Anesteziologie a intenzivní medicína, 2003 (vol. 14), issue 6
Regional Anesthesia with Clonidin - Old Theme RevisitedArticles
A. Doleželová, I. Čundrle, R. Gál, J. Mašek, B. Stibor
Anest. intenziv. Med. 2003;14(6):254-258
Objective:To compare the duration of blockade with levobupivacaine and levobupivacaine with clonidine; to compare theduration of analgesia and the consumption of analgesics on the first post-operation day; the follow-up of the occurrenceand severity of adverse effects of subarachnoidal anaesthesia (SAA) with levobupivacaine.Design: prospective, randomised, comparative.Setting: Dept. of Anaesthesiology and Intensive Care; Dept. of Orthopaedic Surgery. University Hospital, Brno-Bohunice.Patients and methods: Fifty-four patients were included in the study (mean age 66.5 years, weight 81.5 kg), undergoing totalendoprosthesis of knee or hip joints....
Levobupivacaine - Dosing Scheme in Paediatric AnaesthesiaArticles
V. Mixa
Anest. intenziv. Med. 2003;14(6):259-261
Regional anaesthesia is increasingly used in combined anaesthesia and for continuous postoperative analgesia. Next tobupivacaine, its levorotatory enantiomer - levobupivacaine - has been recently used more frequently. The efficacy of thisnew local anaesthetic drug is comparable with that of bupivacaine, however, its neurotoxicity and cardiotoxicity aresignificantly lower. Therefore, levobupivacaine seems to be a suitable anaesthetic drug for newborn babies and smallchildren in which, in case of inaccurate administration, the risk of fatal complication is quite high. In the article we presenta survey of dosage of levobupivacaine for paediatric patients....
Administration of Hyaluronidase in the Treatment of Postoperative Epidural Fibrosis: Results ofTreatment of 100 PatientsArticles
V. Masopust, M. Häckel, S. Ostrý, D. Netuda, V. Beneš, ml.
Anest. intenziv. Med. 2003;14(6):262-266
Objective:Postoperative epidural fibrosis, being a part of failed back surgery syndrome (FBSS), is a frequent sequelae oflumbar disc surgery which is difficult to treat. The second surgery does not yield good results.No single treatment modalityof epidural fibrosis achieves good results. This is the reason for trying of new approaches to its treatment.Design: Retrospective, observational questionnaire based study.Setting: Department of Neurosurgery, Central Military Hospital, Praha.Material and methods: We studied a cohort of the first epidural administration of hyaluronidase to 100 patients with historyof one or more lumbar disc surgeries...
Evaluation of Efficiency and Safety of Various Dose Regimens of Sulperazon (Cefoperazon/Sulbactam) and Serious Infections in Intensive CareArticles
I. Chytra, I. Herold
Anest. intenziv. Med. 2003;14(6):267-277
Objective:Clinical evaluation of efficacy and safety of different types of dosage of cefoperazon/sulbactam (Sulperazon) insevere infections in intensive care. Design: Multicenter prospective observation clinical study.Setting: 31 centers in the Czech Republic (interdisciplinary, surgical and medical ICUs, Departments of surgery).Material and methods: Patients with severe infection treated with Sulperazon who were hospitalized in above mentionedcenters from March to September 2002.Evaluated parameters: basic demographic parameters, type of illness, principal diagnosis for admission to the hospital,diagnosis for hospitalization in intensive...
Risk Factors Associated with Colonisation/Infection by Multiresistant Strains of Klebsiella pneumoniae in Patients at Department of Anaesthesiology and Intensive Care Medicine, University Hospital in Hradec KrálovéArticles
P. Matoulková, P. Čermák, P. Klemera, V. Černý, J. Vlček
Anest. intenziv. Med. 2003;14(6):278-283
Objective:The aim of the study was to determine risk factors for multiresistant Klebsiella pneumoniae isolation in thecritically ill patietns.Design: Prospective, observational study.Setting: The studywascarried out at the Department of Anaesthesiology and Intensive Medicine, University Hospital, Hradec Králové, Czech RepublicMaterial and methods: All patients hospitalized with at least one positive isolation of Klebsiella pneumoniae were enrolledinto the study. The exposure to antibiotics during hospitalization or one month preceding hospitalization; age; gender;APACHE II and SOFA scores on admission; day of ICU stay when sample for microbiological...
Diagnostics of Ventilator-associated PneumoniaArticles
I. Chytra, E. Kasal, P. Pelnář, R. Pradl
Anest. intenziv. Med. 2003;14(6):284-290
Ventilator-associated pneumonia (VAP) is defined as a pneumonia in a patient on mechanical ventilator support (byendotracheal tube or tracheostomy) for > 48 hours.VAP is the major cause of infection in critically ill patients and continuesto complicate the course of 8 to 28% of patients receiving mechanical ventilation. Mortality rate for VAP ranges from 24 to50% and can reach 76%in some specific settings or when lung infection is caused by high-risk pathogens.The predominantorganisms responsible for infection are Enterobacteriaceae, Pseudomonas aeruginosa and Staphylooccus aureus, butcausative agents widely differ according to the population of...
Strategy of Antibiotic Treatment of Severe Community Acquired Pneumonia in ICUArticles
V. Jindrák
Anest. intenziv. Med. 2003;14(6):291-294
The article is focused on optimal strategy in the antibiotic treatment of severe community-acquired pneumonia in ICU. Basicprinciples for correct and effective choice of antibiotics, based on good knowledge of the most frequent etiological agents(especially pathogens typically associated with sever infection - Streptococcus pneumoniae and Legionella pneumophila)are desribed. The strategy of microbiological diagnostics, necessary for obtaining important data for pathogen-specifictherapy of pneumonia is also described. Specific arguments are focused on problems of antibiotic resistance of respiratorypathogens in the national, European and world-wide...
Severe Organophosphate Poisoning in ToddlerArticles
V. Smolka, J. Reitinger, E. Klásková, J. Wiedermann
Anest. intenziv. Med. 2003;14(6):295-297
Intoxication of organophosphate insecticides is rare but life threating condition in young children. Muscarinic, nicotinic andCNS symptoms are manifestated in clinical presentation of acute poisoning due to irreversibile inhibition of acetylcholinesterasewhich leads to accumulation of acetylcholin in nervous system. We describe a 33-month-old boy with severe CNSdepression and hypotonia after organophosphate poisoning which was confirmed by toxicologic investigation of gastriccontens. On the basis of the result of a toxicologic investigation treatment with atropine and obidoxime was started to theclinical features of atropinization. Treatment with obidoxime...