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Johansson, Joakim
Publikasjoner (10 av 17) Visa alla publikasjoner
Samuelsson, L., Tyden, J., Herwald, H., Hultin, M., Walldén, J., Steinvall, I., . . . Johansson, J. (2019). Renal clearance of heparin-binding protein and elimination during renal replacement therapy: Studies in ICU patients and healthy volunteers. PLoS ONE, 14(8), Article ID e0221813.
Åpne denne publikasjonen i ny fane eller vindu >>Renal clearance of heparin-binding protein and elimination during renal replacement therapy: Studies in ICU patients and healthy volunteers
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2019 (engelsk)Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, nr 8, artikkel-id e0221813Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Heparin-binding protein (HBP) is released by neutrophils upon activation, and elevated plasma levels are seen in inflammatory states like sepsis, shock, cardiac arrest, and burns. However, little is known about the elimination of HBP. We wanted to study renal clearance of HBP in healthy individuals and in burn patients in intensive care units (ICUs). We also wished to examine the levels of HBP in the effluent of renal replacement circuits in ICU patients undergoing continuous renal replacement therapy (CRRT).

METHODS: We measured plasma and urine levels of HBP and urine flow rate in 8 healthy individuals and 20 patients in a burn ICU. In 32 patients on CRRT, we measured levels of HBP in plasma and in the effluent of the CRRT circuit.

RESULTS: Renal clearance of HBP (median (IQR) ml/min) was 0.19 (0.08-0.33) in healthy individuals and 0.30 (0.01-1.04) in burn ICU patients. In ICU patients with cystatin C levels exceeding 1.44 mg/l, clearance was 0.45 (0.15-2.81), and in patients with cystatin C below 1.44 mg/l clearance was lower 0.28 (0.14-0.55) (p = 0.04). Starting CRRT did not significantly alter plasma levels of HBP (p = 0.14), and the median HBP level in the effluent on CRRT was 9.1 ng/ml (IQR 7.8-14.4 ng/ml).

CONCLUSION: In healthy individuals and critically ill burn patients, renal clearance of HBP is low. It is increased when renal function is impaired. Starting CRRT in critically ill patients does not alter plasma levels of HBP significantly, but HBP can be found in the effluent. It seems unlikely that impaired kidney function needs to be considered when interpreting concentrations of HBP in previous studies. Starting CRRT does not appear to be an effective way of reducing HBP concentrations.

sted, utgiver, år, opplag, sider
Public Library of Science, 2019
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-162913 (URN)10.1371/journal.pone.0221813 (DOI)000485058200055 ()31465432 (PubMedID)2-s2.0-85071497875 (Scopus ID)
Tilgjengelig fra: 2019-09-02 Laget: 2019-09-02 Sist oppdatert: 2019-11-14bibliografisk kontrollert
Tydén, J., Larsson, N., Lehtipalo, S., Herwald, H., Hultin, M., Walldén, J., . . . Johansson, J. (2018). Heparin-binding protein in ventilator-induced lung injury.. Intensive Care Medicine Experimental, 6(1), Article ID 33.
Åpne denne publikasjonen i ny fane eller vindu >>Heparin-binding protein in ventilator-induced lung injury.
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2018 (engelsk)Inngår i: Intensive Care Medicine Experimental, ISSN 1646-2335, E-ISSN 2197-425X, Vol. 6, nr 1, artikkel-id 33Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: Although mechanical ventilation is often lifesaving, it can also cause injury to the lungs. The lung injury is caused by not only high pressure and mechanical forces but also by inflammatory processes that are not fully understood. Heparin-binding protein (HBP), released by activated granulocytes, has been indicated as a possible mediator of increased vascular permeability in the lung injury associated with trauma and sepsis. We investigated if HBP levels were increased in the bronchoalveolar lavage fluid (BALF) or plasma in a pig model of ventilator-induced lung injury (VILI). We also investigated if HBP was present in BALF from healthy volunteers and in intubated patients in the intensive care unit (ICU).

