Anesteziologie a intenzivní medicína, 2001 (vol. 12), issue 5
Heart Rate as a Predicting Factor of Failed ExtubationArticles
D. Hodr, L. Včela, M. Pelichovská, K. Cvachovec
Anest. intenziv. Med. 2001;12(5):218-219
In a retrospective study in fifty-five patients intubated and mechanically ventilated for at least 24 hours we sought to determine the most accuratelypredicting factor of failed extubation after termination of ventilatory support. Eighteen per cent of patients had to be reintubated within next 24 hours.Reintubation was necessary in one of sixteen trauma patients (6 per cent), in six of twenty-seven surgical patients (22 per cent) and in 3 from twelvemedically ill patients (twenty-five per cent). Mortality in successfully weaned patients was 2.2 per cent, in reintubated patients forty per cent.We found statistically significant difference between successfully...
Inflammatory Disease in the Jaw Region - Difficult IntubationArticles
P. Havel, J. Walter, D. Hrušák, M. Nová, E. Boháčová
Anest. intenziv. Med. 2001;12(5):220-222
Patients with inflammatory disease in oropharyngeal region represent a substantial part of patients acutely operated on in the Department ofmaxillofacial surgery. Except for rare cases, radical surgical repair needs for general endotracheal anaesthesia. Jaw contracture, perifocal edema orinflammatory infiltration of oropharynx or hypopharynx in patients with low trigger to laryngospasm stand for the key factors complicating classicendotracheal intubation, requiring for more specialized techniques. The results of a five-year observational study are presented in the paper. Basedon the results, there are presented recommendations regarding safe induction...
Stop Flow - Anaesthesia and MonitoringArticles
B. Garajová, I. Trubák, I. Čundrle, J. Mach, I. Hanke
Anest. intenziv. Med. 2001;12(5):223-225
Stop flow is a special type of the regional chemotherapy. During this chemotherapy the cytostatic drug is administered into the isolated thoraciccirculation by the pathway of the central venous catheter, and at the same time the big blood circulation is closed. Writes have done research on theinfluence of this changes on the patient's organism and the necessity their correction.
Anaesthesia for Stabilization of Traumatic Spinal FracturesArticles
V. Kotačka, P. Horký, D. Řehořková, P. Wendsche
Anest. intenziv. Med. 2001;12(5):226-228
The paper reviews epidemiology of spinal fractures. Principles of prehospital care are stressed. Great importance is ascribed to early and properadministration of methylprednisolone. Two components of care are stressed: precise preanesthetic monitoring and early surgical stabilization of spinalfractures.
The Effect of Different Patient Population on Clinical Outcome and Intensive Care CostsArticles
R. Pařízková, V. Černý, P. Dostál
Anest. intenziv. Med. 2001;12(5):229-233
Financial burden associated with intensive care represent an important part of used financial resources of health care systems in developed countries.The efforts of effective allocation of financial resources should be an integral part of all scientific decision making process in daily clinical routine.The aim of the study was to evaluate the most frequent patient populations seen as the diagnosis related groups with respect to the clinical outcomeand to the financial costs associated with the health care provided. The patient population was divided into four basic groups: sepsis and itscomplications (SE, n = 99), polytrauma (TR, n = 109), head injury...
Clinical Outcome and Costs in Different Patient Population in Intensive Care: a Multicentre StudyArticles
R. Pařízková, V. Černý, P. Dostál, L. Vašátko, P. Hora, I. Herold, I. Novák, D. Nalos
Anest. intenziv. Med. 2001;12(5):234-239
Intensive care represents an especially costly part of health care, and significantly affects total cost of in-patient hospital facilities. The aim of thestudy was to compare the amount of costs and selected clinical markers in different diagnosis related groups, to compare results and to establish thecharacteristics of patient populations.In the set of 1,368 patients, we prospectively followed APACHE II and SOFA scores, length of hospitalization, clinical outcome and costs.The patients were divided according to the type of admission (primary, secondary within 24 hours and secondary after 24 hours) and according tothe principle diagnosis to the following...
