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Anaesthesiology Intensive Therapy

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https://www.readbyqxmd.com/read/27869288/infraclavicular-access-to-the-axillary-vein-new-possibilities-for-the-catheterization-of-the-central-veins-in-the-intensive-care-unit
#1
Ryszard Gawda, Tomasz Czarnik, Lidia Łysenko
Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27869287/dexmedetomidine-for-attenuating-haemodynamic-response-to-intubation-stimuli-in-morbidly-obese-patients-anaesthetised-using-low-opioid-technique-comparison-with-fentanyl-based-general-anaesthesia
#2
Tomasz Gaszyński, Klaudia Czarnik, Łukasz Łaziński, Wojciech Gaszyński
BACKGROUND: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanyl-based or low-opioid using dexmedetomidine...
November 21, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27838915/incidence-of-in-hospital-cardiac-arrest-in-poland
#3
Jan Adamski, Piotr Nowakowski, Paweł Goryński, Dariusz Onichimowski, Wojciech Weigl
BACKGROUND: In-hospital cardiac arrest with its poor prognosis is a challenging problem in hospitals. The aim of this study was to evaluate in Polish hospitals the frequency of in-hospital cardiac arrests with the subsequent mortality, with special emphasis on the type of unit at which the event occurred, and the patient's demographic data, such as age and sex. METHODS: The study was a retrospective analysis of data for 2012 registered in the Polish General Hospital Morbidity Study...
November 13, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27834985/clinical-outcome-of-critically-ill-patients-with-thrombocytopenia-and-hypophosphatemia-in-the-early-stage-of-sepsis
#4
Evgeni Brotfain, Andrei Schwartz, Avi Boniel, Leonid Koyfman, Matthew Boyko, Ruslan Kutz, Moti Klein
BACKGROUND: Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis METHODS: We analyzed the clinical data, including the outcome of critically ill ICU patients with severe sepsis who presented during a 5 year period with early hypophosphatemia and thrombocytopenia...
November 11, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27834984/effect-of-preoperative-intravenous-oxycodone-administration-on-sufentanil-consumption-after-retroperitoneal-laparoscopic-nephrectomy
#5
Jinguo Wang, Haichun Ma, Honglan Zhou, Yang Gao, Yaowen Fu, Na Wang
BACKGROUND: The aim of this study was to evaluate the efficacy of preoperative intravenous oxycodone administration on postoperative sufentanil consumption in patients undergoing retroperitoneal laparoscopic nephrectomy. METHODS: Fifty patients scheduled for retroperitoneal laparoscopic nephrectomy were enrolled and randomly assigned to two groups - patients in Group O (n = 25) received intravenously 0.1 mg kg⁻¹ oxycodone; while the patients in Group C (n = 25) received 0...
November 11, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824220/isolated-lower-limb-gangrene-a-caveat-of-terlipressin-therapy
#6
Ankur Khandelwal, Devendra Gupta, Rudrashish Haldar, Anindita Rai
No abstract text is available yet for this article.
November 8, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824219/anaesthesia-management-for-non-cardiac-surgery-in-children-with-congenital-heart-disease
#7
Tomohiro Yamamoto, Ehrenfried Schindler
Congenital heart disease (CHD) is the most common form of congenital abnormality and occurs in over 1% of newborns. Approximately 30% of children with CHD have other extra-cardiac anomalies, which significantly increases mortality in CHD patients. It is expected that the number of CHD patients who consult non-specialized hospitals for non-cardiac surgery after palliative or corrective operations has increased because of the extraordinary progression of treatments, such as surgical procedures, interventional procedures, and intensive care medicine, as well as diagnosis...
November 8, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824218/coagulopathy-in-sepsis-a-new-look-at-an-old-problem
#8
Małgorzata Lipinska-Gediga
Sepsis is a life-threatening condition characterized by a systemic response to microbial infection. Despite considerable progress in intensive care medicine, the incidence of sepsis and the number of sepsis-related deaths are increasing world-wide. There is a complex relationship between the coagulation, immune and inflammatory systems in sepsis. Activation of the coagulation cascade in sepsis is a result of a pathogen invasion and is a part of a immuno-inflammatory host response. In sepsis, the close cooperation of the immune and coagulation systems through cross signalling results in immunothrombosis...
November 8, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27785780/successful-retrieval-of-a-knotted-swan-ganz-catheter-using-interventional-approach-in-an-adult-a-case-report
#9
Xiao-Ke Shang, Yan Yan, Bin Wang
No abstract text is available yet for this article.
October 27, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27689430/anaphylaxis-and-cardiac-surgery-for-hypertrophic-obstructive-cardiomyopathy-a-case-report-and-review-of-anaesthetic-management
#10
Kevin Fu Hong Yee, Marcin Wasowicz
BACKGROUND: The aim of this paper is to describe clinical management in a situation where a patient has experienced anaphylaxis while undergoing surgical septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM). CASE REPORT: A 40-yr-old female was scheduled to undergo surgical septal myectomy for the treatment of HOCM. After induction, the patient developed refractory hypotension that did not respond to escalating doses of vasopressors and volume therapy...
