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Anaesthesiology Intensive Therapy

Jan Pluta, Barbara Nicińska, Michał Ciurzyński, Janusz Trzebicki
BACKGROUND: Platelets are responsible for primary haemostasis. Patients with suspected platelet dysfunction require prompt clinical assessment when qualifying for emergency surgical procedures. The purpose of this article is to present our experience in platelet function assessment using whole-blood multiple electrode aggregometry (MEA) in various clinical conditions. CASE REPORTS: Retrospective analysis of three patients with thrombocytopathy associated with normal platelet counts was performed using standard laboratory tests complemented by MEA...
July 16, 2018: Anaesthesiology Intensive Therapy
Jan Pluta, Barbara Nicińska, Janusz Trzebicki
Platelets play an essential role in haemostasis. Assessment of their function is vital for anaesthesiologists evaluating haemostatic potential, especially during emergency operations. The monitoring of platelets function had been implemented into the European recommendations for management of perioperative and posttraumatic bleeding. One of the diagnostic methods described in the recommendations is multiple electrode aggregometry. As antiplatelet therapy becomes more widely used in modern medicine, this method, in contrast to standard laboratory tests, can significantly help to identify patients with drug-induced thrombocytopaty...
July 12, 2018: Anaesthesiology Intensive Therapy
Ewa Woźnica, Lidia Łysenko
Serum procalcitonin (PCT) is a sensitive biomarker used for the diagnosis of infection and sepsis. PCT has also some toxic effects. It is not a proinflammatory stimulus, but may augment the inflammatory processes. High levels of PCT in sepsis may lead to hepatocyte necrosis and, as a result, to liver failure. The pathomechanism of the toxic effect of PCT is still unknown. The influence of liver function on PCT levels has not been studied yet. It is not sure whether the liver dysfunction affects the diagnostic and prognostic value of serum PCT levels...
July 11, 2018: Anaesthesiology Intensive Therapy
Suci Hanifah, Ross Kennedy, Patrick Ball
BACKGROUND: There are no published studies that report on fentanyl and ketamine compatibility in dextrose 5% solution as commonly practiced in hospital settings. METHODS: This study assessed the compatibility of fentanyl and ketamine after their reconstitution in dextrose 5% under ambient temperature and humidity conditions in a hospital setting. Each sample of fentanyl and ketamine was prepared in triplicate by adding dextrose 5% to a prefilled syringe until final concentrations of 9...
July 8, 2018: Anaesthesiology Intensive Therapy
Bjoern Zante, Eva Margarete Hammel, Arno Lauber, Joerg Christian Schefold
No abstract text is available yet for this article.
June 22, 2018: Anaesthesiology Intensive Therapy
Michał Stasiowski, Marek Zuber, Radosław Marciniak, Michał Kolny, Ewa Chabierska, Przemysław Jałowiecki, Aleksandra Pluta, Anna Missir
BACKGROUND: Horner's syndrome is comprised of a set of symptoms caused by a permanent or transient ipsilateral sympathetic trunk lesion or paralysis. It may occur after numerous pathologies in the cervical region, epidural, spinal anaesthesia, and interscalene, transscalene, supraclavicular, or infraclavicular brachial plexus block. The aim of this randomised, prospective clinical study was to evaluate the effect of the interscalene brachial plexus block (IBPB) technique on the occurrence rate of Horner's syndrome and identify contributing risk factors...
June 22, 2018: Anaesthesiology Intensive Therapy
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
Piotr Filip Czempik, Łukasz J Krzych
AHA is an extremely rare disorder, with annual incidence of 1.5 cases per million population. This clinical entity is caused by autoantibodies directed against coagulation factor VIII, what leads to decreased serum activity of thereof, and is characterized by spontaneous or induced by trauma, or invasive procedure bleeding. Approximately 50% of cases are idiopathic in origin, affecting both sexes, with median age at diagnosis of 74 years. We present a case report of a patient diagnosed with acquired haemophilia A (AHA) in the perioperative period...
2018: Anaesthesiology Intensive Therapy
Marco Cascella
2018: Anaesthesiology Intensive Therapy
Kati Järvelä, Markku Rantanen, Tiit Kööbi, Heini Huhtala, Tero Sisto
BACKGROUND: Significant fluid retention is common after cardiac surgery with the use of cardiopulmonary bypass (CPB). The aim of the study was to evaluate the effects of hypertonic saline-hydroxyethyl starch (HS-HES) solution on fluid accumulation in patients undergoing coronary artery bypass grafting surgery (CABG). METHODS: Fifty adult male patients undergoing coronary bypass surgery were enrolled in this interventional, randomized, double-blinded study to compare HS-HES with saline solution...
