• Air Bubbles Activate Complement and Trigger Hemostasis and C3-Dependent Cytokine Release Ex Vivo in Human Whole Blood 

      Storm, Benjamin; Christiansen, Dorte; Fure, Hilde; Ludviksen, Judith K; Lau, Corinna; Lambris, John D.; Woodruff, Trent M.; Brekke, Ole-Lars; Braaten, Tonje Bjørndal; Nielsen, Erik Waage; Mollnes, Tom Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-11-03)
      Venous air embolism, which may complicate medical and surgical procedures, activates complement and triggers thromboinflammation. In lepirudin-anticoagulated human whole blood, we examined the effect of air bubbles on complement and its role in thromboinflammation. Whole blood from 16 donors was incubated with air bubbles without or with inhibitors of C3, C5, C5aR1, or CD14. Complement activation, ...
    • Avoiding ambient air in test tubes during incubations of human whole-blood minimizes complement background activation 

      Storm, Benjamin; Christiansen, Dorte; Mollnes, Tom Eirik; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2020-10-06)
      <p><i>Background - </i>In vitro, the complement system can be studied in test tubes incubated with anticoagulated human whole-blood. Background activation of complement may mask inflammatory signals. Air bubbles are known to activate complement. We examined if removing ambient air from test tubes before incubation reduced background complement activation. <p><i>Methods - </i>Blood from twelve donors ...
    • Bariatric surgery reduces fasting total fatty acids and increases n-3 polyunsaturated fatty acids in morbidly obese individuals 

      Hovland, Anders; Nestvold, Torunn Kristin; Bohov, Pavol; Trøseid, Marius; Aukrust, Pål; Berge, Rolf Kristian; Nielsen, Erik Waage; Retterstøl, Kjetil; Lappegård, Knut Tore (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-10-25)
      Background: <br> Obesity is a global pandemic leading to increased mortality and increased risk of cardiovascular disease. Bariatric surgery is an established treatment of obesity leading to weight loss and reduction of mortality. To further elucidate how bariatric surgery improves metabolic control, we explored the fatty acid (FA) profiles in morbidly obese subjects treated with lifestyle ...
    • Bradykinin-Induced Shock Increase Exhaled Nitric Oxide, Complement Activation and Cytokine Production in Pigs 

      Seip, Knut Fredrik; Evjenth, Bjørg; Hovland, Anders; Dybwik, Knut Gustav; Johansen, Harald Thidemann; Fure, Hilde; Mollnes, Tom Eirik; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2016-03-04)
      Bradykinin is an important mediator in blood pressure regulation, ischemic precondition and capillary leakage, allergy, anaphylaxis, inflammation, and nociception, at least partly via the generation of nitric oxide (NO). Macrophages are particularly abundant in the porcine lung circulation. Upon bradykinin binding macrophages release cytokines and endothelial ...
    • Combined inhibition of C5 and CD14 efficiently attenuated the inflammatory response in a porcine model of meningococcal sepsis 

      Hellerud, Bernt C; Orrem, Hilde L.; Dybwik, Knut Gustav; Pischke, Søren Erik; Barratt-Due, Andreas; Castellheim, Albert; Fure, Hilde; Bergseth, Grete; Christiansen, Dorte; Nunn, Miles A.; Espevik, Terje; Lau, Corinna; Brandtzæg, Petter; Nielsen, Erik Waage; Mollnes, Tom Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-02-27)
      Background<br> Fulminant meningococcal sepsis, characterized by overwhelming innate immune activation, mostly affects young people and causes high mortality. This study aimed to investigate the effect of targeting two key molecules of innate immunity, complement component C5, and co-receptor CD14 in the Toll-like receptor system, on the inflammatory response in meningococcal sepsis.<p> Methods ...
    • Combined inhibition of complement and CD14 improved outcome in porcine polymicrobial sepsis 

      Skjeflo, Espen Waage; Sagatun, Caroline; Dybwik, Knut; Aam, Sturla; Urving, Sven Haakon; Nunn, Miles A.; Fure, Hilde; Lau, Corinna; Brekke, Ole Lars; Huber-Lang, Markus; Barratt-Due, Andreas; Nielsen, Erik Waage; Mollnes, Tom Eirik (Journal article; Tidsskriftartikkel; Peer reviewed, 2015-11-27)
      Introduction: Sepsis is an exaggerated and dysfunctional immune response to infection. Activation of innate immunity recognition systems including complement and the Toll-like receptor family initiate this disproportionate inflammatory response. The aim of this study was to explore the effect of combined inhibition of the complement component C5 and the Toll-like receptor co-factor CD14 on survival, ...
    • Dental and Periodontal Health in Acute Intermittent Porphyria 

