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Dive into the research topics where Rut Norda is active.

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Featured researches published by Rut Norda.


Critical Care Medicine | 2003

Plasma exchange as rescue therapy in multiple organ failure including acute renal failure

Bernd Stegmayr; Ravjet Banga; Lars Berggren; Rut Norda; A. Rydvall; Tomas Vikerfors

OBJECTIVE To describe the outcome of using a rescue therapy including plasma exchange given to patients with a progressive acute disseminated intravascular coagulation and multiple organ dysfunction syndrome. STUDY DESIGN Retrospective study. SETTING University and county hospital. PATIENTS Included were 76 consecutive patients (41 men and 35 women) treated with plasma exchange as rescue therapy besides optimal conventional therapy during a progressive course of disseminated intravascular coagulation and multiple organ dysfunction syndrome, including acute renal failure. Of the 76 patients, 66% needed dialysis. The distribution was hemodialysis in 76%, continuous arteriovenous hemofiltration in 36%, continuous venovenous hemodialysis in 12%, and peritoneal dialysis in 24%. The median organ-failure score was 5 (range, 1-6). Seventy-two percent required mechanical ventilation; septic shock was present in 88%. The median septic shock score was 4 (range, 2-4). Nine patients had another reason than sepsis for the multiple organ dysfunction syndrome. INTERVENTION Plasma exchange (centrifugation technique) was performed until disseminated intravascular coagulation was reversed (median, two times; range, 1-14). Besides antibiotics and fluid administration, most patients received heparin or low molecular weight heparin (77%), steroids (87%), and inotropes (88%). More than one vasoactive drug was used in 57% of the patients. MEASUREMENTS AND MAIN RESULTS Eighty-two percent of the patients survived and could leave the hospital. The previously observed survival rates by others for this category of patients would be <20%, and thus, the outcome in this study is significantly better. CONCLUSION Plasma exchange using plasma as replacement may, in addition to conventional intensive care, help to reverse severe progressive disseminated intravascular coagulation and multiple organ dysfunction syndrome and improve survival.


Transfusion | 2008

Survival after blood transfusion

Mads Kamper-Jørgensen; Martin Ahlgren; Klaus Rostgaard; Mads Melbye; Gustaf Edgren; Olof Nyrén; Marie Reilly; Rut Norda; Kjell Titlestad; Elsa Tynell; Henrik Hjalgrim

BACKGROUND: Long‐term survival of transfusion recipients has rarely been studied. This study examines short‐ and long‐term mortality among transfusion recipients and reports these as absolute rates and rates relative to the general population.


Transfusion and Apheresis Science | 2003

Therapeutic apheresis in Sweden: update of epidemiology and adverse events

Rut Norda; Bernd Stegmayr

The indications of apheresis have changed over time due to results from various studies as well as the innovation of new techniques and ideas. To get an overview of the indications used for apheresis by colleagues elsewhere, data from registries are valuable. In addition, registries can be used for detection of severe adverse events as well as extent of adverse events in various types of treatment. To have a basis for statistical calculations, apheresis units need to be very large or centralisation of data needs to be performed. Data from more than 20000 procedures show that in about 4.3% of occasions adverse events and other problems will develop. Interruption of the procedure was done in 1%, most frequently a plasma exchange. Technical problems can be expected more frequent when performing LDL apheresis and immunoadsorption. Severe adverse events needing medication or interruption of the treatment, such as hypotension and arrhythmia, will develop in about 1% of the procedures. Such an episode occurs more often in patients with TTP/HUS and Guillain-Barré syndrome than in hypercholesterolemia, hyperviscosity syndrome or septic shock/MODS. The non-severe adverse events have increased over time. The results will provide focus in analyses for the reduction of such adverse events.


Vox Sanguinis | 2009

Post-transfusion mortality among recipients of ABO-compatible but non-identical plasma

Agneta Shanwell; Therese M.-L. Andersson; Klaus Rostgaard; Gustaf Edgren; Henrik Hjalgrim; Rut Norda; Mads Melbye; Olof Nyrén; Marie Reilly

Background and Objectives  The consequences of ABO‐compatible non‐identical plasma for patient outcome have not been studied in randomized clinical trials or large cohort studies and use varies widely in the absence of evidence‐based policies. We investigated if transfusion with compatible instead of identical plasma confers any short‐term survival disadvantage on the recipients.


