Anesteziologie a intenzivní medicína, 1999 (vol. 10), issue 1
Low-flow anaesthesia with sevoflurane for endoscopic abdominal surgeryArticles
I. Herold, M. Bednář
Anest. intenziv. Med. 1999;10(1):8-10
15 patients (6 men) aged 59±11,9 years, BMI 29±5,4, ASA 2±0,63 indicated for endoscopic cholecystectomy (12) or herniotomy (3) werepremedicated with diazepam 10 mg PO. The patients were induced with propofol (170±35 mg), fentanyl (0,2 mg) and mivacurium (13±2,5 mg). Aftershort time allowed for equilibration, sevoflurane was administered at 1 l/min fresh gas flow mixture with FA/FI over 0,9 in N2O/O2, while relaxationwas maintained with mivacurium (35±17 mg). Systolic arterial pressure (mmHg) at 13 th minute dropped from 151±23,6 to 98±26,1 (65% of originalvalues), diastolic pressure decreased...
General anaesthesia with sevoflurane using VIMA techniqueArticles
I. Herold, M. Bednář, M. Rosický, L. Piskač, J. Nováček
Anest. intenziv. Med. 1999;10(1):11-13
The paper summarizes our first experience with VIMA technique of sevoflurane anaesthesia. 12 patients scheduled for minor surgical, orthopedicor trauma surgery were induced with VIMA - tidal breath induction technique with sevoflurane. During induction, there was observed apnoea in 3patients, excitatory phenomenons in 2 patients and cough (once) during laryngeal mask insertion. The loss of consciousness assessed as a lack ofeye-lash reflex was observed after 95,6±30 secs. The insertion of laryngeal mask was possible after 190,2±66,6 secs after the beginning of sevofluraneadministration. After 42,1±28,5 mins of anaesthesia duration,...
Trimecain in prevention of coughing after endoscopic ENT surgery in paediatric patientsArticles
T. Vymazal, M. Marková, E. Mikešová
Anest. intenziv. Med. 1999;10(1):14-16
We sought to determine the effect of intravenously administered trimecain (Mesocain 1%, Leciva, CZ) in strictly defined dose and time ofadministration to prevent coughing during recovery from general anaesthesia for endoscopic ENT surgery in paediatric patients. We also followedthe effect of IV trimecain on heart rate, blood pressure, capillary haemoglobin saturation and time to response to verbal command during recovery ofpaediatric patients. We found that administration of trimecain in the dose 1 mg/kg 2-3 mins before the end of general anaesthesia significantly reducesthe occurrence and intensity of coughing after instrumentation in upper and lower...
Anaesthetic management of patients with morbid obesityArticles
R. Záhorec, D. Cintula, D. Setvák
Anest. intenziv. Med. 1999;10(1):17-21
Anaesthesia of morbid obese patient is associated with greater perioperative morbidity than normal patient. In our study we concern on thepathophysiology and anaesthetic management of patient with morbid obesity. Careful preoperative evaluation of clinical status, adequate monitoringand good choice of anaesthesia can prevent the perioperative complications. In the postoperative period are important: the prophylaxis of deep veinthrombosis, cardiotonic and diuretic therapy as well as short-term postoperative mechanical ventilation in MO patients with low cardiorespiratoryreserve.
Correlation of continuous SjvO2 values in neurosurgery patients with values obtained from co-oxymeterArticles
I. Čundrle, J. Mašek, M. Dastych
Anest. intenziv. Med. 1999;10(1):22-24
The authors evaluate the accuracy of hemoglobin oxygen saturation measurement in jugular bulb using Edslab II 4Fr catheter and monitor Vigilance.The difference when compared both to acid-base analysis results and co-oxymeter was statistically significant (p
Principles of primary care for neurointensive patientArticles
J. Procházka, A. Lapáčková, M. Sameš
Anest. intenziv. Med. 1999;10(1):25-28
Appropriate treatment within primary care for neurointensive patient strongly predicts favourable outcome of subsequent therapy. The basicprinciples include treatment according to Advanced Trauma Life Support protocols, basic neurologic exam according to Glasgow Coma Scale orBenes/Zverina with description of brain stem reflexes. Graphic examination presents an important role for differential diagnostic work up, along withvital functions monitoring and effective pharmacology. In the final part there is presented an overview of patients in Intensive Care Unit of NeurosurgeryDept. in Usti nad Labem (1994-1997).