September 30, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27689429/changes-in-heart-rate-variability-during-anaesthesia-induction-using-sevoflurane-or-isoflurane-with-nitrous-oxide
#11
Tomoki Nishiyama
BACKGROUND: The purpose of this study was to compare cardiac sympathetic and parasympathetic balance using heart rate variability (HRV) during induction of anaesthesia between sevoflurane and isoflurane in combination with nitrous oxide. METHODS: 40 individuals aged from 30 to 60 years, scheduled for general anaesthesia were equally divided into sevoflurane or isoflurane groups. After 100% oxygen inhalation for a few minutes, anaesthesia was induced with nitrous oxide 3 L min⁻¹, oxygen 3 L min-1 and sevoflurane or isoflurane...
September 30, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27689428/safety-of-intensivist-led-bedside-decannulation-of-internal-jugular-bi-caval-dual-lumen-veno-venous-extracorporeal-membrane-oxygenation-cannulas-and-report-of-technique
#12
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27660253/high-frequency-oscillatory-ventilation-for-adult-ards-is-this-the-end-of-the-road
#13
Mohan Gurjar, Arvind K Baronia
No abstract text is available yet for this article.
September 23, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27660252/sepsis-and-septic-shock-is-a-microcirculation-a-main-player
#14
Małgorzata Lipinska-Gediga
Shock, defined at a cellular level, is a condition in which oxygen delivery to the cells is not sufficient to sustain cellular activity and support organ function. The central role of microcirculation in providing oxygen to the cells makes it of prime importance in determining organ function. In sepsis and septic shock, macrocirculatory alterations and microcirculatory dysfunction participate concurrently in the pathophysiology of organ failure. Haemodynamic coherence in shock is a condition in which normalization of systemic haemodynamic variables results in simultaneous amelioration in the perfusion of the microcirculation and restoration of tissue oxygenation as a final result...
September 23, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27595746/a-comparison-of-non-endoscopic-and-endoscopic-adhesiolysis-of-epidural-fibrosis
#15
Martina Bellini, Massimo Barbieri
Low back and leg pain may be due to many causes, one of which is scarring in the epidural space. Epidural scarring may provoke this pain for many reasons: nerves may be trapped by scars, while veins in the epidural space press down upon the nerves and become enlarged, putting pressure on the nerves. Endoscopic and percutaneous epidural adhesiolysis allows one to eliminate the deleterious effects of scar formation, which can both physically prevent the direct application of drugs to nerve and provide relief in patients who have not responded to epidurals, physical therapy or medication...
September 6, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27595745/apache-ii-score-predicts-mortality-in-patients-requiring-prolonged-ventilation-in-a-weaning-center
#16
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
BACKGROUND: Little is known about the diagnostic accuracy of the APACHE II scoring system in prolonged mechanical ventilation. The aim of this study was to assess the utility of APACHE II in order to predict in-hospital mortality, length of stay (LOS) and discharge destination of patients in a weaning centre. METHODS: The study group included 130 consecutive patients (median age 71 years; IQR 62-77). APACHE II was assessed based on the worst values taken during the first 24 hours post admission...
September 6, 2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797097/neuromuscular-blockade-in-the-elderly
#17
Michał Stankiewicz-Rudnicki
The aim of the presented review is to highlight the clinical problem of postoperative residual curarization (PORC) following general anaesthesia in the elderly. Possible complications of PORC are described along with age-induced changes in pharmacokinetics of long and intermediate-acting neuromuscular blocking agents. This is intended to facilitate the selection and to promote appropriate intraoperative use of muscle relaxants in patients over the age of 65 years.
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797096/a-comparison-of-bis-recordings-during-propofol-based-total-intravenous-anaesthesia-and-sevoflurane-based-inhalational-anaesthesia-in-obese-patients
#18
Tomasz Gaszyński, Andrzej Wieczorek
BACKGROUND: Intraoperative awareness is a rarely occurring phenomenon. Obesity is considered as one of the factors increasing the probability of intraoperative awareness due to problems with the dosing of anaesthetics. In a randomized prospective study we compared bispectral index (BIS) recordings during propofol-based total intravenous anaesthesia (TIVA) and sevoflurane-based inhalation anaesthesia in morbidly obese patients as a sign of possible intraoperative awareness. METHODS: 120 morbidly obese patients were randomly allocated into two subgroups: TIVA or SEVO...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797095/anaesthesia-for-carotid-endarterectomy-ultrasound-guided-superficial-intermediate-cervical-plexus-block-combined-with-carotid-sheath-infiltration
#19
Paweł Mądro, Alina Dąbrowska, Jarosław Jarecki, Piotr Garba
BACKGROUND: Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient's consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical plexus block for patient safety and comfort...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797094/comparison-of-the-techniques-for-the-identification-of-the-epidural-space-using-the-loss-of-resistance-technique-or-an-automated-syringe-results-of-a-randomized-double-blind-study
#20
Larysa Duniec, Piotr Nowakowski, Jakub Sieczko, Marcin Chlebus, Tomasz Łazowski
BACKGROUND: The conventional, loss of resistance technique for identification of the epidural space is highly dependent on the anaesthetist's personal experience and is susceptible to technical errors. Therefore, an alternative, automated technique was devised to overcome the drawbacks of the traditional method. The aim of the study was to compare the efficacy of epidural space identification and the complication rate between the two groups - the automatic syringe and conventional loss of resistance methods...
2016: Anaesthesiology Intensive Therapy
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