Anaesthesiology Intensive Therapy

Thirty years ago, the traditional approach to mechanical ventilation consisted of the normalization of PaCO2 and pH at the expense of using a tidal volume (VT) of 10-15 mL kg-1. But then, the use of 6-8 mL kg-1 became a dogma for ventilating patients either with acute respiratory distress syndrome (ARDS) or without lung disease in the operating theatre. It is currently recognized that even low tidal volumes may be excessive for some patients and insufficient for others, depending on its distribution in the aerated lung parenchyma...

INTRODUCTION: Adhesive tape is commonly used to secure endotracheal tubes (ETT) during general anaesthesia. Although a variety of adhesives are used in practice, few studies have investigated the likelihood of different adhesives in producing facial skin injury. Given that differences in cost exist between adhesives that are often used interchangeably, it would be prudent to use the most economical option. MATERIAL AND METHODS: A single-centre, prospective, randomised controlled non-inferiority trial of patients undergoing general anaesthesia with an ETT was conducted...

INTRODUCTION: This study aimed to evaluate the current awareness and management of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) among paediatric intensivists. MATERIAL AND METHODS: A web-based electronic survey was sent to all physicians working in paedia-tric intensive care units (PICUs) in Saudi Arabia. The survey questions obtained information regarding awareness of ACS and IAH, recognition criteria, monitoring of intra-abdominal pressure (IAP), and experience in managing ACS...

Breast surgeries belong to the most frequently performed procedures and are often associated with a high intensity of pain in the postoperative period. Regional anesthesia techniques, and paravertebral block, have been the gold standard of postoperative pain management for major breast cancer surgeries. In recent years, the development of new techniques of regional anesthesiology, which is due to the extensive implementation of ultrasound imaging, has enabled the use of a number of new blockades. The "new players" in regional anesthesiology include numerous fascial plane blocks...

BACKGROUND: To determine the predictive value of mid-regional pro-adrenomedullin (MR-proADM) compared to routine clinical and laboratory parameters in patients with COVID-19. METHODS: A total of 135 adult patients hospitalized with COVID-19 were included in a prospective single-centre study. In addition to routine parameters, the levels of MR-proADM in blood plasma were measured on the day of hospitalization. The patients were divided into 2 groups: those who survived and were discharged (n = 115, 85%) and those who did not survive (n = 20, 15%)...

INTRODUCTION: COVID-19 has disturbed the functioning of Polish healthcare for the past two years. Due to the high proportion of patients requiring admission to the intensive care unit (ICU), these wards are particularly overwhelmed and are considered the bottleneck of the healthcare system. The aim of this study was to describe clinical outcomes of critically ill patients treated in a single tertiary ICU in Poland, assess factors associated with mortality and compare outcomes of patients treated during the 2nd and 3rd waves of the pandemic...

Penetrating thoracic trauma accounts for 20-25% of all deaths due to trauma in the first four decades of life. About 33% of deaths from thoracic trauma occur due to penetrating trauma. In an autopsy study that enrolled 1178 trauma patients, 82% of the patients with tracheobronchial injuries died at the incidence site. In another study, 30% of those who could be transferred to the hospital died. This review aimed to revisit penetrating thoracic trauma with respect to complications and the strategies for airway management...

INTRODUCTION: Malignant hyperthermia (MH) is a life-threatening syndrome caused by sudden skeletal muscle hypermetabolism in response to inhalation anaesthetics and depolarising relaxants. The estimated incidence of MH is between 1 : 10,000 and 1 : 250,000 anaesthetic procedures. In Poland the incidence of MH is unknown. Dantrolene is imported as a life-saving drug and temporally authorised for sale. The aim of the study is to assess the incidence of MH and access to dantrolene in the Mazovia Province...

BACKGROUND: Fibreoptic intubation through a supraglottic airway device (SAD) is recom-mended in difficult airway management algorithms. The Difficult Airway Society published a guideline describing the details of this technique in 2011. This study was designed to compare the efficiency of two different 2nd generation SADs as a conduit for Aintree catheter-guided fibreoptic tracheal intubation. METHODS: 80 adult patients with an ASA score of 1-3 undergoing elective surgical procedures were included in the study...

A growing body of evidence shows that some septic patients experience fluid overload, which leads to an increased number of serious complications and death. This is because the majority of septic patients are fluid non-responders. Therefore, a reliable distinction of which patient would benefit from fluid boluses is crucial in current sepsis mana-gement. Several methods used to assess fluid responsiveness have been developed. The principle of "dynamic" measurements (in contrast to static indices such as central venous pressure) involves the induction of a change in cardiac preload and the measurement of its effect on stroke volume...

BACKGROUND: Postoperative pain following lower abdominal surgery is one of the most common complications reported by patients. Gabapentin given two hours before surgery as pre-emptive analgesia has been reported to reduce postoperative pain and decrease postoperative analgesia requirements. The aim of this study was to determine the effectiveness of 600 mg oral gabapentin as a pre-emptive analgesia to reduce postoperative pain and morphine requirements following nonobstetric lower abdominal surgery...

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BACKGROUND: The Sequential Organ Failure Assessment (SOFA) score has been developed to score the severity of organ dysfunction in critically ill sepsis patients and has been proven to have a high predictive value for intensive care unit (ICU) mortality in severely ill patients. Our goal was to evaluate the prognostic value of the SOFA score as well as trends in SOFA score for ICU mortality in COVID-19 patients. METHODS: All consecutive patients with confirmed COVID-19 pneumonia admitted to the ICU between March 13th, 2020, and October 17th, 2020 were included in this retrospective cohort study...

No abstract text is available yet for this article.

Healthcare personnel who work for prolonged periods in highly stressful environments are susceptible to the effects of these stressors and the cumulative nature of their exposure. The term 'burnout' has been coined to describe a constellation of symptoms related to work, organisational and personal issues occurring in individuals with no prior history [1]. Burnout has been described as particularly prevalent in the critical care setting [2-4]; it affects not only the health and wellbeing of those individuals experiencing the deleterious consequences, but also the quality of the care they provide [1]...

Clostridioides difficile infection (CDI) has become a serious medical and epidemiological problem with a marked increase in incidence and severity [1]. CDI is responsible for 15-25% of all anti-biotic-associated diarrhea cases, with a considerable increase in the 21st century [2]. Recommended first-line therapy for CDI involves oral vancomycin [1]. Oxygen therapy might be a variant of etiological therapy for anaerobic infection, including CDI [3]. Here we present a case of successful treatment of clostridial colitis in a child by enteral oxygen administration (state scientific project "Investigation of gastrointestinal tract nondigestive functions and the role of enteral oxygenation")...

In recent years, ultrasonography has gained unmatched importance in medical practice. After the initial use for central vascular access placement and regional anaesthesia, its application has expanded to airway, ocular, abdominal, lung and cardiac ultrasound, with the concept of point of care ultrasound (POCUS) gaining acceptability and applicability in the most diverse situations. In fact, it has recently been acclaimed as the fifth pillar to bedside evaluation [1]. Performing a POCUS-guided eva-luation has proved to be of value in emergency medicine, with studies demonstrating improved diagnosis and better outcomes [2]...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.