METHODS: Anaesthetized pigs were randomized to receive ventilation with either tidal volumes of 8 ml/kg (controls, n = 6) or 20 ml/kg (VILI group, n = 6). Plasma and BALF samples were taken at 0, 1, 2, 4, and 6 h. In humans, HBP levels in BALF were sampled from 16 healthy volunteers and from 10 intubated patients being cared for in the ICU.

RESULTS: Plasma levels of HBP did not differ between pigs in the control and VILI groups. The median HBP levels in BALF were higher in the VILI group after 6 h of ventilation compared to those in the controls (1144 ng/ml (IQR 359-1636 ng/ml) versus 89 ng/ml (IQR 33-191 ng/ml) ng/ml, respectively, p = 0.02). The median HBP level in BALF from healthy volunteers was 0.90 ng/ml (IQR 0.79-1.01 ng/ml) as compared to 1959 ng/ml (IQR 612-3306 ng/ml) from intubated ICU patients (p < 0.001).

CONCLUSIONS: In a model of VILI in pigs, levels of HBP in BALF increased over time compared to controls, while plasma levels did not differ between the two groups. HBP in BALF was high in intubated ICU patients in spite of the seemingly non-harmful ventilation, suggesting that inflammation from other causes might increase HBP levels.

sted, utgiver, år, opplag, sider
SpringerOpen, 2018
Emneord
HBP, Neutrophils, Pigs, Ventilator-induced lung injury
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-151814 (URN)10.1186/s40635-018-0198-x (DOI)000445485300001 ()30203380 (PubMedID)
Tilgjengelig fra: 2018-09-13 Laget: 2018-09-13 Sist oppdatert: 2019-09-02bibliografisk kontrollert
Nelson, A., Johansson, J., Tydén, J. & Bodelsson, M. (2017). Circulating syndecans during critical illness. Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), 125(5), 468-475
Åpne denne publikasjonen i ny fane eller vindu >>Circulating syndecans during critical illness
2017 (engelsk)Inngår i: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 125, nr 5, s. 468-475Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Circulating syndecans are proposed to be markers of glycocalyx degradation and previous investigations have found higher plasma levels of syndecan-1 among patients with different pathological conditions. We wanted to investigate if levels of other syndecans (-2,-3 and -4) are altered during critical illness and compare the levels to syndecan-1. In 137 consecutive intensive care unit (ICU) patients with sepsis, cardiac arrest, gastrointestinal bleeding, intoxication or trauma, plasma levels of syndecan-1, -2, -3 and -4 were measured using ELISA. Syndecan-1 and syndecan-3 levels were similar among the different ICU patient groups but higher than controls. No differences in plasma levels of syndecan-2 or syndecan-4 were found neither among the different ICU patient groups nor compared to controls. All syndecans showed an association with mortality and the levels of syndecan-1 and -3 and correlated with each other. The results indicate that syndecan release is triggered by the physiological stress of critical illness in general and involves several subtypes such as syndecan-1 and syndecan-3.

Emneord
Syndecan, glycocalyx, critical illness
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-136342 (URN)10.1111/apm.12662 (DOI)000402174000006 ()28256016 (PubMedID)
Tilgjengelig fra: 2017-06-16 Laget: 2017-06-16 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Tydén, J., Herwald, H., Hultin, M., Walldén, J. & Johansson, J. (2017). Heparin-binding protein as a biomarker of acute kidney injury in critical illness. Acta Anaesthesiologica Scandinavica, 61(7), 797-803
Åpne denne publikasjonen i ny fane eller vindu >>Heparin-binding protein as a biomarker of acute kidney injury in critical illness
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2017 (engelsk)Inngår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, nr 7, s. 797-803Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

