Anaesthesiology Intensive Therapy

PURPOSE: The mean systemic filling pressure (Pms) plays a central role for our understanding of the circulation. In a retrospective analysis of a clinical trial, we studied whether Pms indicates fluid responsiveness and whether Pms can indicate an anaesthesia-induced increase of the unstressed blood volume, which is the volume that does not increase the transmural pressure. METHODS: An analogue to P ms based on cardiac output, the mean arterial pressure and the central venous pressure, abbreviated to P msa , were calculated in 86 patients before induction of general anaesthesia and before 3 successive bolus infusions of 3 mL kg -1 of colloid fluid...

INTRODUCTION: The search for an effective sedation schedule in managing delirium tremens that would ensure an adequate sedation level and good safety profile is an urgent problem of modern intensive care medicine. In this respect, the use of dexmedetomidine combined with magnesium preparations seems to be promising. MATERIAL AND METHODS: A quasi-randomized prospective observational study was conducted on 80 patients with alcoholic delirium, who were divided into 4 groups...

INTRODUCTION: Sepsis is a syndrome of physiological, pathological, and biochemical disorders with several processes co-occurring; reactive oxygen species (ROS) production and apoptosis are 2 of them. Succinate is a Krebs cycle intermediate that is oxydized in complex II of the mitochondria. This study aims to investigate the influence of succinate infusion on these processes. MATERIAL AND METHODS: Sepsis was induced with caecal ligation and puncture in 200 gr Sprague Dawley rats...

INTRODUCTION: An awake craniotomy (AC) is the gold standard for the resection of supra-tentorial brain tumours in eloquent areas. Intraoperative monitoring "on-demand" of essential eloquent brain functions and the increasing need to preserve higher intellectual functions during surgery requires a unique anaesthetic approach during AC. Dexmedetomidine is considered the first-choice pharmacological agent for sedation during AC. MATERIAL AND METHODS: Twenty-six patients with a single brain tumour located in areas of eloquent brain function were enrolled in this prospective study...

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.

INTRODUCTION: The benefits of type I/II pectoral nerve blocks (PECS I/II), which can be dose dependent, have been examined in different studies. Nonetheless, few randomised trials have been performed in South America. The present randomised trial examined the efficacy of PECS I/II with a higher dose of the local anaesthetic to manage perioperative pain after mastectomy in Brazil. MATERIAL AND METHODS: This was a randomised, parallel, single-centre, and single-blind trial...

INTRODUCTION: COVID-19 is associated with severe respiratory distress and high mortality. We investigated the evolution of the respiratory mechanics in COVID-19 acute respiratory distress syndrome (ARDS) and the occurrence of a restrictive respiratory pattern. MATERIAL AND METHODS: A retrospective, single-centre study including patients admitted to the ICU during the first wave of the pandemic (March-April 2020). RESULTS: A total of 141 consecutive patients were included...

INTRODUCTION: Upper gastrointestinal bleeding (UGIB) is a common reason for intensive care admission. While there exist a number of UGIB scoring systems which are used to predict mortality, there are limited studies assessing the discriminative value of these scores in intensive care unit (ICU) patients. The purpose of this study was to analyse five different UGIB scoring systems in predicting ICU mortality and length of stay and compare them to two commonly used ICU mortality scoring systems...

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...

The debate about medical futility often involves intensive care units where life-support procedures are routinely applied. Futile therapy is part of end-of-life therapy. In the discussion about medical futility it is important to distinguish the effect of therapy from the benefit for the patient. The goal of treatment is not to maintain the function of an organ, body part or physiological activity, but to maintain health as a whole. Prolonging ineffective treatment violates the standard of good medical practice...

INTRODUCTION: Patients with major burn injury are prone to hypothermia, potentially resulting in an increase in mortality and length of hospital stay. Our study comprehensively evaluates the practicalities of physiological thermoregulation and temperature control in the largest cohort of critically ill adult burn patients to date. MATERIAL AND METHODS: This retrospective study of routinely collected patient data from the Intensive Care Unit (ICU) of the West Midlands Burn Centre was conducted over a three-year period (2016-2019)...

RATIONALE AND SCOPE OF THE GUIDELINES Pain is a subjective unpleasant sensory and emotional experience. Acute pain occurs irrespective of age and has a prevalence of about 5% of the general population. Surgical procedures and painful diagnostic procedures are the main causes of this unpleasant and dangerous phenomenon for hospitalized children. It should be remembered that maintaining homeostasis in a child undergoing surgery is also affected by provision of an adequate level of analgesia and sedation as well as nerve conduction block within the surgical site...

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...

The current opioid epidemic has had a massive impact on the critical care sector. This is due to an increase in the number of acute opioid overdose-related admissions and the number of opioid-dependent and opioid-tolerant patients admitted to intensive care units (ICUs). This review discusses the challenges that intensive care physicians face when caring for patients suffering from opioid-related disorders and analyses existing solutions. Preference for non-opioid analgesics, treatment of acute pain in the ICUs to avoid chronic pain syndrome, and education of patients and caregivers are critical to preventing this pandemic...

Working Group: Prof. Łukasz Krzych, MD, PhD - Chairman of the Working Group, Chairman of the Intensive Care Section of the Polish Society of Anaesthesiology and Intensive Therapy Assistant Prof. Alicja Bartkowska-Śniatkowska, MD, PhD - Deputy Chairwoman of the Paediatric Section of the Polish Society of Anaesthesiology and Intensive Therapy Prof. Piotr Knapik, MD, PhD - Chairman of the Scientific and Educational Section of the Polish Society of Anaesthesiology and Intensive Therapy Assistant Prof...

INTRODUCTION: Recent advances in airway management have led to supraglottic airway devices (SAD) being increasingly often chosen instead of tracheal intubation for laparoscopic surgery. However, there are ongoing arguments regarding the use of SAD due to worries about the risks of insufficient ventilation and pulmonary aspiration. The LMA Protector is a second generation SAD which was put into use recently. This prospective randomised trial investigated whether the LMA Protector was comparable to the tracheal tube regarding respiratory parameters, perioperative complications and haemodynamic parameters in patients undergoing laparoscopic surgery...

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...

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