Anesteziologie a intenzivní medicína, 2002 (vol. 13), issue 4
Is Succinylcholine at the End of Its Story?Articles
M. Svítek
Anest. intenziv. Med. 2002;13(4):142-152
The article presents the experience with succinylcholine fromrecent decades.It explains the mechanism of its action,side effects and shows alternativemethods and drugs which can replace succinylcholine.The main indication for succinylcholine is rapid-sequence intubation or anticopated difficultairway.Succinylcholine can not be recommended as ideal neuromuscular blocking agent for elective procedures,mainly in newborns and little children.For elective procedures in children we should choose a nondepolarizing drug with short or middle-lasting effect.The future perspective seems to be inrocuronium or rapacuronium.
Cis-atracurium in Clinical Practice:Evaluation of Intubation Conditions,Haemodynamic Changes and Side EffectsArticles
P. Nohel, J. Pavlíková
Anest. intenziv. Med. 2002;13(4):153-154
The authors evaluated the intubating conditions,haemodynamic parameters and possible signs of histamine release after application of therecommended intubating dose of cis-atracurium (3x ED95,i.e.0.15 mg.kg -1 ).At 120 sec after application of the intubating dose the intubating conditionswere assessed as good or excellent in 56 of 60 patients (93.3%).Haemodynamic effects were mild only;no patient had any sign of histamine release.Cis-atracurium is suitable alternative to atracurium.It has better cardiovascular stability,lower histamine release and therefore less side effects thanatracurium.
Anaesthesia for Paediatric Day-case SurgeryArticles
I. Voháňková
Anest. intenziv. Med. 2002;13(4):155-157
Day-case surgery has become a common part of health care system.The author describes the course of paediatric day-case surgery:visit to theconsulting roomof the department of anaesthesia,admission of the patient,anaesthesia,surgical procedure and discharge from the hospital.The articlepresents experience of Children Hospital in Brno from the point of view of anaesthetist 's nurse.Paediatric day-case surgery was introduced in thishospital in 1996.
Sevoflurane in Anaesthesia of Burn Adult PatientsArticles
J. Málek, J. Jandová, A. Kurzová, E. Šimánková, L. Brož
Anest. intenziv. Med. 2002;13(4):158-160
Anaesthesia of burn patients is important medical problem.The use of anaesthetics is limited by severe patient conditions,repeated anaesthesia andnecessity of rapid emergence from general anaesthesia to ensure adequate nutrition.The most frequent combination is composed of ketamine,diazepamand fentanyl.It has some advantages but in higher doses it stimulates the sympathetic system and causes the long period of sleep after anaesthesia,hallucinations and the development of tolerance.The new inhalational anaesthetic agent -sevoflurane -seems to be anaesthetic of choice because ofits minimal side effects,high speed of onset and recovery and easy control.With...
Differential Diagnosis of Acute BleedingArticles
J. Valenta, M. Stříteský
Anest. intenziv. Med. 2002;13(4):161-164
There are cases of massive acute bleeding during surgical procedures,labours and injuries which are used to be labeled as coagulopathy and thislabel is not right.The common case is disseminated intravascular coagulation (DIC).The authors describe the most frequent causes of acute secondarybleeding:extensive trauma,dilution coagulopathy,DIC,iatrogenic intervention and their possible relationships.The author presents laboratory testsand their validity in the diagnosis of bleeding,shows clinical and laboratory signs of common types of bleeding and emphasizes early differentialdiagnosis.
Initial Antibiotic Therapy of Bacterial Diseases at Patients in Intensive Care UnitsArticles
M. Kolář, L. Blahut, O. Marek, J. Lochmannová jr.
Anest. intenziv. Med. 2002;13(4):165-169
Early application of antibiotic regimen represents an important part of the complex therapy of bacterial infections in critically ill patients,so thereis not possible to wait till the results of microbiological cultivation tests are available.However,an optimum schedule of initial antibiotic therapy canbe chosen basing on the knowledge of the local prevailing bacterial agents and their resistance against antimicrobial drugs.Crucial points is the indication of antibiotic therapy,as it is to be considered as a risk factor in the selection of bacterial strains with higher degreeof primary resistance (e.g.enterococci,Pseudomonas aeruginosa,Acinetobacter...
Haemodynamics in Organ DonorsArticles
H. Říha, A. Březina, P. Kellovský, J. Sedláček, Š. Černý, E. Pokorná
Anest. intenziv. Med. 2002;13(4):170-174
The article presents review of the pathophysiology of brain death and its impact on haemodynamics in the brain death patients.In detail it describesthe results of an autonomic storm,influence on the aerobic metabolism,endocrine changes and the histological organ damage.From hearttransplantation point of view the authors deal with the myocardial dysfunction.They explain in detail the possibilities for haemodynamic monitoringand optimization in the care of the brain death patients.
Sulperazon for the Treatment of Severe and Nosocomial InfectionsArticles
I. Herold, I. Chytra, B. Horová
Anest. intenziv. Med. 2002;13(4):175-183
The multicenter observational clinical trial evaluating clinical efficacy of Sulperazon (cefoperazone with sulbactam)followed 203 patients withsevere and nosocomial infectious complications.Majority of the patients were admitted to the intensive care unit (79.8%).The therapy was successfulin 80.3%with maximum efficacy in abdominal infections (91.9%).The lowest treatment efficacy was noted in the patients with sepsis (72.5%)andbronchopneumonia (76.4%).The most frequent treatment regime was 2x2 g i.v.in 24 hours for 10 days (median).The adverse effects were not in anycase indication for the interruption of the treatment.Ventilatory support,pneumonia,incorrect...
Pressure-volume Curve:Automated Measurement of Respiratory Mechanics -A.R.M.SoftwareArticles
J. Růžička, M. Nalos, A. Klein, E. Kasal, I. Novák
Anest. intenziv. Med. 2002;13(4):184-190
We developed software able to control mechanical ventilator (Adult Star TM Infrasonics,USA)via serial port and to simultaneously read data fromthe ventilator output.This enables to deliver randomly selected test tidal volumes under constant flow conditions with computer controlled expiratoryand inspiratory valve holds and to record the volume and respective pressures for automated pressure-volume curve measurements.We tested thesoftware performance in 4 patients suffered by a several lung injury on three different PEEP levels.Data obtained automatically from the ventilatorwere compared with independent calibrated measuring system consisting of airway...