International Journal of Artificial Organs | 1999

Plasma exchange or immunoadsorption in patients with rapidly progressive crescentic glomerulonephritis : A Swedish multi-center study

Bernd Stegmayr; Gabriel Almroth; Gösta Berlin; I. Fehrman; J. Kurkus; Rut Norda; R. Olander; G. Sterner; H. Thysell; Björn Wikström; J. E. Wirén

A therapeutic removal of antibodies may be achieved by immunoadsorption (IA) or by plasma exchange (PE). The aim of this prospective randomised study was to compare the efficacy of these different techniques with regard to treatment of patients with rapidly progressive glomerulonephritis (RPG) having at least 50% crescents. Forty-four patients with a RPG were included for treatment either by IA or PE (with albumin as substitution for removed plasma). All patients were additionally treated with immunosuppression. A median of 6 sessions of PEs were performed in 23 patients compared with 6 IAs in 21 patients. Goodpastures syndrome (GP) was present in 6 patients (PE 3, IA 3). All of them started and ended in dialysis, two died. Among the remaining 38 patients (26 men, 12 women) 87% had antibodies to ANCA. Creatinine clearance for PE versus IA were at a median at start 17.1 and 19.8 ml/min, and at 6 months 49 and 49 ml/min, respectively. At 6 months 7 of 10 patients did not need dialysis (remaining: IA 0/5 and PE 2/5, n.s.). The extent of improvement did not differ between the groups. Three patients died during the observation period of 6 months (IA 2; PE 1, on HD). Although no difference was found between the IA or the PE group this study shows that the protocol used was associated with an improved renal function in most patients (except for Goodpastures syndrome) whereas 70% of them could leave the dialysis program.


Transfusion and Apheresis Science | 2008

World apheresis registry 2003-2007 data

Bernd Stegmayr; Jan Pták; Björn Wikström; G. Berlin; C. G. Axelsson; A. Griskevicius; Paolo Emilio Centoni; Giancarlo M. Liumbruno; Pietra Molfettini; J. Audzijoniene; K. Mokvist; B. Nilsson Sojka; Rut Norda; Folke Knutson; W. Ramlow; M. Blaha; Volker Witt; M. Evergren; J. Tomaz

OBJECTIVES Seventy-five centers from many countries have applied for a login code to the WAA apheresis registry. Fifteen centers from 7 countries have been actively entering data at the internet site from 2003 until 2007. We report on data from the registry so far. METHODS This is a web-based registry. A link is available from the WAA homepage (www.worldapheresis.org). So far data from 2013 patients (12,448 procedures) have been included. A median of 6 treatments have been performed (range 1-140). Mean age 51 years (range 1-94 years; 45% women). Seven percent of the patients were < or = 21 years and 4% were < or = 16 years. RESULTS The purpose of the apheresis procedure was therapeutic in 67% and retrieval of blood components in 33%. Main indications: neurological and hematological diseases, lipid apheresis and stemcell collection (autologous, and some allogeneic). Blood access: peripheral vessels (71%), central dialysis catheter through jugular (6.5%) or subclavian veins (6.7%), femoral vein (8%) and AV fistula (4%). ACD was used for anticoagulation in 73% of the procedures. Albumin was mainly used as replacement fluid. Adverse events (AE) were registered in 5.7% of the procedures. AE was graded as mild (2.5%), moderate (2.7%) or severe (0.5%). No death occurred due to treatment. The procedures were interrupted in 2.6%. Most frequent AEs were blood access problems (29%), tingling around the mouth (20%), hypotension (18%), and urticaria (9%). There were significant differences between the centers regarding mild and moderate AEs. Data indicate that centers using continuous infusion of calcium had fewer AEs. CONCLUSION There was a limited number of severe AEs. Centers use various standard procedures for apheresis. By learning from the experience of others the treatment quality will improve further. In the near future, an update of the registry will enable more extensive evaluation of the data.