Monitoring Quality of Life in Critically Ill Patients: a Multicenter StudyArticles
R. Pařízková, V. Černý, P. Dostál, L. Vašátko, P. Hora, I. Herold, I. Novák, D. Nalos
Anest. intenziv. Med. 2001;12(5):240-251
The restoration of quality of life has become one of the key goals of the intensive care. Quality of life becomes one of the factors of evaluation theclinical outcome from the long-term perspective. The aim of the prospective observational study was to assess the quality of life of patients hospitalizedin intensive care units 6 months and one year after the discharge. From the total number of 1,368 patients enrolled to the study, 1,110 were dischargedto home care. Quality of life was assessed according to the questionnaire SF-36 (Short Form 36-Item Health Survey). In all patients the followingparameters were assessed: diagnostic group; APACHE II and...
Dipeptiven and Its Effect on Immune Response in Polytraumatized PatientsArticles
R. Hájek, P. Hude, P. Horký, E. Baltusová, H. Bosáková, D. Řehořková
Anest. intenziv. Med. 2001;12(5):252-255
In a prospective randomized study, seven polytraumatized patients were given alanyl-glutamine as Dipeptiven (20 g daily for 10 days) as anadditional component to parenteral nutrition administered as All-In-One regimen. Control group consisted of seven patients with comparable APACHEII scores, SOFA and PTS-Hannover scores, who were given parenteral nutrition without glutamine. Parameters of cellular and humoral immunitywere assessed before the administration of parenteral nutrition, and subsequently on the 5 th and 11 th day after the trauma. In comparison of bothgroups, the effects on immunity parameters were not significant. We were not able to prove...
The Nutritional Support of Critically Ill PatientsArticles
P. Jiránek
Anest. intenziv. Med. 2001;12(5):256-259
At the estimation of the nutritional support in critically ill patients we respect the classical model of stress metabolism (D. Cuthbertson, 1942),according to which the metabolic response to stress runs in 2 subsequent phases - the ebb phase and the flow phase. The aim of the nutritional supportis catabolism grade decrease and sufficient delivery ensurement of the nutritional substrates for the proteosynthesis support. Algorithm of the nutritionalsupport planning has 3 steps: fulfilment of the conditions for nutritional support start, estimation of the actual nutritional requirements anddetermination of the nutritional support strategy with the preference...
Post-traumatical Tracheomalacia with Tracheo-oesophageal Phistula - Less Frequent Complication of Blunt Neck Trauma: a Case ReportArticles
D. Řehořková, P. Svoboda, I. Kantorová, R. Hájek, H. Bosáková, J. Vrastyák, D. Chasáková
Anest. intenziv. Med. 2001;12(5):260-262
A polytraumatized patient with blunt trauma to the upper torso and comminutive femur fracture developed ventilation problems on the seventh dayof hospitalization. Endoscopic examination revealed tracheomalacia with tracheo-oesophageal phistula. The paper summarizes the subsequenttreatment, stressing the importance of multidisciplinary approach and proper timing of surgical interventions. Intensive care appropriate to the severityof disease and actual condition should be focused on optimalization of hemodynamics and markers of nutrition and immunity.
Epidemiology of Drug Intoxications in Prague in the Period 1997-2000Articles
J. Šeblová, J. Šejda, V. Polanecký, B. Studničková
Anest. intenziv. Med. 2001;12(5):263-265
The paper presents statistical data regarding drug intoxications in Prague in the period 1997-2000. The data collection was performed by theDepartment of drug epidemiology, Center for Hygiene, of the Capital of Prague. This project is a part of European monitoring system and allows forevaluation of drug abuse in the Czech Republic within European context. Intoxications associated with drug abuse are considered as health risk indexof separate drugs. During the last years there is an increased share of heroin intoxications as well as the total number of intoxications. The mostaffected age group consists of people from 20 to 24 years of age. There is...