 min to take place. (C) 2013 American Society of Anesthesiologists, Inc. LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Véghné Juhász, Marianna Beáta AU - Szatmári, Szilárd Attila AU - Enyedi, Attila AU - Sessler, DI AU - Szegedi, LL AU - Fülesdi, Béla TI - Effects of different tidal volumes for one-lung ventilation on oxygenation with open chest condition and surgical manipulation: a randomised cross-over trial. JF - MINERVA ANESTESIOLOGICA J2 - MINERVA ANESTESIOL VL - 79 PY - 2013 IS - 1 SP - 24 EP - 32 PG - 9 SN - 0375-9393 UR - https://m2.mtmt.hu/api/publication/2275990 ID - 2275990 N1 - 160126 AB - BACKGROUND: The ideal tidal volume (TV) during one-lung ventilation (OLV) remains controversial. High TVs may increase the incidence of postoperative lung injury after thoracic surgery. There is nonetheless little evidence that the use of low TV during OLV will fail to provide adequate arterial oxygenation. We evaluated the influence of low (5 mL/kg-1) and high (10 mL/kg-1) TV on arterial oxygenation during one-lung ventilation in clinical conditions. METHODS: A hundred patients scheduled for lung surgery were studied. Patients were randomly assigned to either 30 minutes of one-lung ventilation with a TV of 10 mL/kg-1 at a rate of 10 breaths/minute (Group 10, N.=50) or a TV of 5 mL/kg-1 with 5 cmH2O PEEP at a rate of 20 breaths/minute (Group 5, N.=50). According to the rules of crossover design during the subsequent 30 minutes, each patient received the alternative management. Arterial blood partial pressures, hemodynamic responses, and ventilatory parameters were recorded. Results are presented as means +/- SDs; P<0.05 was considered statistically significant. RESULTS: PaO2 was unaffected by TV (10 mL/kg-1: 218+/-106 versus 5 mL/kg-1: 211+/-119 mmHg, P=0.29). Calculated intrapulmonary shunt fraction was also similar with each TV during OLV (5 mL/kg-1: 25+/-9% versus 10 mL/kg-1: 24+/-8%, p=0.14). In contrast, low TV significantly increased PaCO2 (10 mL/kg-1: 39+/-6 versus 5 mL/kg-1: 44+/-8 mmHg, P<0.001). There were significant differences both in peak (10 mL/kg-1: 27+/-6 versus 5 mL/kg-1: 21+/-5 cmH2O, P<0.001) and plateau airway pressure values (10 mL/kg-1: 22+/-6 versus 5 mL/kg-1: 18+/-5 cmH2O, P<0.001) during OLV. CONCLUSION: Low TV (5 mL/kg-1) accompanied by 5 cmH2O PEEP provides comparable arterial oxygenation and intrapulmonary shunt fraction during one-lung ventilation as higher TV (10 mL/kg-1) without PEEP. LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Szatmári, Szilárd Attila AU - Véghné Juhász, Marianna Beáta AU - László, István AU - Vaskó, Attila AU - Takács, István AU - L, Szegedi AU - Fülesdi, Béla TI - One-lung ventilation does not result in cerebral desaturation during application of lung protective strategy if normocapnia is maintained JF - ACTA PHYSIOLOGICA HUNGARICA J2 - ACTA PHYSIOL HUNG VL - 100 PY - 2013 IS - 2 SP - 163 EP - 172 PG - 10 SN - 0231-424X DO - 10.1556/APhysiol.100.2013.003 UR - https://m2.mtmt.hu/api/publication/2271187 ID - 2271187 AB - Background: Previously a report has suggested that administration of lung protective strategy for one-lung ventilation (OLV) results in oxygen desaturation of the brain parenchyma. The aim of our work was to confirm that the maintenance of normocapnia during protective OLV strategy results in alteration of cerebral blood flow and cerebral oxygen saturation as compared to double-lung ventilation. Methods: Data were obtained from 24 patients undergoing thoracic surgery. Cerebral oxygen saturation (rSO(2)) was continuously monitored by INVOS 5100C Cerebral Oxymeter System along with measurement of cerebral blood flow velocity (MCAV) by transcranial Doppler sonography. Arterial blood samples were taken for blood gas analysis in the awake state, in the supine and lateral decubitus position during double-lung ventilation (DLV), and during OLV. Results: When ventilation was changed from DLV to OLV, no significant change was observed in rSO(2). A significant decrease of rSO(2) was found compared to the value observed during DLV in lateral decubitus at the time point 60 minutes after the start of OLV. No clinically significant changes in the MCAV was