Anesteziologie a intenzivní medicína, 2002 (vol. 13), issue 6
Anaesthesia and Postanaesthesia Care for Renal TransplantationArticles
P. Michálek, R. Danč
Anest. intenziv. Med. 2002;13(6):263-268
Renal transplantation is the only causal and already standard therapy in patients with severe and irreversible chronic renal failure. The aim of renaltransplantation is to improve the quality of life and stabilize the complications associated with chronic renal failure and dialysis. The authors describepathophysiology of chronic renal failure, historical context, indications for renal transplantation, perioperative care of patients with renal failure,choice of anaesthesia and postanaesthesia care in these patients.
Arteria Spinalis Anterior Syndrome: Complication after Vascular Abdominal Surgery - Case ReportArticles
V. Černák, S. Ondrejovič, R. Andrejčáková
Anest. intenziv. Med. 2002;13(6):269-270
The use of regional block is very often blamed as a cause for postoperative neurological complication, if they are present. Arteria spinalis anteriorsyndrome is a very rare complication with the possibility of permanent neurologic deficit. We present a case report of a. spinalis anterior syndrome ina 58-years-old woman after vascular surgery. The aetiological factors that may have contributed to this tragic complication are discussed.
Cannulated Vessel as the Risk Factor for Infectious Complications of Central Venous Catheters in Children - Our ExperiencesArticles
M. Uher, M. Pisarčíková, J. Filka, M. Kurák, A. Černáková, V. Takáčová
Anest. intenziv. Med. 2002;13(6):271-275
The authors present the results of 5-years follow-up of infectious complications of central venous catheters in children. They evaluated the relationshipbetween infectious complications and the cannulated vessel. In agreement with the literature they marked the internal jugular vein and the femoralvein as the most dangerous vessels.
Intoxication with Datura stramonium in Children and AdolescentsArticles
M. Uher, M. Pisarčíková, M. Kurák, J. Filka, T. Rosenbergerová, A. Černáková
Anest. intenziv. Med. 2002;13(6):276-278
In the last years there is increasing number of plant poisoning in teenagers. The poisoning with Datura stramonium belongs among intoxications.The authors review its effects in human and describe their own experiences. The clinical picture of poisoning with Datura stramonium is identical toatropine intoxication including hallucinations. The prognosis is usually good. The symptoms disappear within 12-24 hours but mydriasis can lastseveral days. After disappearing of symptoms there is amnesia on hallucination period.
Biochemical Values during Mild Hypothermia Therapy in Severe Brain Injured PatientsArticles
R. Gál, I. Čundrle, I. Zimová
Anest. intenziv. Med. 2002;13(6):279-280
A laboratory values of 15 patients with severe brain injury, in which was used deliberate mild hypothermia 34 °C during 72 hours as a componentof intensive care management together with standard treatment protocol according to European Brain Injury Consortium, are presented. Surface coolingwas initiated within 15 hours of injury in all patients. Hypothermia to core temperature 34 °C was achieved by forced air cooling in combination withcirculating-water mattress cooling and maintained for 72 hours. After this time were patients rewarmed to 36,5 °C of core temperature. The laboratoryvalues were obtained from 9 examinations of arterial blood in 8 hours...
Severe Suicidal Attempt in the Patient with Acute Mental Disorder - Case ReportArticles
J. Mannová, D. Seidlová, I. Zimová, R. Slámová
Anest. intenziv. Med. 2002;13(6):281-285
The authors present the case of unique severe suicidal attempt in the patient with acute onset of paranoid-depressive psychosis. At the first, thepatient made cutting injuries of his both wrists, and then he made severe cutting injury to his neck affecting 3/4 of its circumference to the cervicalspine. This injury touched the internal jugular vein only but no other vital structures in this area. Next part of the article presents review of suicides inCzech Republic in the last ten years, which shows increasing number of suicides since 1994.
Clinical Impact of Intraoperative Transesophageal EchocardiographyArticles
J. ©oupal, O. Biebl, B. Jurenka, P. Kolouch, P. Michálek, M. Stern, P. ©ebesta
Anest. intenziv. Med. 2002;13(6):286-288
Since 1990, transesophageal echocardiography has been spreading beyond echocardiographic laboratories to the everyday care of surgical andintensive care patients. Its effectiveness as a clinical monitor during anaesthesia and critical care has been well established. This article shows themain advantages and challenges of this rapidly evolving method.
