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Anaesthesiology Intensive Therapy

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https://www.readbyqxmd.com/read/28215043/is-the-change-of-percutaneous-oxygen-pressure-available-to-judge-the-effects-of-brachial-plexus-block
#1
Tomoki Nishiyama
BACKGROUND: To know the objective methods of the effects of the brachial plexus block, we studied the changes in percutaneous oxygen pressure (tcPO₂) with the hypothesis that tcPO₂ increases significantly on the blocked arm in comparison with the non-blocked arm, a phenomenon which is connected with vasodilation following the brachial plexus block. METHODS: Fifteen patients scheduled for upper extremity surgery, aged 20 to 70 years, with ASA physical status I or II were included...
February 19, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28194747/local-anaesthesia-with-analgosedation-in-patients-qualified-for-transcatheter-aortic-valve-implantation-tavi-first-institute-s-results-and-experiments
#2
Robert Musiał, Magdalena Lipińska-Strasik, Agnieszka Piątkiewicz, Jarosław Stoliński, Rafał Drwiła
BACKGROUND: The authors present their own experience of the treatment of patients qualified for transcatheter aortic valve implantation (TAVI) carried out in a modern hybrid operating room. The objective of the present study was to demonstrate the initial results of conducting anaesthesia in high-risk patients qualified for the TAVI procedure (transcatheter aortic valve implantation). In addition, the authors' aim was also to point out to the special challenges of an anaesthesiologist conducting local anaesthesia in such a type of procedures and to evaluate the safety and efficacy of the TAVI procedure conducted under remifentanil analgosedation...
February 14, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28084614/nasogastric-tube-insertion-in-anesthetized-patients-a-comprehensive-review
#3
Sarvin Sanaie, Ata Mahmoodpoor, Mahdi Najafi
Nasogastric tubes still remain the easiest and the best way for gastrointestinal tract access. There are various indications for the insertion of a nasogastric tube in anaesthetized and critically ill patients. Although many techniques have been introduced to facilitate nasogastric tube insertion using anatomic landmarks and a group of devices, there is no consensus on a standard method. Moreover, there are different methods for the assessment of the correct placement of a nasogastric tube. In addition to these challenges in insertion and assessment methods, there are varieties of major life-threatening and minor complications to be addressed...
January 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000205/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-ii-controlled-vs-spontaneous-ventilation
#4
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation)...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000204/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-i-pathophysiology
#5
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Severe acute respiratory distress syndrome (ARDS, PaO₂/FiO₂ < 100 on PEEP ≥ 5 cm H₂O) is treated using controlled mechanical ventilation (CMV), recently combined with muscle relaxation for 48 h and prone positioning. While the amplitude of tidal volume appears set < 6 mL kg⁻¹, the level of positive end-expiratory pressure (PEEP) remains controversial. This overview summarizes several salient points, namely: a) ARDS is an oxygenation defect: consolidation/ difuse alveolar damage is reversed by PEEP and/or prone positioning, at least during the early phase of ARDS b) ARDS is a dynamic disease and partially iatrogenic...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000203/comparison-of-continuous-epidural-block-and-continuous-paravertebral-block-in-postoperative-analgaesia-after-video-assisted-thoracoscopic-surgery-lobectomy-a-randomised-non-inferiority-trial
#6
Sylweriusz Kosiński, Edward Fryźlewicz, Michał Wiłkojć, Adam Ćmiel, Marcin Zieliński
BACKGROUND: Video-assisted (VATS) lung lobectomy can be associated with stronger postoperative pain than is commonly believed. It is generally accepted to introduce multimodal analgaesic strategies based on regional blockade, opioids and non-steroidal anti-inflammatory drugs. However, there is still no consensus regarding the optimal regional technique. The aim of this study was to compare the analgaesic efficacy of continuous thoracic epidural block (TEA) and percutaneous continuous paravertebral block (PVB) in patients undergoing video-assisted lung lobectomy...
2016: Anaesthesiology Intensive Therapy
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
#7
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...
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
#8
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: fentanylbased or low-opioid using dexmedetomidine...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27838915/incidence-of-in-hospital-cardiac-arrest-in-poland
#9
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...
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
#10
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...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27834984/effect-of-preoperative-intravenous-oxycodone-administration-on-sufentanil-consumption-after-retroperitoneal-laparoscopic-nephrectomy
#11
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...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824220/isolated-lower-limb-gangrene-a-caveat-of-terlipressin-therapy
#12
Ankur Khandelwal, Devendra Gupta, Rudrashish Haldar, Anindita Rai
No abstract text is available yet for this article.
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824219/anaesthesia-management-for-non-cardiac-surgery-in-children-with-congenital-heart-disease
#13
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 will increase because of the extraordinary progression of treatments, such as surgical procedures, interventional procedures, and intensive care medicine, as well as diagnosis...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27824218/coagulopathy-in-sepsis-a-new-look-at-an-old-problem
#14
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...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27797097/neuromuscular-blockade-in-the-elderly
#15
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
#16
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
#17
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
#18
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
https://www.readbyqxmd.com/read/27797093/a-comparison-of-selective-and-conventional-spinal-anaesthesia-for-ambulatory-surgery
#19
Andrzej Daszkiewicz, Andrzej Janik, Magdalena Śliwczyńska, Jacek Karpe, Hanna Misiołek
BACKGROUND: Selective spinal anaesthesia is the practice of employing minimal doses of intrathecal agents so that only the nerve roots supplying a specific area and only the modalities that require to be anaesthetised are affected. The study is based on the hypothesis that small dose lidocaine spinal anaesthesia may be adequate for elective surgical procedures, providing limited motor and sensory block, and thus enabling earlier patient's discharge. The aim of this study was the comparison of the low and the conventional dose of lidocaine spinal anaesthesia discharge time...
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
#20
Xiao-Ke Shang, Yan Yan, Bin Wang
No abstract text is available yet for this article.
2016: Anaesthesiology Intensive Therapy
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