BACKGROUND: There is no biomarker with high sensitivity and specificity for the development of acute kidney injury (AKI) in a mixed intensive care unit (ICU) population. Heparin-binding protein (HBP) is released from granulocytes and causes increased vascular permeability which plays a role in the development of AKI in sepsis and ischemia. The aim of this study was to investigate whether plasma levels of HBP on admission can predict the development of AKI in a mixed ICU population and in the subgroup with sepsis. METHODS: Longitudinal observational study with plasma HBP levels from 245 patients taken on admission to ICU. Presence and severity of AKI was scored daily for 1 week. RESULTS: Mean (95% CI) plasma concentrations of log HBP (ng/ml) in the groups developing different stages of AKI were: stage 0 (n = 175), 3.5 (3.4-3.7); stage 1 (n = 33), 3.7 (3.5-4.0), stage 2 (n = 20), 4.4 (3.5-4.8); and stage 3 (n = 17), 4.6 (3.8-5.2). HBP levels were significantly higher in patients developing AKI stage 3 (P < 0.01) compared to AKI stage 0 and 1. The area under the curve (AUC) for HBP to discriminate the group developing AKI stage 2-3 was 0.70 (CI: 0.58-0.82) and in the subgroup with severe sepsis 0.88 (CI: 0.77-0.99). CONCLUSION: Heparin-binding protein levels on admission to ICU are associated with the development of severe kidney injury. The relationship between HBP and AKI needs to be further validated in larger studies.

sted, utgiver, år, opplag, sider
John Wiley & Sons, 2017
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-136671 (URN)10.1111/aas.12913 (DOI)000404981100012 ()28585315 (PubMedID)1399-6576 (Electronic) 0001-5172 (Linking) (ISBN)
Tilgjengelig fra: 2017-06-21 Laget: 2017-06-21 Sist oppdatert: 2019-09-02bibliografisk kontrollert
Johansson, J., Lindahl, M., Gyllencreutz, E. & Hahn, R. G. (2017). Symptomatic absorption of isotonic saline during transcervical endometrial resection. Acta Anaesthesiologica Scandinavica, 61(1), 121-124
Åpne denne publikasjonen i ny fane eller vindu >>Symptomatic absorption of isotonic saline during transcervical endometrial resection
2017 (engelsk)Inngår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, nr 1, s. 121-124Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Absorption of irrigating fluid is a well-known complication of endoscopic surgeries, such as transurethral resection of the prostate and transcervical endometrial resection (TCER). Irrigating fluid is used to distend the hollow organ and allows the surgeon to visualize the operating field. Traditional monopolar diathermy requires irrigating fluid to be electrolyte free, which is unphysiological and therefore elicits various symptoms when absorbed.(1-4) In recent years, endoscopic resections have often been conducted with a bipolar resectoscope, which allows crystalloid fluid to be used for irrigation. The symptoms, hemodynamic effects, and biochemical changes that arise from rapid inadvertent overload of crystalloid fluid in clinical settings are not as well known as those due to overload of electrolyte-free fluid. Further, current guidelines may be interpreted as that 2500-ml resorption of saline could be accepted.(5) Therefore, we describe two patients who absorbed isotonic saline during TCERs performed under general anesthesia. The second one (case B) probably was further complicated by a venous gas embolus.

HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-133271 (URN)10.1111/aas.12834 (DOI)000394907900016 ()27918101 (PubMedID)
Tilgjengelig fra: 2017-04-07 Laget: 2017-04-07 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Schollin-Borg, M., Nordin, P., Zetterström, H. & Johansson, J. (2016). Blood Lactate Is a Useful Indicator for the Medical Emergency Team. Critical Care Research and Practice, Article ID 5765202.
Åpne denne publikasjonen i ny fane eller vindu >>Blood Lactate Is a Useful Indicator for the Medical Emergency Team
2016 (engelsk)Inngår i: Critical Care Research and Practice, ISSN 2090-1305, E-ISSN 2090-1313, artikkel-id 5765202Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Lactate has been thoroughly studied and found useful for stratification of patients with sepsis, in the Intensive Care Unit, and trauma care. However, little is known about lactate as a risk-stratification marker in the Medical Emergency Team-(MET-) call setting. We aimed to determine whether the arterial blood lactate level at the time of a MET-call is associated with increased 30-day mortality. This is an observational study on a prospectively gathered cohort at a regional secondary referral hospital. All MET-calls during the two-year study period were eligible. Beside blood lactate, age and vital signs were registered at the call. Among the 211 calls included, there were 64 deaths (30.3%). Median lactate concentration at the time of the MET-call was 1.82 mmol/L (IQR 1.16-2.7). We found differences between survivors and nonsurvivors for lactate and oxygen saturation, a trend for age, but no significant correlations between mortality and systolic blood pressure, respiratory rate, and heart rate. As compared to normal lactate (<2.44 mmol/L), OR for 30-day mortality was 3.54 (p < 0.0006) for lactate 2.44-5.0 mmol/L and 4.45 (p < 0.0016) for lactate >5.0 mmol/L. The present results support that immediate measurement of blood lactate in MET call patients is a useful tool in the judgment of illness severity.

sted, utgiver, år, opplag, sider
Hindawi Publishing Corporation, 2016
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-119091 (URN)10.1155/2016/5765202 (DOI)000372258000001 ()
Tilgjengelig fra: 2016-04-15 Laget: 2016-04-11 Sist oppdatert: 2018-06-07bibliografisk kontrollert
Tydén, J., Herwald, H., Sjoberg, F. & Johansson, J. (2016). Increased Plasma Levels of Heparin-Binding Protein on Admission to Intensive Care Are Associated with Respiratory and Circulatory Failure. PLoS ONE, 11(3), Article ID e0152035.
Åpne denne publikasjonen i ny fane eller vindu >>Increased Plasma Levels of Heparin-Binding Protein on Admission to Intensive Care Are Associated with Respiratory and Circulatory Failure
2016 (engelsk)Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 3, artikkel-id e0152035Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Purpose: Heparin-binding protein (HBP) is released by granulocytes and has been shown to increase vascular permeability in experimental investigations. Increased vascular permeability in the lungs can lead to fluid accumulation in alveoli and respiratory failure. A generalized increase in vascular permeability leads to loss of circulating blood volume and circulatory failure. We hypothesized that plasma concentrations of HBP on admission to the intensive care unit (ICU) would be associated with decreased oxygenation or circulatory failure.

Methods: This is a prospective, observational study in a mixed 8-bed ICU. We investigated concentrations of HBP in plasma at admission to the ICU from 278 patients. Simplified acute physiology score (SAPS) 3 was recorded on admission. Sequential organ failure assessment (SOFA) scores were recorded daily for three days.

Results: Median SAPS 3 was 58.8 (48-70) and 30-day mortality 64/278 (23%). There was an association between high plasma concentrations of HBP on admission with decreased oxygenation (p<0.001) as well as with circulatory failure (p<0.001), after 48-72 hours in the ICU. There was an association between concentrations of HBP on admission and 30-day mortality (p = 0.002). ROC curves showed areas under the curve of 0,62 for decreased oxygenation, 0,65 for circulatory failure and 0,64 for mortality.

Conclusions: A high concentration of HBP in plasma on admission to the ICU is associated with respiratory and circulatory failure later during the ICU care period. It is also associated with increased 30-day mortality. Despite being an interesting biomarker for the composite ICU population it's predictive value at the individual patient level is low.