      Storjord, Elin; Airila-Månsson, Stella; Karlsen, Katarzyna; Madsen, Martin Ragnar Skjerve; Dahl, Jim André; Landsem, Anne; Fure, Hilde; Ludviksen, Judith K; Fjøse, Johannes Østrem; Dickey, Amy K.; Karlsen, Bård Ove; Nielsen, Erik Waage; Mollnes, Tom Eirik; Brekke, Ole Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2022-08-19)
      In the inherited metabolic disorder acute intermittent porphyria (AIP), high sugar intake prevents porphyric attacks due to the glucose effect and the following high insulin levels that may lower AIP disease activity. Insulin resistance is a known risk factor for periodontitis and sugar changes diabetogenic hormones and affects dental health. We hypothesized differences in homeostasis model ...
    • Dissection of the internal carotid artery and stroke after mandibular fractures: a case report and review of the literature 

      Tveita, Ingrid Aune; Madsen, Martin Ragnar Skjerve; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-06-02)
      Background: We present a report of a patient with blunt trauma and mandibular fractures who developed a significant cerebral infarction due to an initially unrecognized injury of her left internal carotid artery. We believe that increased knowledge of this association will facilitate early recognition and hence prevention of a devastating outcome. <br>Case presentation: A 41-year-old ethnic ...
    • Effect of the anticoagulant, storage time and temperature of blood samples on the concentrations of 27 multiplex assayed cytokines – Consequences for defining reference values in healthy humans 

      Hennø, Linda Torrissen; Storjord, Elin; Christiansen, Dorte; Bergseth, Grete; Ludviksen, Judith K; Fure, Hilde; Barene, Svein; Nielsen, Erik Waage; Mollnes, Tom Eirik; Brekke, Ole Lars (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-06-06)
      Cytokines are potentially useful biomarkers of sepsis and other inflammatory conditions. Many cytokines can be released by leukocytes and platelets after sampling. The sampling and processing techniques are consequently critically important to measure the <i>in vivo</i> levels. We therefore examined the effects of four different anticoagulants, EDTA, citrate, lepirudin, heparin compared to serum, ...
    • Ethical challenges in home mechanical ventilation : a secondary analysis 

      Dybwik, Knut; Nielsen, Erik Waage; Brinchmann, Berit Støre (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      The aim of this study was to explore the ethical challenges in home mechanical ventilation based on a secondary analysis of qualitative empirical data. The data included perceptions of healthcare professionals in hospitals and community health services and family members of children and adults using home mechanical ventilation. The findings show that a number of ethical challenges, or dilemmas, ...
    • Factor VII activating protease (FSAP) is not essential in the pathophysiology of angioedema in patients with C1 inhibitor deficiency 

      Gramstad, Olav Rogde; Kandanur, Sai Priya Sarma; Etscheid, Michael; Nielsen, Erik Waage; Kanse, Sandip (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-12-29)
      Background: Excessive bradykinin (BK) generation from high molecular weight kininogen (HK) by plasma kallikrein (PK) due to lack of protease inhibition is central to the pathophysiology of hereditary angioedema (HAE). Inadequate protease inhibition may contribute to HAE through a number of plasma proteases including factor VII activating protease (FSAP) that can also cleave HK.<p> <p>Objective: ...
    • "Fighting the system" : families caring for ventilator-dependent children and adults with complex health care needs at home 

      Dybwik, Knut; Tollåli, Terje; Nielsen, Erik Waage; Brinchmann, Berit Støre (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      An increasing number of individuals with complex health care needs now receive life-long and lifeprolonging ventilatory support at home. Family members often take on the role of primary caregivers. The aim of this study was to explore the experiences of families giving advanced care to family members dependent on home mechanical ventilation. Using qualitative research methods, a Grounded Theory ...
    • Gas embolism during surgery. A complement mediated condition? 

      Storm, Benjamin Stage; Christiansen, Dorte; Dybwik, Knut; Mollnes, Tom Eirik; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2017-10-01)
      <p><i>Introduction</i>: Venous air embolism (VAE) may arise during surgical procedures. VAE might be complicated with a systemic inflammatory response, disseminated intervascular coagulation, multi-organ failure and cardiovascular collapse. During a short time-span, three patients at our institution developed signs of VAE in conjunction with gynecological surgery. One died, one developed severe ...
    • Hands-free continuous carotid Doppler ultrasound for detection of the pulse during cardiac arrest in a porcine model 

      Faldaas, Bjørn Ove; Nielsen, Erik Waage; Storm, Benjamin; Lappegård, Knut Tore; How, Ole-Jakob; Nilsen, Bent Aksel; Kiss, Gabriel Hanssen; Skogvoll, Eirik; Torp, Hans; Ingul, Charlotte Ingeborg Björk (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-06-20)
      Background/Purpose - Pulse palpation is an unreliable method for diagnosing cardiac arrest. To address this limitation, continuous hemodynamic monitoring may be a viable solution. Therefore, we developed a novel, hands-free Doppler system, RescueDoppler, to detect the pulse continuously in the carotid artery.<p> <p>Methods - In twelve pigs, we evaluated RescueDoppleŕs potential to measure blood ...
    • Home mechanical ventilation and specialised health care in the community : between a rock and a hard place 