Transfusion and Apheresis Science | 2001

Adverse events and problems in therapeutic hemapheresis. A report from the Swedish registry

Rut Norda; Olle Berséus; Bernd Stegmayr

BACKGROUND Since 1996 adverse events (AE) in therapeutic apheresis (TA) have been more extensively registered in Sweden. This report analyzes the extent and relation of AEs to procedures and diagnoses. MATERIALS AND METHODS Reporting of TA performed in Sweden was centralized. A separate system for the registration of AE in TA was established and the data received were entered into a central database for registration and analyses. Fifteen of all 35 apheresis units reported both TA and AE during 1996-1999. These centers performed 75% of all TA procedures. Adverse events included medical symptoms, vascular access problems, technical and other problems. RESULTS More than 14,000 procedures were registered during the observation period. No fatalities occurred. AEs occurred in 3.7% (1996), 4.6% (1997), 4.2% (1998) and 4.4% (1999) of procedures. Interventions during the adverse event were performed in about 65% of the events. Apheresis procedures were interrupted due to an adverse event in about 1%. Adverse events occurred in 5.6% of plasma exchanges, 1.9% of plasma modulations and 6.8% of cytapheresis procedures. Paresthesia was registered in 22% and hypotensive events in 20.5%. Other more frequent symptoms were urticaria (14.4%), shivering (7.4%) and nausea (7.4%). AEs were most frequent in patients with Goodpastures syndrome (12.5%), TTP/HUS (10.5%) and GuillainBarré syndrome (11.0%). CONCLUSION AEs are few, often mild and less common in plasma modulation than plasma exchange. AEs are more frequent during TA of patients with certain diagnoses such as TTP/HUS.


Transfusion | 2001

Long-term survival in transfusion recipients in Sweden, 1993.

Elsa Tynell; Rut Norda; Agneta Shanwell; Anders Björkman

BACKGROUND: Survival and characteristics of transfusion recipients have not been studied enough, although they represent key measures in cost‐effectiveness analyses of various donor screening procedures.


Transfusion | 2015

The new Scandinavian Donations and Transfusions database (SCANDAT2): a blood safety resource with added versatility

Gustaf Edgren; Klaus Rostgaard; Senthil K. Vasan; Agneta Wikman; Rut Norda; Ole Birger Pedersen; Christian Erikstrup; Kaspar Rene Nielsen; Kjell Titlestad; Henrik Ullum; Mads Melbye; Olof Nyrén; Henrik Hjalgrim

Risks of transfusion‐transmitted disease are currently at a record low in the developed world. Still, available methods for blood surveillance might not be sufficient to detect transmission of diseases with unknown etiologies or with very long incubation periods.


Transfusion and Apheresis Science | 2001

Apheresis registry in Sweden: scope, techniques and indications for treatment. A report from the Swedish apheresis study group

Rut Norda; Bernd Stegmayr

Registries of therapeutic apheresis can be used to evaluate changes in technology, clinical indications and applications over the years. This study reports data collected prospectively and voluntarily in Sweden during 1993-1999. A total number of 40 apheresis units have been performing therapeutic apheresis procedures: 16 blood centers, 20 dialysis units, two intensive care units, one hematology ward and one hemotherapy unit. The registry includes a median of 92%) of the centers for therapeutic apheresis in Sweden during the years and in 1999 there were 31 active units in 26 hospitals. The total numbers of procedures per year have remained fairly stable corresponding to a median of 46 treatments/ 100,000 inhabitants, and in 1999 4084 procedures were performed. The number of plasma exchanges has decreased, but LDL-apheresis and immunoadsorption procedures have increased over the years. 70% of the patients have been referred for 12 indications. A significant decline was found for patients with SLE and Guillain Barres syndrome. The use of extracorporeal photo-chemotherapy has increased over the years, and 3 indications include >75

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Agneta Wikman

Karolinska University Hospital

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Elsa Tynell

Karolinska University Hospital

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Folke Knutson

Uppsala University Hospital

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