observed throughout the course of the thoracic surgical procedure. Conclusions: OLV does not result in clinically relevant decreases in cerebral blood flow and cerebral oxygen saturation during application of lung protective ventilation if normocapnia is maintained. LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Véghné Juhász, Marianna Beáta AU - Szatmári, Szilárd Attila AU - Enyedi, Attila AU - D I, Sessler AU - Szegedi, L L AU - Fülesdi, Béla TI - A magas és alacsony légzési térfogat hatása az artériás oxigenizációra és intrapulmonális shunt frakcióra egytüdős lélegeztetés során: randomizált crossover vizsgálat JF - ANESZTEZIOLÓGIA ÉS INTENZÍV TERÁPIA J2 - ANESZTEZIOLÓGIA INTENZÍV TERÁPIA VL - 42 PY - 2012 IS - 2 SP - 85 EP - 89 PG - 5 SN - 0133-5405 UR - https://m2.mtmt.hu/api/publication/2454455 ID - 2454455 N1 - 172212 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Fülesdi, Béla AU - Szatmári, Szilárd Attila AU - Antek, C AU - Fülep, Z AU - Sárkány, Péter AU - Csiba, László AU - Molnár, Csilla TI - Cerebral vasoreactivity to acetazolamide is not impaired in patients with severe sepsis JF - JOURNAL OF CRITICAL CARE J2 - J CRIT CARE VL - 27 PY - 2012 IS - 4 SP - 337 EP - 343 PG - 7 SN - 0883-9441 DO - 10.1016/j.jcrc.2011.11.002 UR - https://m2.mtmt.hu/api/publication/2022685 ID - 2022685 AB - Introduction: The pathophysiology of sepsis-associated encephalopathy (SAE) is not entirely clear, but one of the possible underlying mechanisms is the alteration of the cerebral microvascular function. The aim of the present work was to test whether cerebral vasomotor reactivity is impaired in patients with severe sepsis. Methods: Patients fulfilling the criteria of clinical sepsis and showing at least 2 organ dysfunctions were included (n = 16). Nonseptic healthy persons without previous diseases affecting cerebral vasoreactivity served as controls (n = 16). Transcranial Doppler blood flow velocities were measured at rest and at 5, 10, 15, and 20 minutes after intravenous administration of 15 mg/kg acetazolamide. The time course of the acetazolamide effect on cerebral blood flow velocity (cerebrovascular reactivity [CVR]) and the maximal vasodilatory effect of acetazolemide (cerebrovascular reserve capacity [CRC]) were compared among the groups. Results: Absolute blood flow velocities after administration of the vasodilator drug did not differ between control and septic patients. Assessment of the time course of the vasomotor reaction showed that patients with sepsis reacted in a similar fashion to the vasodilatory stimulus than control persons. When assessing the maximal vasodilatory ability of the cerebral arterioles to acetazolamide during vasomotor testing, we found that there was no difference in vasodilatory ability between septic and healthy subjects (CRC controls, 54.8% ± 11.1%; CRC sepsis-associated encephalopathy, 61.1% ± 34.4%; P = .49). Conclusions: We conclude that cerebrovascular reactivity is not impaired in patients with severe sepsis. It is conceivable that cerebral vasoreactivity may be differently involved at different severity stages of the septic process. © 2011 Elsevier Inc. All rights reserved. LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Szabó-Maák, Z AU - Szatmári, Szilárd Attila AU - Hallay, Judit AU - László, István AU - Takács, István AU - Fülesdi, Béla TI - Impact of normocapnic and permissive hypercapnic one-lung ventilation on arterial oxygenation (P175) JF - CRITICAL CARE J2 - CRIT CARE VL - 15 PY - 2011 IS - (Suppl 1) PG - 1 SN - 1364-8535 DO - 10.1186/cc9595 UR - https://m2.mtmt.hu/api/publication/2559635 ID - 2559635 N1 - 110569 LA - English DB - MTMT ER - TY - JOUR AU - Végh, Tamás AU - Véghné Juhász, Marianna Beáta AU - Szatmári, Szilárd Attila AU - Enyedi, Attila AU - Szegedi, László AU - Fülesdi, Béla TI - Effects of high and low tidal volumes on oxygenation during one-lung ventilation: Is less more? (O-50) JF - JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA J2 - J CARDIOTHOR VASC AN VL - 25 PY - 2011 IS - Suppl. 3 SP - S21 EP - S22 SN - 1053-0770 DO - 10.1053/j.jvca.2011.03.063 UR - https://m2.mtmt.hu/api/publication/2559631 ID - 2559631 LA - English DB - MTMT ER -