Hypothermia during anaesthesia - are (not) we ruining the outcome of our clinical practice?Editorial

Vladimír Černý

Anest. intenziv. Med. 2014;25(4):261-262  

Czech Obstetric Anaesthesia and the year 2014Editorial

Jan Bláha

Anest. intenziv. Med. 2014;25(4):263-264  

Shall we change the management of respiratory failure?Editorial

K. Cvachovec

Anest. intenziv. Med. 2014;25(4):264-265  

Incidence of peri-operative hypothermia - a unicentric, observational studyAnaesthesiology - Original Paper

Obare Pyszková Lenka, Nevtípilová Michaela, Žáčková Dagmar, Fritscherová Šárka, Zapletalová Jana, Hrabálek Lumír, Adamus Milan

Anest. intenziv. Med. 2014;25(4):267-273  

Objective:To study peri-operative temperature changes in patients during short and medium duration operations. Design:Unicentric, prospective, observational study. Setting:Department of Anaesthesiology and Intensive Care, University Hospital. Materials and methods:We measured patients' peri-operative temperature during a period of 59 working days (June - August 2013). Using the anaesthetic chart we recorded the age, sex, type of surgical operation, duration of anaesthesia, use/no use of temperature management devices and electronic measurement of theatre temperature. No correlation...

Initial experience with the Vivasight ETView® double-lumen fibreoptic tube in thoracic surgeryAnaesthesiology - Original Paper

Bicek Vladimír, Krečmerová Martina, Ungermannová Veronika, Vymazal Tomáš

Anest. intenziv. Med. 2014;25(4):274-276  

Objective:The double-lumen fibreoptic tube Vivasight ETView^® is a new tool that allows lung isolation without the use of a fibrescope. The aim of the study was to evaluate the success and complication rates of its insertion in thoracic surgery procedures. Design:Prospective observational study (clinical audit). Settings:Department of Anaesthesiology and Intensive Care Medicine, University Hospital. Material and methods:We evaluated the success rate, speed of insertion, incidence of malposition and other complications associated with the insertion of a fibreoptic double-lumen tube...

Case report of missed diagnosis of intracranial haemorrhage in a patient after tricuspid valve annuloplastyAnaesthesiology - Case Reports

Matloch Zdeněk, Říha Hynek, Netuka Ivan, Kment Martin, Kotulák Tomáš

Anest. intenziv. Med. 2014;25(4):277-280  

This case report describes the management of a patient who required reoperation for tricuspid valve regurgitation. The procedure was further complicated by right ventricular failure and an unsatisfactory result of tricuspid valve annuloplasty. On the ICU this patient developed systemic inflammatory response syndrome, followed by multiple-organ failure requiring V-A ECMO. The clinical course was also complicated by acute kidney failure needing continuous renal replacement therapy and by pulmonary haemorrhage requiring several bronchoscopy interventions and blood transfusions. The patient deceased 5 days after surgery. The presumed causes of death were...

The role of remifentanil in obstetric analgesiaAnaesthesiology - Review articles

Štourač Petr, Harazim Hana, Kosinová Martina

Anest. intenziv. Med. 2014;25(4):281-287  

Epidural analgesia is still considered the "gold standard" for labour analgesia, especially because of its efficacy. In case of its contraindication, systemic administration of remifentanil is possible. The aim of this article is to provide a summary of current information on the efficacy and safety of remifentanil during labour. There are further described possible ways of application, dosage and side effects for the mother, fetus or newborn. Some of these questions remain open and further randomized trials are needed.

The INKA Program - "tailor made" obstetric analgesiaAnaesthesiology - Special Article

A. Pařízek

Anest. intenziv. Med. 2014;25(4):288-295  

Setting:Department of Obsterics and Gynecology 1st Faculty of Medicine, Charles University and General Faculty Hospital in Prague. Objective:Predicting both the course of childbirth and the intensity of pain felt during childbirth is difficult, especially with first-time mothers. Some women tolerate birthing pains well, others require effective pain relief. Sometimes simple methods are enough, such as the presence of a partner, a relaxing atmosphere, massages, or walking, while other times the services of a birthing assistant or physician or even an anaesthesiologist are required. Choosing the right approach or methods should...

