Anesteziologie a intenzivní medicína, 1999 (vol. 10), issue 2
Sevoflurane in clinical practice - first experienceArticles
J. Ďurčovič
Anest. intenziv. Med. 1999;10(2):50-53
The author presents his first experience with sevoflurane. 170 adult and pediatric patients were scheduled for different procedures in generalanesthesia with this agent. The results and minimal incidence of adverse effects in the set of patients document that sevoflurane is an ideal inhalationalanesthetic for pediatric anesthesia, ENT procedures especially.
Sevoflurane in anaesthesia of burned childrenArticles
E. Šimánková, J. Jandová, A. Kurzová, J. Málek
Anest. intenziv. Med. 1999;10(2):54-59
The difference between sevoflurane anaesthesia (premedication with tramadol 1 mg/kg p.o.) and intramuscular ketamine anaesthesia (premedicationmidazolam 0.4 mg/kg p.o.) was tested in 10 paediatric patients with 2 nd degree burns during their repeated anaesthesias (average 3.6 per patient). Thetested parameters were distress at induction (scale 1-3), duration of induction, time of recovery, perioperative complications, postoperative distress(scale 1-3) and time to first oral intake of fluids. The differences were in duration of induction (66s sevoflurane vs 216s ketamine) and in time to firstoral intake of fluids (22 min sevoflurane vs 75 min ketamine)....
COPA - Cuffed Oropharyngeal AirwayArticles
J. Kovaľ
Anest. intenziv. Med. 1999;10(2):57-58
The author followed 25 patients who underwent surgery under general anaesthesia in whom cuffed oropharyngeal airway was used to maintainairway patency. COPA is put in just alike oral airway. The sealing cuff rests above vocal cords, securing airway patency practically the same way asendotracheal tube. The duration of surgery varied between 60 and 120 minutes. The author did not observe any adverse event, therefore he canrecommend the use of COPA especially for cases when difficult intubation is expected. COPA will find its place in resuscitation practice as well.
Does perioperative use of cell saver device influence homeostasis of an organism?Articles
D. Balšíková, H. Ondrášková
Anest. intenziv. Med. 1999;10(2):59-61
Cell saver device C.A.T.S. was used perioperatively for autotransfusion during corrective operations for trauma or spine deformities. The effectson homeostasis were assessed in 16 patients. Following data were obtained prior and after autotransfusion: Na, K, Cl, bilirubin, urea and creatinine.Statistical evaluation using t-test yielded no significant differences between the followed parameters. Autotransfusion technique using cell saver deviceC.A.T.S. does not affect homeostasis.
4,000 ml blood loss without a need for allogenic blood transfusion - a case reportArticles
B. Stibor, I. Čundrle
Anest. intenziv. Med. 1999;10(2):62-65
The patient scheduled for major urologic surgery has suffered 4,000 ml blood loss (78% of total blood volume) during the procedure. Two methodsof blood preservation were implemented - acute isovolemic hemodilution and preoperative autologous blood donoring (autotransfusion). With thesetechniques, allogenic blood transfusion could have been avoided, while perioperative levels of hemoglobin and hematocrit did not fall below safemargins for the patient.
Liver transplantationArticles
R. Wagner, M. Šimková, M. Haslingerová, O. Janíčková, P. Němec, P. Studeník
Anest. intenziv. Med. 1999;10(2):66-72
Liver transplantation has become widely accepted and effective therapy for different irreversible acute and chronic liver diseases. Transplantationcan extend the life expectancy period, and quality of life. First clinical liver transplantation was performed at Colorado University in 1963; however,this method of treatment remained in clinical experimental stage until the end of 70's. The introduction of new immunosuppresive agents into clinicalpractice in 80's (cyclosporine A and antilymphocyte agents) increased one-year survival rate from 40% to 60% and triggered a new progressivere-development of clinical transplantology. Along with increasing number...
Využitie vysokofrekvenčnej ventilácie pri resekciách trachey, laserovej liečbemalígnych procesov trachey, tracheálnej kariny a bronchovArticles
M. Janíková, M. Tonkovičová, M. Šarafín, M. Refka
Anest. intenziv. Med. 1999;10(2):73-76
Critical clinical conditions necessitating surgery require the use of non conventional ventilation. High frequency ventilation has proved to be veryhelpful in laser therapy of malignant tracheal and bronchial obstructions and also in tracheal resections.
Our experience with Midhumeral BlockArticles
D. Mach, J. Bonaventura
Anest. intenziv. Med. 1999;10(2):77-78
Midhumeral Block (MHB) represents one of recently described approaches to anaesthesia of upper extremity. It is based on anaesthesia of fourprinciple nerves in the area of middle and proximal third of humerus. These nerves pass this region separately, off of common tendon. However, theycould be reached from single injection point just with slight angulation of needle point. This block - philosophically a little illogical - has a greateffectiveness, based on wide patient populations. It leaves behind its greatest competitor, axillary block. Personal experience with 53 blocks aredescribed. Based on this experience, the author recommends this approach...
Airway Pressure Release Ventilation (APRV) and Biphasic Positive Airway Pressure (BIPAP) in children without severe pulmonary pathologyArticles
M. Fedora, M. Klimovič, M. Šeda, R. Nekvasil, P. Dominik
Anest. intenziv. Med. 1999;10(2):79-84
Thirty-four mechanically ventilated paediatric patients without severe lung dysfunction (ALI/ARDS) were ventilated in APRV/BIPAP mode.Following parameters were monitored: acid-base balance were achieved (pO2 11,5 kPa in time 0 and 12,3 kPa in 72 hours, pCO2 6,33 and 4,72 kPa;p 0,05); FiO2 could be decreased from 0,42 to 0,33. There were lower pressures in the airways [Phigh 15,3 vs. 14,3 MAP 6,8 vs. 4,3; Plow 4,8 vs. 3,3(cmH2O)] and better indexes - AaDO2 20,2 vs. 13,2 kPa; OI 3,3 vs. 1,4; pO2/FiO2 217,3 vs. 296,6 torr (p 0,05). We did not observe any complicationassociated with mechanical ventilation; ventilatory mode was well tolerated.
A short history of cardiopulmonary resuscitation: from ancient myths to ourpresent days 1Articles
S. Kleinschmidt
Anest. intenziv. Med. 1999;10(2):85-89
Since the re-discovery of chest compressions and ventilation with expired air nearly 40 years ago, this essential and standard method of BCLS hasnot changed significantly. Reliable data from laboratory and clinical studies such on arterial pressure, coronary perfusion pressure, cardiac outputor neurologically intact survival is necessary for the evaluation of any new method and will determine if a "new" technique or device can replaceS-CPR in the future. We must take into account that laboratory data are derived from "healthy" animals with a relatively short duration of inducedcardiac arrest - this situation cannot be transferred to clinical practice....