Clinical practice and procedures for postoperative care in Sweden: Results from a nationwide survey.

A nationwide survey describing Swedish post-anaesthesia care units (PACUs), n = 75 was undertaken. The patients most commonly cared for at PACUs were patients who had undergone laparoscopic surgery, 69.3%, followed by patients who had undergone minor orthopaedic surgery, 68%. At the majority of the PACUs, 86.7%, the staff cared for emergency surgery patients and 48% for day surgery patients. In 31% of the PACUs, a pain relief service was offered through a specific pain service team. During the daytime, the anaesthetist in charge most frequently worked in the operating room 42.7%, and on call in the intensive care unit, 37.3% of the time. In 88% of the PACUs, either all or most registered nurses had a specialist education at an advanced level. The most frequent ratio of registered nurses to patients was 1 to 4, 37.3%. However, Swedish PACUS are also staffed by assistant nurses and the most frequent ratio of registered nurse to assistant nurse was 1:1. Thirty-three (44%) of the PACUs had access to a physiotherapist during the daytime. Almost all PACUs (93.3%) had predetermined discharge criteria but in the majority of PACUs' high-risk patients (68%) were not followed up by an anaesthetist after discharge from the PACU.

Lipid peroxidation of lung surfactant due to reactive oxygen species released from phagocytes stimulated by bacteria from children with cystic fibrosis.

We used Pseudomonas aeruginosa, Burkholderia cepacia and Stenotrophomonas maltophilia, live or heat-killed, isolated from the airways of children with Cystic Fibrosis, to stimulate human neutrophils (PMN) and rat alveolar macrophages (AM) to produce reactive oxygen metabolites in the presence or absence of Curosurf, a natural porcine lung surfactant. We determined: (1) the amount of lipid peroxidation (LPO) as assessed by the amounts of malondialdehyde (MDA) and 4-hydroxyalkenals (4-HNE) using the LPO 586 test kit; (2) the production by AM of superoxide with the nitroblue tetrazolium test and (3) of nitric oxide (NO) with the Griess reaction. Stimulation of PMN or AM increases LPO of Curosurf and cell wall lipids. In both types of phagocytes, B. cepacia induced the highest LPO levels followed by P. aeruginosa and S. maltophilia. PMN, stimulated by live bacteria, induced higher LPO than those stimulated by heat-killed bacteria. B. cepacia stimulated AM to produce more superoxide and NO than did P. aeruginosa and S. maltophilia. The high phagocyte-stimulating ability of B. cepacia and its higher surfactant LPO than those of the other bacteria used in this in vitro study may play a role in vivo in the serious clinical condition known as the "Cepacia syndrome".