Anesteziologie a intenzivní medicína, 2000 (vol. 11), issue 5
Pneumonectomy: Postoperative ComplicationsArticles
V. Bosek, L. A. Robinson
Anest. intenziv. Med. 2000;11(5):191-196
The risk of complications following the pulmonary resection tends to be directly proportional to the amount of lung removed and to the pulmonaryand cardiac reserve of the patient. The surgical consideration must respect the cardiopulmonary state of the patient and the vast majority of pulmonaryresection. The resectability refers to the anatomic location of the cancer.The authors summarize the surgical and non-surgical complications. The direct surgical complications are hemorrhage, intraoperative arrhytmias,recurrent laryngeal nerve injury, bronchopleural fistula, wound infection, mediastinal shift and empyema. The ventilation techniques may playa...
A Comparison of Mono-inhalational and Balanced Anaesthesia in Infants of Lowest Weight GroupsArticles
D. Štěpánková, J. Crhová, M. Fedora
Anest. intenziv. Med. 2000;11(5):197-201
Objective:To compare cardiovascular stability and recovery time in anaesthesia with and without opioid; to evaluate the possibilities to achievebetter cardiovascular stability with application of potent, easy-to-titrate analgetic agent.Study design: Retrospective study.Setting: ARO and COS, University Hospital Brno, Children Hospital.Patients: Newborns and infants up to 5,000 g weight with intact carciovascular system who were scheduled for anaesthesia with tracheal intubation(anaesthesia time > 60 min). The study period was between January 1997 and February 1999.Interventions: Inhalational anaesthesia was maintained with isoflurane (68%)...
Minimally Invasive Surgery and Anaesthesia in PediatricsArticles
J. Crhová, M. Strnadlová, D. Štěpánková, M. Fedora, J. Pavlíková
Anest. intenziv. Med. 2000;11(5):202-205
Objective:To assess changes in ventilatory parameters, lung mechanics, cardiovascular stability and body temperature during laparoscopicprocedures especially in children of low body weight.Type of study: Prospective observational study.Setting: ARO and COS, University Teaching Hospital Brno, Children Hospital.Patients: 40 children (26 boys, 14 girls) scheduled for laparoscopic surgery. Mean age 69.55 months (1 month to 18 years of age), mean body weight23.93 kilograms; mean ASA grade 1.85.Method: Patients received routine oral premedication one hour before surgery (or were premedicated intramuscularly 30 mins prior to surgery).Anaesthesia...
Accelerometry for Detection of Residual Neuromuscular BlockadeArticles
M. Adamus
Anest. intenziv. Med. 2000;11(5):206-210
We have compared two techniques of neuromuscular blockade monitoring, accelerometry and electromyography (ACC vs EMG). Neuromusculartransmission was measured using both EMG and ACC in 20 ASA I - III patients undergoing elect ive craniotomy in general anaesthesia longer thentwo hours. After suxamethonium administration (Ł 100 mg) to facilitate tracheal intubation, neuromuscular block was maintained by repeated bolusesof vecuronium (1 - 4 mg). Stimulation pattern consisted of TOF supramaximal stimuli (ulnar nerve) every 20 seconds, muscle response of the adductorpollicis was observed. 1218 paired measurements of TOF were obtained (TOFEMG and TOFACC)....
Economic Comparison of In-hospital vs Out-hospital Treated PatientArticles
J. Matyáš
Anest. intenziv. Med. 2000;11(5):211-212
Out-hospital day case surgery and anesthesia has become one of the fastest evolving concepts of the past decade. It represents reasonable andunavoidable trend in the medicine. However, in the Czech Republic it is not so. We name the reasons why the number of out-hospital anesthesia casesdid not rise significantly. The main obstacle preventing further development of out-hospital anesthesia represents the economic implications associatedwith that type of anesthesia. We try to figure out what are our chances when comparing ourselves to the developed West European countries.