2018: Anaesthesiology Intensive Therapy
Vitaliy Ivanovich Kolomachenko
BACKGROUND: Serum C-reactive protein (CRP) detects the inflammatory response to surgical trauma in hip surgery. It corresponds to the type of surgery, with a higher level of CRP being found in surgery techniques with greater tissue damage. The aim of our study was to analyze the CRP level in serum and drainage blood after hip surgery in patients with coxarthrosis depending on the method of anaesthesia and post-operative analgesia. METHODS: 65 patients, 58 ± 12 years old, were included in the study...
2018: Anaesthesiology Intensive Therapy
Cristina Petrisor, Robert Szabo, Catalin Constantinescu, Adrian Prie, Natalia Hagau
BACKGROUND: Ultrasonography-assessed hyomental distance (HMD) ratio has been found to discriminate between obese patients with Cormack-Lehane grades 1 or 2 vs. those with grades 3 or 4. The aim of our study is to evaluate the performance of the HMD evaluated ultrasonographically in neutral, ramped, and maximum hyperextended positions, as well as for the ratios obtained by dividing the HMD in the ramped position to that in the neutral position (HMDR1) and by dividing the HMD in maximum hyperextension to that in the neutral position (HMDR2), in order to predict the occurrence of Cormack-Lehane grades 3 or 4 during direct laryngoscopy...
2018: Anaesthesiology Intensive Therapy
Jolanta Wierzchowska, Przemysław Kowiański, Seweryn Niewiadomski, Zbigniew Karwacki
BACKGROUND: In nearly all cases of general anaesthesia with a volatile agent, the anaesthetic concentration has to be increased. Since the anaesthetic affects both the factors determining intracranial homeostasis and the systemic circulation, it is crucial that cerebral perfusion pressure (CPP) is protected. The aim of the present study was to assess the influence of gradually increased concentrations of desflurane on the cerebral and systemic circulations based on CPP, mean arterial pressure (MAP), intracranial pressure (ICP) and their correlations...
2018: Anaesthesiology Intensive Therapy
Gali Katznelson, Gali Katznelson, Hance Clarke
As organ transplantation science continues to mature, both physicians and the public face challenges defining death and, subsequently, caring for an individual when they are deemed eligible for organ procurement. This paper revisits the anaesthesiologist's role with respect to the provision of analgesic medication at the time of organ procurement. It provides a historical overview of the ethics of organ procurement, explaining how the definition of brain death and the ethical principle of the 'dead donor rule' have shaped the practice of organ procurement...
2018: Anaesthesiology Intensive Therapy
Katarzyna Kotfis, Annachiara Marra, Eugene Wesley Ely
ICU delirium is a common medical problem occurring in patients admitted to the intensive care units (ICUs). Studies have shown that ICU delirium is associated with increased mortality, prolonged hospitalization, prolonged mechanical ventilation, costs and the occurrence of cognitive disoders after discharge from ICU. The tools available for ICU delirium screening and diagnosis are validated tests available for all members if the medical team (physicians, nurses, physiotherapists). Their use for routine patient assessment is recommended by international medical and scientific societies...
2018: Anaesthesiology Intensive Therapy
Matteo Parotto, Maral Ouzounian, Ludwik Fedorko, George Oreopoulos, Thomas Lindsay, Rita Katznelson
BACKGROUND: Complex aortic repair (CAR) carries high rates of debilitating postoperative complications, including spinal cord injury. The rate of spinal cord deficits post-CAR is approximately 10%, with permanent paraplegia in 2.9% and paraparesis in 2.4% of patients. Treatment options are limited. Rescue therapies include optimization of spinal cord perfusion and oxygen delivery by mean arterial pressure augmentation (> 90 mm Hg), cerebrospinal fluid drainage, and preservation of adequate haemoglobin concentration (> 100 g L⁻¹)...
2018: Anaesthesiology Intensive Therapy
Michał Hys, Rafał Rutyna, Olga Psujek, Khaled Salameh, Wojciech Dąbrowski
No abstract text is available yet for this article.
2018: Anaesthesiology Intensive Therapy
Tomasz Gaszyński
No abstract text is available yet for this article.
2018: Anaesthesiology Intensive Therapy
Małgorzata Albin, Tomasz NIkodemski
No abstract text is available yet for this article.
2018: Anaesthesiology Intensive Therapy
Paul McNulty, Tamas Szakmany, Welsh Digital Data Collection Platform Collaborators
No abstract text is available yet for this article.
2018: Anaesthesiology Intensive Therapy
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