• Activation of Coagulation and Fibrinolysis in Acute Respiratory Distress Syndrome: A Prospective Pilot Study 

      Ozolina, Agnese; Sarkele, Marina; Sabelnikovs, Olegs; Skesters, Andrejs; Jaunalksne, Inta; Serova, Jelena; Ievins, Talins; Bjertnæs, Lars J.; Vanags, Indulis (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-11-28)
      Introduction: Coagulation and fibrinolysis remain sparsely addressed with regards to acute respiratory distress syndrome (ARDS). We hypothesized that ARDS development might be associated with changes in plasma coagulation and fibrinolysis. Our aim was to investigate the relationships between ARDS diagnosis and plasma concentrations of tissue factor (TF), tissue plasminogen activator (t-PA), and ...
    • Comparison of Goal-Directed Hemodynamic Optimization using Pulmonary Artery Catheter and Transpulmonary Thermodilution in Combined Valve Repair: A Randomized Clinical Trial 

      Lenkin, A; Kirov, Mikhail; Kuzkov, Vsevolod; Paromov, KV; Smetkin, Alexey Anatolievich; Lie, Mons; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      Our aim was to compare the effects of goal-directed therapy guided either by pulmonary artery catheter (PAC) or by transpulmonary thermodilution (TTD) combined with monitoring of oxygen transport on perioperative hemodynamics and outcome after complex elective valve surgery. Measurements and Main Results. Forty patients were randomized into two equal groups: a PAC group and a TTD group. In the ...
    • Controversial treatment of a victim of severe head injury complicated by septic shock and acute respiratory distress syndrome 

      Haavind, Anniken; Hevrøy, Olav; Hennig, rune; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      Pneumonia, severe sepsis, and acute respiratory distress syndrome (ARDS) are frequent complications after head trauma. Recombinant human activated protein C (APC) reportedly improves circulation and respiration in severe sepsis, but is contraindicated after head injury because of increased risk of intracranial bleeding. A 21-year-old man with severe head injury after a car accident was endotracheally ...
    • Derecruitment Test and Surfactant Therapy in Patients with Acute Lung Injury. 

      Smetkin, Alexey Anatolievich; Kuzkov, Vsevolod; Gaidukov, Konstantin M; Bjertnæs, Lars J.; Kirov, Mikhail (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      A recruitment maneuver (RM) may improve gas exchange in acute lung injury (ALI). The aim of our study was to assess the predictive value of a derecruitment test in relation to RM and to evaluate the efficacy of RM combined with surfactant instillation in patients with ALI. Materials and Methods. Thirteen adult mechanically ventilated patients with ALI were enrolled into a prospective pilot study. ...
    • Development and validation of the Efficacy Safety Score (ESS), a novel tool for postoperative patient management 

      Skraastad, Erlend Johan; Ræder, Johan; Dahl, Vegard; Bjertnæs, Lars J.; Kuklin, Vladimir (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-03-28)
      Background: <br> Several reports have shown that postoperative monitoring of general safety and quality issues, including pain treatment, after discharge from recovery is often non-systematic and inadequate. We suggest a new score with assessment of key recovery parameters, as a supportive tool for postoperative care and a call-out algorithm for need of extra help. The aim of this investigation ...
    • Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs 

      Halsøy, Kathrine; Kondratyev, Timofey; Tveita, Torkjel; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-12-23)
      Victims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic- isolated blood-perfused rat lungs whether perfusion at constant ...
    • Epidural anesthesia and postoperative analgesia with ropivacaine and fentanyl in off-pump coronary artery bypass grafting: a randomized, controlled study 

      Kirov, Mikhail; Eremeev, Alexey; Smetkin, Alexey Anatolievich; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      Our aim was to assess the efficacy of thoracic epidural anesthesia (EA) followed by postoperative epidural infusion (EI) and patient-controlled epidural analgesia (PCEA) with ropivacaine/fentanyl in off-pump coronary artery bypass grafting (OPCAB). In a prospective study, 93 patients were scheduled for OPCAB under propofol/fentanyl anesthesia and randomized to three postoperative analgesia regimens ...
    • Extravascular lung water assessed by transpulmonary single thermodilution and postmortem gravimetry in sheep 

      Kirov, Mikhail Y.; Kuzkov, Vsevolod V.; Kuklin, Vladimir N.; Wærhaug, Kristine; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2004-10-19)
      Introduction: Acute lung injury is associated with accumulation of extravascular lung water (EVLW). The aim of the present study was to compare two methods for quantification of EVLW: transpulmonary single thermodilution (EVLWST) and postmortem gravimetric (EVLWG). Methods: Eighteen instrumented and awake sheep were randomly assigned to one of three groups. All groups received Ringer's ...
    • Hypothermic cardiac arrest far away from the center providing rewarming with extracorporeal circulation. 