Regional Analgesia for Out-patient SurgeryArticles
Dana Vondráčková
Anest. intenziv. Med. 2000;11(5):213-215
Regional analgesia allows for safe surgery without the need for in-hospital treatment and intensive postoperative monitoring. Postoperativeanalgesia also allows for early rehabilitation, shorter convalescence and decreases the cost of a procedure. Local techniques with continuousapplication of an anesthetic down the catheter to the wound provide sufficient analgesia even in more painful procedures.
Treatment of Postoperative PainArticles
J. Švehla, T. Beran
Anest. intenziv. Med. 2000;11(5):216-218
Good treated postoperative pain decreases number of postoperative complications. Preemptive analgesia can blocate development of chronicalpain syndrome. Farmakotherapy is starting point for postoperative analgesia. The application of NSAIDs is very poor in our country, the reason isfear of adverse events. The all arrangement of opioids is not full utilized, just as, it is not common to exploate the alternative ways of their application.The anestesiological and non-farmakological approaches are more usefull, day by day.
Lung Changes as a Possible Result of Adverse Effects of Betalactam AntibioticsArticles
M. Filaun, I. Lišková, J. Stejskal, V. Mužíková, O. Lochman, E. Bébrová
Anest. intenziv. Med. 2000;11(5):219-221
Authors refer to not much known adverse reaction in treatment with betalactam antibiotics. In years 1997 - 1998 there was 691 children treatedin our ICU, we found in 25 of them increased level of antibodies against betalactam antibiotics. Indication for examination of level antibodies wasX-ray picture of wet lung, contemporary application of betalactam antibiotics and somet imes positive allergic history. Antibodies was determined withmethod of non direct hemaglutination and as a positive finding was level 1:320 and more. In these cases was antibiotic treatment changed to antibioticsof other type. We found recess of X-ray picture in 20 cases, 5 children...
Traumatic Spinal Cord Lesion of C-area in ChildrenArticles
I. Lišková, M. Filaun, V. Mrzena, D. Hechtová
Anest. intenziv. Med. 2000;11(5):222-223
Damage of cervical spine cord in head trauma in children is estimated according our experiences often even until autopsy. Signs of spine cord lesioncan be overlap with neurologic signs of severe head trauma and with signs of hypoxic brain damage. Authors refer in this study about pitfalls inassessment and treatment this injured children. In years 1990 - 1997 302 children with head trauma were admitted, 68 children died (22,5%), totalnumber of children with spinal cord injury was 20 (6,62%), 12 children died and had spinal cord lesion found in autopsy. Eight patients with spinalcord lesion survived in age bracket 2 till 15 years. Examination targeting...
The Influence of Anaemia and Blood Transfusion on the Immunity System of Cadaver Organ DonorsArticles
H. Živná, P. Živný, V. Černý, V. Palička, D. Vokurková
Anest. intenziv. Med. 2000;11(5):224-227
Kidney transplantation from brain dead donors has become a routine treatment for renal failure. Acute graft failure or early rejection aftertransplantation is multifactorial process; the characteristics of cadaveric donor is one of the features. Our study evaluated brain dead donors andpossible effect of their therapy on the graft survival prognosis. In our study we evaluated thirty-three brain dead donors of cadaveric kidney. Fifteendonors had a brain death following non-traumatic injury (D1), ten patients suffered brain death after craniocerebral injury and were not transfused(D2), eight brain dead patients after craniocerebral injury were transfused...
Brain Death - a New Protocol ProposedArticles
M. Smrčka, O. Baudyšová, J. Boudný, R. Gál, V. Smrčka
Anest. intenziv. Med. 2000;11(5):228-230
In the Czech Republic, brain death can be pronounced after two panangiography series done with 30 minutes time interval in-between. Thisexamination has a high falsely negative results, even though the patient is apparently brain dead, according to the clinical examination. Radio-opaquefluid frequently flows above skull base to the intracranial part of the vasculature; sometimes, ophthalmic artery can be visualized. The intracranialfilling of the vasculature can be affected by previous decompressive craniectomy.Based on the authors' experience, there are recommended possible changes in the evaluation of brain death. This should be stated on clinicalexamination...