      Dybwik, Knut; Nielsen, Erik Waage; Brinchmann, Berit Støre (Journal article; Tidsskriftartikkel; Peer reviewed, 2011)
      Home mechanical ventilation probably represents the most advanced and complicated type of medical treatment provisioned outside a hospital setting. The aim of this study was both to explore the challenges experienced by health care professionals in community health care services when caring for patients dependent on home mechanical ventilation, continual care and highly advanced technology, and their ...
    • How should tranexamic acid be administered in haemorrhagic shock? - continuous serum concentration measurements in a swine model 

      Lynghaug, Trine; Bakke, Håkon Kvåle; Fuskevåg, Ole Martin; Nielsen, Erik Waage; Dietrichs, Erik Sveberg (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-11)
      Background: Tranexamic acid (TXA) reduces mortality in trauma patients. Intramuscular (IM) administration could be advantageous in low-resource and military settings. Achieving the same serum concentration as intravenous (IV) administration is important to achieve equal mortality reduction. Therefore, we aimed to investigate whether dividing an IM dose of TXA between two injection sites and whether ...
    • Iatrogenic air embolism: pathoanatomy, thromboinflammation, endotheliopathy, and therapies 

      Marsh, Phillip L.; Moore, Ernest E.; Moore, Hunter B.; Bunch, Connor M.; Aboukhaled, Michael; Condon, Shaun M.; Al-Fadhl, Mahmoud D.; Thomas, Samuel J.; Larson, John R.; Bower, Charles W.; Miller, Craig B.; Pearson, Michelle L.; Twilling, Christopher L.; Reser, David W.; Kim, George S.; Troyer, Brittany M.; Yeager, Doyle; Thomas, Scott G.; Srikureja, Daniel P.; Patel, Shivani S.; Añón, Sofía L.; Thomas, Anthony V.; Miller, Joseph B.; Van Ryn, David E.; Pamulapati, Saagar V.; Zimmerman, Devin; Wells, Byars; Martin, Peter L.; Seder, Christopher W.; Aversa, John G.; Greene, Ryan B.; March, Robert J.; Kwaan, Hau C.; Fulkerson, Daniel H.; Vande Lune, Stefani A.; Mollnes, Tom Eirik; Nielsen, Erik Waage; Stage Storm, Benjamin; Walsh, Mark M. (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-09-19)
      Iatrogenic vascular air embolism is a relatively infrequent event but is associated with significant morbidity and mortality. These emboli can arise in many clinical settings such as neurosurgery, cardiac surgery, and liver transplantation, but more recently, endoscopy, hemodialysis, thoracentesis, tissue biopsy, angiography, and central and peripheral venous access and removal have overtaken surgery ...
    • Increased thromboinflammatory load in hereditary angioedema 

      Gramstad, Olav Rogde; Schjalm, Camilla; Mollnes, Tom Eirik; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2023-08-10)
      C1 inhibitor (C1Inh) is a serine protease inhibitor involved in the kallikrein-kinin system, the complement system, the coagulation system, and the fibrinolytic system. In addition to the plasma leakage observed in hereditary angioedema (HAE), C1Inh deficiency may also affect these systems, which are important for thrombosis and inflammation. The aim of this study was to investigate the thromboinflammatory ...
    • Intramuscular uptake of tranexamic acid during haemorrhagic shock in a swine model 

      Bakke, Håkon Kvåle; Fuskevåg, Ole Martin; Nielsen, Erik Waage; Dietrichs, Erik Sveberg (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-12-18)
      Background: Tranexamic acid (TXA) reduce mortality in bleeding trauma patients, with greater efect if administered early. Serum concentrations above 10 µg/mL are considered sufcient to inhibit fbrinolysis. Normally administered intravenously (i.v.), TXA can also be administered intramuscularly (i.m.). This could be advantageous in low resource and military settings, if sufcient serum concentrations ...
    • Intraosseous fluid resuscitation causes systemic fat emboli in a porcine hemorrhagic shock model 

      Kristiansen, Steinar; Storm, Benjamin; Dahle, Dalia; Josefsen, Terje D.; Dybwik, Knut Gustav; Nilsen, Bent Aksel; Nielsen, Erik Waage (Journal article; Tidsskriftartikkel; Peer reviewed, 2021-12-20)
      Background: Intraosseous cannulation can be life-saving when intravenous access cannot be readily achieved. However, it has been shown that the procedure may cause fat emboli to the lungs and brain. Fat embolization may cause serious respiratory failure and fat embolism syndrome. We investigated whether intraosseous fluid resuscitation in pigs in hemorrhagic shock caused pulmonary or systemic ...