      Mark, Eckhard; Jacobsen, Olaf; Kjerstad, Astrid Kristine; Næsheim, Torvind; Busund, Rolf; Bahar, Ramez; Jensen, Jon Kjetil; Skorpen, Per Kristian; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      A 41-year-old man suffered hypothermic cardiac arrest after water immersion and was transported to our university hospital by ambulance helicopter for rewarming on cardiopulmonary bypass. He resumed spontaneous cardiac activity 6 h 52 min after cardiac arrest and recovered completely.
    • Increased Extravascular Lung Water reduces the Efficacy of Alveolar Recruitment Maneuver in Acute Respiratory Distress Syndrome. 

      Smetkin, Alexey Anatolievich; Kuzkov, Vsevolod; Suborov, Evgeny; Bjertnæs, Lars J.; Kirov, Mikhail (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      In acute respiratory distress syndrome (ARDS) the recruitment maneuver (RM) is used to reexpand atelectatic areas of the lungs aiming to improve arterial oxygenation. The goal of our paper was to evaluate the response to RM, as assessed by measurements of extravascular lung water index (EVLWI) in ARDS patients. Materials and Methods. Seventeen adult ARDS patients were enrolled into a prospective ...
    • Inhaled aerosolised recombinant human activated protein C ameliorates endotoxin-induced lung injury in anaesthetised sheep 

      Wærhaug, Kristine; Mortensen, Rica; Nordhus, Kåre C.; Kuzkov, Vsevolod V.; Kuklin, Vladimir N.; Kirov, Mikhail Y.; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2009-04-08)
      Introduction We recently demonstrated that intravenously infused recombinant human activated protein C (APC) attenuates ovine lipopolysaccharide (LPS)-induced lung injury. In this study, our aim was to find out whether treatment with inhaled aerosolised APC (inhAPC) prevents formation of increased lung densities and oedema and derangement of oxygenation during exposure to LPS. <br> Methods: ...
    • Inhibitor of neuronal nitric oxide synthase improves gas exchange in ventilator-induced lung injury after pneumonectomy. 

      Suborov, Evgeny; Smetkin, Alexey Anatolievich; Kondratyev, Timofey; Valkov, Andrey Yurjevich; Kuzkov, Vsevolod; Kirov, Mikhail; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      Mechanical ventilation with high tidal volumes may cause ventilator-induced lung injury (VILI) and enhanced generation of nitric oxide (NO). We demonstrated in sheep that pneumonectomy followed by injurious ventilation promotes pulmonary edema. We wished both to test the hypothesis that neuronal NOS (nNOS), which is distributed in airway epithelial and neuronal tissues, could be involved in the ...
    • Measuring extravascular lung water. Animals and humans are not the same 

      Bjertnæs, Lars J.; Kirov, Mikhail; Kuzkov, Vsevolod V.; Fernandez-Mondejar, Enrique (Journal article; Tidsskriftartikkel; Peer reviewed, 2006-07-24)
      The evolution of extravascular lung water (EVLW) monitoring is an important step forward in the hemodynamic assessment of critically ill patients.
    • PAI-1 and t-PA/PAI-1 complex potential markers of fibrinolytic bleeding after cardiac surgery employing cardiopulmonary bypass. 

      Ozolina, A.; Strike, E.; Jaunalksne, I.; Krumina, A.; Bjertnæs, Lars J.; Vanags, I. (Journal article; Tidsskriftartikkel; Peer reviewed, 2012)
      Enhanced bleeding remains a serious problem after cardiac surgery, and fibrinolysis is often involved. We speculate that lower plasma concentrations of plasminogen activator inhibitor – 1 (PAI-1) preoperatively and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex postoperatively might predispose for enhanced fibrinolysis and increased postoperative bleeding. Totally 88 adult patients (mean ...
    • Polymorphisms on PAI-1 and ACE genes in association with fibrinolytic bleeding after on-pump cardiac surgery 

