Anesteziologie a intenzivní medicína, 1999 (vol. 10), issue 5
Clonidine in premedication in burn patientsArticles
J. Málek, L. Hess, J. Jandová, A. Kurzová, E. Šimánková
Anest. intenziv. Med. 1999;10(5):186-189
We tested a hypothesis that clonidine in premedication suppresses adverse hemodynamic reactions during ketamine-diazepam-fentanyl anesthesiafor burned patients. In every enrolled patient during repeated anesthetic procedures we alternated between premedication with and without clonidine.20 patients were administered 0,150 mg clonidine in 100 mls of normal saline intravenously, 15 minutes prior to the start of the procedure (clonidinei.v.). 10 patients were administered 0,300 mg clonidine intramusculary 30 minutes prior to the start of the procedure (clonidine i.m.). In both groupswe observed decreased incidence of hypertension a tachycardia during...
The anaesthesia for videothorascopic operationsArticles
M. Janíková, M. Tonkovičová, M. Šarafín, M. Refka, J. Hamžík
Anest. intenziv. Med. 1999;10(5):190-193
Over the period of 1993 - 1998 500 operations was performed by videothoracoscopic method at our institute. We present ventilatory andhaemodynamical changes that occur during the procedures. By this article we want to emphasize the safety of one-lung anaesthesia, provide it iscorrectly managed.
Reye's syndrome and intensive careArticles
M. Filaun, K. Dlask, I. Lišková
Anest. intenziv. Med. 1999;10(5):194-196
Authors evaluate in retrospective study group of 102 children treated in years 1980 - 1996 in PICU v Motol for brain oedema caused by Reye'ssyndrome. Input criteria of the group were Reye's syndrome and ICP monitoring. Epidural way of ICP monitoring was used. Standard therapeuticalprotocol for treatment of brain oedema as a part of treatment of hepatocerebral syndrome was used. Evaluated group had 102 children, mortality ratewas 48%. Greatest incidence was in years 1983, 1984 and 1986. Last case appeared in year 1995. Decrease of incidence is associated with end ofusing of Acylpyrin in common paediatric practice.
Brain oedema in children and inracranial pressure monitoringArticles
M. Filaun, K. Dlask, I. Lišková
Anest. intenziv. Med. 1999;10(5):197-199
Authors evaluate in retrospective study group of 442 children in year 1980 - 1996 treated in PICU in Motol for brain oedema. Input criteria of thegroup was ICP monitoring. Epidural way of ICP monitoring was used. Standard staircase therapeutical protocol was used updated during time. Mostfrequent group of school children had greatest count (49%), most frequent diagnosis was trauma (35 %). General rate of surviving was 54 % withoutdifference of age and diagnosis. The children with age till one year were highest risk group. Time of monitoring was 1 - 43 days. Since 1997 wasepidural ICP monitoring replaced with intraparenchymal acces.
Barbiturates and brain oedema in childrenArticles
M. Filaun, I. Lišková, K. Dlask
Anest. intenziv. Med. 1999;10(5):200-202
Barbiturates are used in treatment of brain oedema as a barbiturate coma and as a short term barbiturate in bolus repeated dose. Aim of thisretrospective study is to evaluate the effect of barbiturates on decreasing of mortality in children with intracranial hypertension of traumatic and nontraumatic etiology. We evaluated group of 233 children, trauma 109, non trauma 124. Input criteria was extension reaction on pain stimuli. Intracranialpressure was measured in epidural way. Staircase therapeutical protocol was used, short term barbiturate Thiopental was use in periods of intracranialhypertension in repeated dose 1-2 mg/kg of b. w. Thiopental was...
Lipoperoxidation and antioxidatory protection of an organism during weaning from mechanical ventilationArticles
V. Černý, P. Živný, P. Dostál, R. Pařízková
Anest. intenziv. Med. 1999;10(5):203-209
According to the current literature data, free oxygen radicals and mechanism of lipoperoxidation play an important role during development ofmuscular system dysfunction during sepsis and septic shock. Muscular dysfunction can affect respiratory muscles and contribute to muscular fatiguewith subsequent need for ventilatory support. The aim of the study was to assess the degree of lipoperoxidation and capacity of antioxidatory apparatusin patients during weaning period. In 37 mechanically ventilated patients we prospectively monitored the concentrations of malonedialdehyd,glutathion, glutathionperoxidase activity and superoxiddismutase activity; betacaroten...
The importance of routine evaluation of biochemical and clinical markers during long-term ventilatory support and difficult weaningArticles
V. Černý, P. Živný, P. Dostál, R. Pařízková
Anest. intenziv. Med. 1999;10(5):210-216
Difficult weaning from ventilatory support is observed in almost one fourth of ventilated patients. Difficult weaning results in longer ICU stay, whilerepeated weaning trials can account for a respectable part of the whole ventilatory support time. The aim of the study was to evaluate selected clinicaland metabolic markers in patients with different duration of ventilatory support and weaning process. In 37 patients we prospectively monitoredfollowing parameters: albumin, pre-albumin, transferin, cholinesterase, CRP, ionized magnesium, phosphorus, myoglobin urine level, and selectedclinical parameters (APACHE II, SOFA, Goris score, presence of septic...
Cytokines during weaning from ventilatorArticles
V. Černý, P. Živný, P. Dostál, R. Pařízková
Anest. intenziv. Med. 1999;10(5):217-220
Muscular fatigue as one of the symptoms of organ dysfunction can contribute to difficult weaning from ventilatory support in septic patients onlong-term ventilatory support. Pathogenesis of this muscular dysfunction is not completely understood; however, various experimental papers implythat TNF-a negatively affects diaphragm contractility and metabolism of striated muscles. In 40 patients we prospectively followed the levels of selectedcytokines (TNF-a, IL-8, sIL-2R) during mechanical ventilation and weaning period. According to the length of weaning, patients were divided intotwo groups: group S, weaning period Ł 3 days, n = 15; group L, weaning...
Thromboelastography - why especially that?Articles
I. David, K. Cvachovec, M. Horáček
Anest. intenziv. Med. 1999;10(5):221-226
The review article presents current possibilities of hemocoagulation monitoring, with a special attention to its disorders in the operating roomsetting and ICU setting. The core of the article is devoted to thromboelastography (TEG). This method has been used experimentally since 1948.However, that method did not attract greater attention until last two decades. The greatest advantage of TEG is to assess the course of hemocoagulationin real time, and provide us with a thorough information on thrombogenesis and thrombolysis. TEG can simplify the diagnostic procedures of manycoagulation disorders, while making the final diagnosis more accurate. TEG has...