The first clinical experience with organ donation from donors after cardiac death (DCD) - Case reportIntesive Care Medicine - Case Report

Schmidt Matouš, Pažout Jaroslav, Fric Michal, Waldauf Petr, Pokorná Eva, Pachl Jan

Anest. intenziv. Med. 2014;25(4):296-300  

Two separate types of organ donation from dead donors exist in the Czech law. The first type is donation from donors after brain death (DBD) and the second type is donation from donors after cardiac death (DCD). While the first type is a routine part of clinical practice in the Czech Republic, donation from donors after circulatory death is in its begin-nings. The recommendation of competent professional societies for donation after cardiac death was approved in 2013. In this case report of a 45-year old man after severe brain injury, we try to point out the important differences in the cardiac (circulatory) death donation proces.

Organ retrieval from a donor after circulatory arrest - case report and reviewIntesive Care Medicine - Review Article

Rusinová Kateřina, Pokorná Eva, Vávra Václav, Kusová Dagmar, Janoušek Libor, Froněk Jiří, Stach Zdeněk, Turčianský Martin, Otáhal Michal, Doležal Adam, Černý David, Balík Martin, Černý Vladimír

Anest. intenziv. Med. 2014;25(4):301-306  

This case study reports the initial management, prognosis assessment and withdrawal of life support followed by retrieval of vital organs for transplantation in a patient admitted after out-of-hospital cardiac arrest. This is the first description of a case of controlled donation after circulatory death in the Czech Republic. We discuss in detail the practical aspects of organ retrieval management, the role of echocardiography in circulatory arrest, indication of palliative treatment including terminal weaning and determining death due to circulatory arrest. We also emphasize communication with family members. The protocol used to determine death after...

Current trends in long-term pharmacological sedation of the critically illIntesive Care Medicine - Review Article

Stibor Bronislav, Schwameis Franz

Anest. intenziv. Med. 2014;25(4):307-314  

Pain and stress are very common in critically ill patients. Provision of adequate analgesia and elimination of psychological discomfort are essential components of treatment goals on the ICU care. In the past few years there has been a focus on the side-effects of long-term sedation such as the presence of delirium, cognitive dysfunction, prolongation of the time on mechanical ventilation, and ICU and hospital length of stay. The new 2013 guidelines by the American College of Critical Care Medicine and Society of Critical Care Medicine have redefined the management of sedation, analgesia and prevention and treatment of the delirium.The traditional...

Renal sonograhy in peri-operative medicine and intensive care medicinePostgraduate education - ECHO didactics

Michálek Pavel, Kiška Rostislav, Sedláček Josef, Dobiáš Miloš

Anest. intenziv. Med. 2014;25(4):315-320  

Sepsis, severe sepsis and septic shockPostgraduate Education - Topics for Board Examination

Černý Vladimír

Anest. intenziv. Med. 2014;25(4):321-323  

Difficult weaning - physiological approach (focusing on cardial causes)Postgraduate education - Selected Topics in Clinical Physiology

Černý Vladimír

Anest. intenziv. Med. 2014;25(4):324-325  

Clinical practice guideline on diagnosis and treatment of hyponatraemiaGuidelines

Černý Vladimír

Anest. intenziv. Med. 2014;25(4):326-329  

A kidney for sale - I need the moneyEthics and Medicine Law

Černá Pařízková Renata

Anest. intenziv. Med. 2014;25(4):330-336  

Intensive care medicine has tight connections to both sides of transplantation medicine - organ donors are usually recruited from ICU on the one hand, while on the other hand organ recipients are usually admitted to ICU after organ transplantation. The increasing gap between organ supply and the number of patients on the waiting lists has led to searching for new alternatives and ways to obtain more available organs. Transplanting one of paired organs (or part of single organ) from living donors seems to be one of the best options in terms of medical outcome and cost. The legal, ethical and economic issues of the "organ market" are discussed in the...

Prague is an established examination centre for EDIC in the new formateLetter to Editor

Balík Martin, Duška František

Anest. intenziv. Med. 2014;25(4):337-338  

New Slovac booksBook Reviews

Karel Cvachovec

Anest. intenziv. Med. 2014;25(4):338