      Ozolina, Agnese; Strike, Eva; Nikitina-Zake, Liene; Jaunalksne, Inta; Krumina, Angelika; Lacis, Romans; Bjertnæs, Lars J.; Vanags, Indulis (Journal article; Tidsskriftartikkel; Peer reviewed, 2015-09-04)
      Background: Carriers of plasminogen activator inhibitor -1 (PAI-1) -675 genotype 5G/5G may be associated with lower preoperative PAI-1 plasma levels and higher blood loss after heart surgery using cardiopulmonary bypass (CPB). We speculate if polymorphisms of PAI-1 -844 A/G and angiotensin converting enzyme (ACE) intron 16 I/D also might promote fibrinolysis and increase postoperative bleeding. ...
    • Recombinant human activated protein C ameliorates oleic acid-induced lung injury in awake sheep 

      Wærhaug, Kristine; Kirov, Mikhail Y.; Kuzkov, Vsevolod V.; Kuklin, Vladimir N.; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2008-11-20)
      Introduction: Acute lung injury (ALI) may arise both after sepsis and non-septic inflammatory conditions and is often associated with the release of fatty acids, including oleic acid (OA). Infusion of OA has been used extensively to mimic ALI. Recent research has revealed that intravenously administered recombinant human activated protein C (rhAPC) is able to counteract ALI. Our aim was to ...
    • Recombinant human activated protein C attenuates endotoxin-induced lung injury in awake sheep 

      Langbakk, Bodil; Wærhaug, Kristine; Kuklin, Vladimir N.; Kirov, Mikhail Y.; Sovershaev, Mikhail; Ingebretsen, Ole C.; Ytrehus, Kirsti; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2008-08-15)
      Introduction: Acute lung injury often complicates severe sepsis. In Gram-negative sepsis, bacterial endotoxin activates both coagulation and inflammation. Enhanced lung vascular pressures and permeability, increased extravascular lung water content and deteriorated gas exchange characterize ovine endotoxin-induced lung injury, a frequently used model of acute lung injury. Recombinant human ...
    • Rewarming From Hypothermic Cardiac Arrest Applying Extracorporeal Life Support: A Systematic Review and Meta-Analysis 

      Bjertnæs, Lars J.; Hindberg, Kristian; Næsheim, Torvind; Suborov, Evgeny V.; Reierth, Eirik; Kirov, Mikhail Y.; Lebedinskii, Konstantin M.; Tveita, Torkjel (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-05-13)
      <i>Introduction</i>: This systematic review and meta-analysis aims at comparing outcomes of rewarming after accidental hypothermic cardiac arrest (HCA) with cardiopulmonary bypass (CPB) or/and extracorporeal membrane oxygenation (ECMO).<br><br> <i>Material and Methods</i>: Literature searches were limited to references with an abstract in English, French or German. Additionally, we searched ...
    • Tezosentan reduces the microvascular filtration coefficient in isolated lungs from rats subjected to cecum ligation and puncture 

      Kuklin, Vladimir N.; Sovershaev, Mikhail; Andreasen, Thomas; Skogen, Vegard; Ytrehus, Kirsti; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2005-10-18)
      Introduction: We recently demonstrated that the non-selective endothelin-1 (ET-1) receptor blocker tezosentan antagonizes ovine acute lung injury (ALI) following infusion of endotoxin or ET-1 by reducing the enhanced lung microvascular pressure, although we could not exclude the possibility of a simultaneous decline in microvascular permeability. In the present study, our aim was to find out if ...
    • Tezosentan-induced attenuation of lung injury in endotoxemic sheep is associated with reduced activation of protein kinase C 

      Ingebretsen, Ole C.; Kuklin, Vladimir N.; Kirov, Mikhail Y.; Sovershaev, Mikhail; Andreasen, Thomas; Ytrehus, Kirsti; Bjertnæs, Lars J. (Journal article; Tidsskriftartikkel; Peer reviewed, 2005-03-04)
      Introduction: Studies in vitro reveal that endothelin-1 (ET-1) activates the α isoform of protein kinase C (PKC-α) in cultures of endothelial cells, thereby deranging cellular integrity. Sepsis and endotoxemia are associated with increased plasma concentrations of ET-1 that induce acute lung injury (ALI). We recently reported that non-selective ET-1 receptor blockade attenuates ALI in sheep by ...