Emneord
Biomarkers, Blood Proteins, Organ Dysfunction Scores
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-120365 (URN)10.1371/journal.pone.0152035 (DOI)000372701200089 ()27007333 (PubMedID)
Tilgjengelig fra: 2016-05-16 Laget: 2016-05-16 Sist oppdatert: 2019-09-12bibliografisk kontrollert
Larsson, N., Gouveia-Figueira, S., Claesson, J., Lehtipalo, S., Behndig, A., Tyden, J., . . . Nording, M. L. (2016). Oxylipin Profiling In The Acute Respiratory Distress Syndrome. Paper presented at International Conference of the American-Thoracic-Society (ATS), MAY 13-18, 2016, San Francisco, CA. American Journal of Respiratory and Critical Care Medicine, 193, Article ID A4419.
Åpne denne publikasjonen i ny fane eller vindu >>Oxylipin Profiling In The Acute Respiratory Distress Syndrome
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2016 (engelsk)Inngår i: American Journal of Respiratory and Critical Care Medicine, ISSN 1073-449X, E-ISSN 1535-4970, Vol. 193, artikkel-id A4419Artikkel i tidsskrift, Meeting abstract (Fagfellevurdert) Published
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-131012 (URN)000390749603801 ()
Konferanse
International Conference of the American-Thoracic-Society (ATS), MAY 13-18, 2016, San Francisco, CA
Tilgjengelig fra: 2017-02-16 Laget: 2017-02-16 Sist oppdatert: 2019-05-06bibliografisk kontrollert
Grauman, S., Boethius, J. & Johansson, J. (2016). Regional Anaesthesia Is Associated with Shorter Postanaesthetic Care and Less Pain Than General Anaesthesia after Upper Extremity Surgery. Anesthesiology Research and Practice, Article ID 6308371.
Åpne denne publikasjonen i ny fane eller vindu >>Regional Anaesthesia Is Associated with Shorter Postanaesthetic Care and Less Pain Than General Anaesthesia after Upper Extremity Surgery
2016 (engelsk)Inngår i: Anesthesiology Research and Practice, ISSN 1687-6962, E-ISSN 1687-6970, artikkel-id 6308371Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Introduction: For surgery on the upper extremity, the anaesthetist often has a choice between regional anaesthesia (RA) and general anaesthesia (GA). We sought to investigate the possible differences between RA and GA after upper extremity surgery with regard to postoperative patient comfort. Methods: This is a retrospective observational study that was performed at an acute care secondary referral centre. One hundred and eighty-seven procedures involving orthopaedic surgery on the upper extremity were included. The different groups (RA and GA) were compared regarding the primary outcome variable, length of stay in Postanaesthesia Unit, and secondary outcome variables, opioid consumption and nausea treatment. Results: RA was associated with significantly shorter median length of stay (99 versus 171 minutes). In the GA group, 32% of the patients received opioid analgesics and 21% received antiemetics. In the RA group, none received opioid analgesics and 3% received antiemetics. Conclusion: In this observational study, RA was superior to GA for surgery of the upper extremity regarding Postanaesthesia Care Unit length of stay, number of doses of analgesic, and number of doses of antiemetic administered.

sted, utgiver, år, opplag, sider
Hindawi Publishing Corporation, 2016
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-130119 (URN)10.1155/2016/6308371 (DOI)000389217100001 ()
Tilgjengelig fra: 2017-01-11 Laget: 2017-01-11 Sist oppdatert: 2018-06-09bibliografisk kontrollert
Johansson, J. & Sjöberg, F. (2016). Response to the article by Jämsä: Leukocyte receptor expression as a biomarker for severe sepsis [Letter to the editor]. Acta Anaesthesiologica Scandinavica, 60(3), 407-408
Åpne denne publikasjonen i ny fane eller vindu >>Response to the article by Jämsä: Leukocyte receptor expression as a biomarker for severe sepsis
2016 (engelsk)Inngår i: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, nr 3, s. 407-408Artikkel i tidsskrift, Letter (Fagfellevurdert) Published
sted, utgiver, år, opplag, sider
John Wiley & Sons, 2016
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-124890 (URN)10.1111/aas.12647 (DOI)000368856500012 ()26482839 (PubMedID)
Tilgjengelig fra: 2016-08-29 Laget: 2016-08-29 Sist oppdatert: 2018-06-07bibliografisk kontrollert
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