What was new in general anaesthesia last year? Literature reviewAnaesthesiology

J. Málek

Anest. intenziv. Med. 2006;17(2):64-67  

The author presents a subjective selection from the recently published articles on general anaesthesia.The main topics are safety, postoperative analgesia and pharmacology.

New developments in regional anaesthesia in 2005Anaesthesiology

D. Mach

Anest. intenziv. Med. 2006;17(2):68-71  

Regional anaesthetic techniques are very successful in providing surgical anaesthesia and postoperative analgesia. New developments in this area are discussed in terms of their impact on the anaesthetist's daily practice. A summary report of the key studies published over the last 12 months in the leading journals is presented. Author also notes achievements in regional anaesthesia in the Czech Republic.

Cardiac anaesthesia in 2005Anaesthesiology

M. Horáček

Anest. intenziv. Med. 2006;17(2):72-77  

This review gives a summary of the current understanding of mechanisms mediating ischaemia and reperfusion injury, stunning, cardioprotection, ischaemic and pharmacological preconditioning, postconditioning and their clinical consequences.

What's new in the pharmacotherapy of pain?Algeziology

Anest. intenziv. Med. 2006;17(2):78-81  

New developments in the pharmacotherapy of pain have brought both new drugs and new delivery forms of already established substances.The aim of the development of new drugs is first of all reducing the occurrence of undesirable side effects, an increase in efficiency and more comfortable modes of application.The new opioid formulas include controlled-release hydromorfon, matrix transdermal delivery of fentanyl and Ionsys transdermal fentanyl for treatment of acute postoperative pain.Ionsys combines fixed background delivery of fentanyl and patient-controlled bolus administration of rapidly absorbing fentanyl. Ionsys will be the first application...

Vasopressors in septic shock - 2005 updateIntensive Care Medicine

V. Černý

Anest. intenziv. Med. 2006;17(2):82-84  

Vasopressors represent a major part of haemodynamic management in patients with septic shock. Current recommendations mostly prefer using norepinephrine as a first line agent in this setting. In norepinephrine-resistant septic shock, administration of vasopressin or its synthetic analogue terlipressin has been shown to reverse hypotension and to decrease the dose of norepinephrine. Nonetheless, severe adverse events during vasopressin/terlipressin therapy (extensive vasoconstriction in various vascular beds, namely in the splanchnic and coronary regions) may occur. In view of these potentially harmful effects, administration of vasopressin or terlipressin...

Progress in the pathophysiology and therapy of ventilatory failure in critically ill patientsIntensive Care Medicine

I. Herold

Anest. intenziv. Med. 2006;17(2):85-94  

The article summarises progress in the understanding of the pathophysiology and therapy of ALI/ARDS including the main algorithms of mechanical ventilation from the perspective of evidence based medicine and pharmacological treatment, new modes of mechanical ventilation and recommendations for home ventilation.

Progress in the prevention, diagnosis and therapy of nosocomial ventilatory pneumonia in 2005Intensive Care Medicine

P. Dostál

Anest. intenziv. Med. 2006;17(2):95-98  

Ventilator-associated pneumonia continues to complicate the course of a significant proportion of patients on mechanical ventilation. This article reviews recent advances in the prevention, diagnosis and treatment of VAP presented in articles published during the last year and summarises major changes in guidelines on VAP.

Renal replacement therapy in critically ill patients: 2005 updateIntensive Care Medicine

I. Novák, M. Matějovič, A. Kroužecký, J. Raděj

Anest. intenziv. Med. 2006;17(2):99-101  

Renal replacement therapy (RRT) is needed in 50% to 70% of patients with sepsis-related acute renal failure (ARF) in the ICU. The ARF in this setting is often accompanied by multiple organ dysfunction and is associated with very high mortality (53% to 73%). Thus, there is a great deal of interest in developing renal replacement strategies to reduce the mortality rate.Traditional intermittent haemodialysis in the treatment of ARF offers good metabolic control but poor haemodynamic tolerance, especially in septic patients. Haemofiltration is the more commonly used method in septic shock due to its better haemodynamic tolerance, and it is argued that...

Metabolism, endocrinology, and nutrition: Progress in 2005Intensive Care Medicine

M. Matějovič, A. Kroužecký, J. Raděj, R. Sýkora, I. Novák

Anest. intenziv. Med. 2006;17(2):102-109  

The purpose of this article is to review the literature in the year 2005 covering different aspects of metabolism, endocrinology and nutrition in critically ill patients. In particular, studies reviewed in this paper cover: glucose control and its consequences, putative mechanisms of protective effects affiliated with glucose control, new insights into the metabolism of lactate in the critically ill, low dose corticosteroids, the role of ethomidate in intensive care medicine, current concepts in nutrition, immunonutrition and antioxidant treatment.

Therapy of brain injuryIntensive Care Medicine

R. Pařízková

Anest. intenziv. Med. 2006;17(2):110-115  

Patients with brain injury represent one of the major problems in medicine. This review article aims to present the epidemiology, pathophysiology and current recommendations for prehospital and hospital care in brain injury patients. The key factors in clinical practice for achieving the best possible neurological outcome are stressed. Secondary insults are considered as a major cause of poor long-term outcome in these patients.

Echocardiography in the critically ill patientIntensive Care Medicine

M. Balík

Anest. intenziv. Med. 2006;17(2):116-122  

Availability of an ultrasound device in the critical care setting significantly extends diagnostic options and makes the management of critically ill patients more effective. A growing amount of papers confirm that qualified intensivists can provide accurate, safe and extensive diagnosis of the haemodynamic system with the aid of echocardiography. Intensivists involved in the management of the critically ill are fully aware of all patient's clinical and laboratory data and they should be able to interpret the echocardiographic examination in a complex manner and with immediate application for further therapy. Performing echocardiography in the intensive...

Guidelines 2005: What is different compared with Guidelines 2000?Intensive Care Medicine

E. Kasal

Anest. intenziv. Med. 2006;17(2):123-129  

The author presents the most important changes in the European Resuscitation Council Guidelines for cardiopulmonary resuscitation (CPR) 2005 in comparison with Guidelines 2000. The new Guidelines published in November 2005 are derived from the 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations produced by the International Liaison Committee on Resuscitation (ILCOR) and published simultaneously in an issue of Resuscitation. The new Guidelines, containing 9 sections, present many changes of algorithms used in the existing guidelines targeted at the unification...