Early Diagnosis of Atypical Cardiac Tamponade with Transesophageal Echocardiography - Case ReportArticles
J. ©oupal, B. Jurenka, P. Kolouch, M. Stern, P. ©edivý, P. ©ebesta
Anest. intenziv. Med. 2002;13(6):289-291
We report one case of atypical locacized cardiac tamponade after cardiac surgery. Cardiac tamponade after cardiosurgery is life-threateningcondition and diagnosis is often difficult and delayed. If suspected, the diagnosis is best confirmed by transesophageal echocardiography.
Triapridal in the Treatment of Delirium after Cardiac SurgeryArticles
M. Brtko
Anest. intenziv. Med. 2002;13(6):292-294
Fifty consecutive patients (35 male, 15 female) with postoperative delirium after cardiac surgery were treated in a prospective study by neurolepticTiapridal (tiaprid). 27 patients (54 %) were operated on in extracorporeal circulation, 23 patients (46 %) on a beating heart. 30 patients (60 %) hadsigns of cerebral atherosclerosis prior to the operation. At the beginning Tiapridal was administered intravenously with the consecutive switch to oraladministration in the dose of 100-1600 mg/day. The delirium occured mostly on the second postoperative day. In 72 % of the patients the deliriumdisappeared within 3 days of the treatment, no patient had to be...
Right Ventricle Perforation: a Complication of the Pulmonary Thermodilution CatheterArticles
D. Vrąanský, Z. Valúch, I. Beer
Anest. intenziv. Med. 2002;13(6):295-297
Fifty years old male patient with low ejection fraction (35%) was admitted to our department for elective bypass graft surgery. Anaesthesiologistdecided to insert the pulmonary artery thermodilution catheter for hemodynamic monitoring. Insertion was normal. The only reported problem wasnot correct wedge pressure curve. After opening the pericardium we found perforation of the anterior wall of the right ventricle with approximately 8cm of the catheter penetrated to the pericardial cavity. The perforation was sutured, operation was successfully completed and the patient haduncomplicated postoperative course. The only prevention of severe complication...
Relationship between the Value and Blood Flow Velocity Early after Brain InjuryArticles
R. Hlatký, J. Habalová, C. S. Robertson
Anest. intenziv. Med. 2002;13(6):298-302
In the prospective study of 36 patients following severe head injury a close relationship was found between cerebral blood flow velocity measuredby transcranial Doppler ultrasonography and cerebral blood flow measured by xenon enhanced computed tomography. The relationship was presentonly at the earliest time after injury and was dissolved within 24 hours. The presented study documents a possible application of transcranial Dopplerultrasonography in detection of posttraumatic hypoperfusion early after brain injury.
Our Experiences with NICO Monitoring System - Case ReportsArticles
M. Fořtová, Z. Křivánek
Anest. intenziv. Med. 2002;13(6):303-306
The authors deal with non-invasive haemodynamic monitoring system NICO. This device uses the gas analysis and the Fick principle to computecardiac output (CO). It based on the changes of CO2 elimination and end-tidal CO2. The shunt blood which does not participate in CO2 eliminationis calculated from the values of SaO2 and FIO2 with the use of Nunn's diagrams. The NICO device can be easily used both in the intensive care unitand the operating room. The authors present a few cases to demonstrate the use of NICO system which shows not only haemodynamic parameters butalso some respiratory system parameters.
Acute Subarachnoid Haemorrhage as an Unusual Cause of Myocardial Infarction - Case ReportArticles
P. Lavička, M. Choc, J. ©rogl, V. Červený
Anest. intenziv. Med. 2002;13(6):307-309
The acute subarachnoid harmorrhage (SAH) on the basis of the rupture of intracranial aneurysm may significantly increase sympathetic activitywhich leads to cardiac arrythmias and ECG changes. The authors present the case in which the rupture of patient's intracranial aneurysm led to theacute myocardial infarction with circulatory failure.
Early Diagnosis of Complications Associated with the Thoracic Wall and Lung Trauma - Case ReportsArticles
M. Carda, J. Vanáč, K. Havlíček, J. ©iller
Anest. intenziv. Med. 2002;13(6):310-312
The authors describe the diagnostic procedures related to complications following thoracic wall trauma. Two cases reports are based on the latediagnosis of posttraumatic pneumothorax and hemothorax, respectively. In the theoretical part, factors increasing the probability of those complicationsare discussed. There is stressed the need for continuous monitoring of patients prone to those complications. The value of repeated chest radiographsis emphasized, along with physical examinations and laboratory tests. Indications for chest drainage for therapeutic intervention are discussed alongwith its prophylactic function.