Hemodynamic and oxygen transport parameters in critically ill patientsArticles
A. Kazda, J. Valenta, M. Stříteský, J. Polívková, J. Hendl, V. Vondráček
Anest. intenziv. Med. 1999;10(1):29-32
Hemodynamic and oxygen transport parameters in two group of critically ill patients were compared in the presented study. The data were obtainedfrom right heart catheterization using Swan-Ganz catheter. First group consisted of 15 patients with multi-organ dysfunction (109 measurements), theother group consisted of 20 patients after cardiac surgery with low cardiac output syndrome (100 measurements). Following parameters werecompared: cardiac index (CI), indexed systemic and pulmonary vascular resistance (SVRI and PVRI), paO2/FiO2, pulmonary shunt (Qs/Qt), O2 deliveryand consumption (DO2, VO2), hemoglobin level a lactate level.In both groups CI was...
Lymphocytic activation in critically ill septic patients during CVVHDArticles
M. Holub, M. Kolář, M. Helcl, P. Pudil
Anest. intenziv. Med. 1999;10(1):33-35
In 10 critically ill septic patients treated with continuous veno-venous hemodiafiltration (CVVHD), we investigated lymphocytic activation moleculesHLA-DR. The control group consisted of 35 septic patients not treated with CVVHD. The average expression of HLA-DR molecules in critically illpatients before introducing hemodiafiltration was significantly lower than in the control group (p = 0,0394). 24 hours after introducing CVVHD, thevalues of expression were significantly higher than before aplying the method (p = 0,0034). 3 days after discontinuing CVVHD the expression stayedsignificantly increased when compared to the values obtained before using...
The evaluation of accuracy of prediction of survival probability in trauma patients according to APACHE II, ISS and TRISSArticles
I. Chytra, E. Kasal, P. Pelnář, J. Lejčko, P. Lavička, S. Machart, R. Pradl, M. Bílek
Anest. intenziv. Med. 1999;10(1):36-39
The target of the study was to compare the accuracy of survival probability according to scoring systems APACHE II (Acute Physiologic and ChronicHealth Evaluation), ISS (Injury Severity score) and TRISS (Trauma and Injury Severity Scoring) in trauma patients hospitalized in Department ofAnaesthesiology and Intensive Care, University Hospital Pilsen from January 1, 1995 to December 31, 1997. The patients were divided into threegroups according to the type of diagnosis. First group of patients consisted of polytrauma patients without head injury (P, n = 165), the second groupconsisted of polytrauma patients with head injury (P+H, n = 109), the third...
The early and later survival time after the serious brain injuryArticles
B. Sániová, M. Drobný, L. Kneslová, S. Richterová, A. Sukup
Anest. intenziv. Med. 1999;10(1):40-45
The authors have analyzed patient time survival after serious brain injuries. The group of 83 comatose patients has included 27 after traumaticinjury, 21 after spontaneous brain haemorrhage, and 35 after hypoxic-ischemic injury. An early letality rate, since the comatose state onset till then 2days was 39.75% (n = 33).All 33 dead subjects have had GCS = 3 points. It has further shown later letality rate in the postraumatic injury group 47%, in the spontaneoushaemorrhagic 36.36% and in the hypoxic-ischemic brain injury group 36.36%.It could be considered a trend index letality rate in particular 3 diagnostic patient's groups. Quality survival evaluation...