Anesteziologie a intenzivní medicína, 2017 (vol. 28), issue 2
The correlation between the citrate contained in the transfused blood products and the plasma concentration of ionised calcium in cardiac surgery patientsAnaesthesiology - Original Paper
M. Mynář, J. Samek, Z. Turek
Anest. intenziv. Med. 2017;28(2):75-79 
Objective:The goal of the study was to evaluate the correlation between the dose of infused citrate and plasma ionized calcium changes in cardiac surgery patients requiring transfusion treatment. The secondary goal was to establish the incidence of perioperative hypocalcaemia. Design:Prospective, observational, non-interventional study. Setting:Department of Anaesthesia and Intensive Care Medicine, University Hospital Hradec Kralove, Charles University, Faculty of Medicine, Hradec Kralove. Patients and methods:During the study period, 42 cardiac surgery patients treated with transfusion were enrolled...
Anaphylactic reaction to sugammadex administered at the end of surgeryAnaesthesiology - Case Reports
S. Palásková, H. Paříková, J. Vydláková, E. Uchytilová, E. Kieslichová
Anest. intenziv. Med. 2017;28(2):80-84
The possibility of rapid and predictable reversal of neuromuscular blockade induced by rocuronium or vecuronium leads to more frequent use of sugammadex in clinical practice. Sugammadex seems to be a safe and well tolerated medicament, which is available throughout the European Union. We noted a case of serious anaphylactic reaction after the administration of sugammadex, manifested by cardiovascular collapse. The situation required immediate initiation of fluid and pharmacological resuscitation. With this case report we would like to illustrate that even a generally safe medicament such as sugammadex may cause serious life-threatening complications.
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):84
Impact of night work on the QT interval in nurses and doctors (EQUINDOC trial)Intensive Care Medicine - Original Paper
M. Horáček, J. Beroušek, T. Vymazal
Anest. intenziv. Med. 2017;28(2):85-92
Objective:To determine the impact of sleep deprivation due to night shift/duty in ITU nurses and doctors on the QT interval and the index of cardio-electrophysiological balance (ICEB), predictors of arrhythmias. Design:Observational trial. Setting:University Hospital ITU. Materials and methods:Nurses/doctors on night shift/duty. Standard 12-lead ECG before and after the shift was recorded. Heart rate, QRS, QT from automated analysis, corrected QTc using Hodges formula and ICEB = QT/QRS were calculated. A questionnaire on the health status and sleep behaviour was filled in. Results:Total...
Deep vein thrombosis and pulmonary embolism in pregnancyAnestezie v gynekologii a porodnictví - Přehledový článek
J. Mannová, M. Penka, P. Štourač
Anest. intenziv. Med. 2017;28(2):93-100
Pulmonary embolism (PE) is the leading cause of maternal mortality in the developed world. During gravidity the incidence of deep vein thrombosis (DVT) is five to seven times higher and can be increased by other risk factors. Despite concerns for foetal teratogenicity and oncogenicity and maternal risks associated with diagnostic testing, and potential adverse effects of pharmacological treatment, an accurate diagnosis of pulmonary embolism and a timely therapeutic intervention are crucial. Compression ultrasonography is a non-invasive test with high sensitivity for the diagnosis of symptomatic deep vein thrombosis. For the diagnosis of pulmonary embolism,...
Inhalational application of furosemide - the breathlessness panacea?Case Report
R. Škulec
Anest. intenziv. Med. 2017;28(2):101-105
Dyspnoea is a serious symptom requiring causal and/or palliative management in a variety of acute and chronic clinical conditions. It has been shown that inhaled furosemide (IAF) has the potential to be a new effective approach to dyspnoea management in a number of indications. This route of administration exerts significant bronchodilatation, relieves dyspnoea by suppressing the afferentation to the central nervous system and has a minimum diuretic effect. The author summarizes our current knowledge about the use of IAF in bronchial asthma, chronic obstructive pulmonary disease, heart failure and in the palliative treatment of dyspnoea, and presents...
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):105
Long-term treatment and addiction to opioidsLéčba bolesti - přehledový článek
J. Lejčko, T. Gabrhelík
Anest. intenziv. Med. 2017;28(2):106-113
Chronic pain is a serious public health concern. Under-treatment of chronic pain causes intense physical and psychological suffering and can destroy patient's quality of life. Experience with long-term opioid analgesia in patients with cancer pain has shown highly favourable risk/benefit ratio. Where standard therapeutical methods have failed, patients can be treated by administration of strong opioids. However, opioid treatment has its issues. Life expectancy of chronic pain patients is temporarily unlimited and for that reason the time horizon of opioid therapy is unlimited as well. The effect of opioids on the organism is very complex. In comparison...
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):113
Dexmedetomidine and its use in anaesthesia and intensive careSpecial article
B. Bilý, F. Sabol, P. Török, P. Čandík
Anest. intenziv. Med. 2017;28(2):114-126
Dexmedetomidine is a potent, highly selective and specific α2-adrenergic agonist with sedative, analgesic and sympatholytic effect. It is characterized by high selectivity of α2:α1 at a ratio of 1600:1. Dexmedetomidine acts through the G-protein coupled receptor, which induces inhibition of adenylate cyclase, which in turn leads to a decrease in cAMP. The result is inhibition of the release of norepinephrine, which leads to a decrease of excitation in particular in the locus coeruleus. It also reduces the release of norepinephrine into the systemic circulation, thereby improving the haemodynamic stability,...
Zajímavosti, tipy a trikyZajímavosti, tipy a triky
V. Černý
Anest. intenziv. Med. 2017;28(2):126
Paediatric airway management update: Myths and traditions versus evidence-based medicine (EBM)Review Article
J. Klučka, M. Ťoukálková, I. Křikava, R. Štoudek, P. Štourač
Anest. intenziv. Med. 2017;28(2):128-134
Airway management is a critical part of paediatric anaesthesia. Only a minority of anaesthesiologists are experienced in paediatric airway management because of the relatively small number of surgical procedures (compared with the adult population) and also due to the centralization of paediatric medical care. This situation, together with the absence of evidence-based data (EBM) and recommendations often leads to "eminence-based" care (local medical authority experience), which can have negative impact on the final outcome. The author's aim was to analyse and evaluate the current EBM data and recommendations related to paediatric airway management...
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):134
The physician and the law II - forensic medical experts and expert institutionsEthics and Medicine Law
I. Piňos
Anest. intenziv. Med. 2017;28(2):135-138
The article describes the system of registration for legal experts in medicine, the qualification required and other requirements on the applicants. The common circumstances of legal expertise in medicine and some typical pitfalls are discussed. The work of legal expertise institutions is described too. Possible improvements to the system are mentioned.
Volba způsobu anestezie - celková a/nebo regionálníPostgraduate Education - Topics for Board Examination
V. Černý
Anest. intenziv. Med. 2017;28(2):139-140
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):140
Selhání kostí u kriticky nemocných - zapomenutá oblast pro lékaře pracovišť intenzivní péče?Postgraduate education - Selected Topics in Clinical Physiology
Černý V., D. Astapenko
Anest. intenziv. Med. 2017;28(2):141-142
K tekutinové léčbě hospitalizovaných dospělých pacientůNews from CSIM
Jan Beneš, Vladimír Černý, Martin Matějovič
Anest. intenziv. Med. 2017;28(2):143-144
Zajímavosti z literaturyHighlights from the literature
J. Drábková
Anest. intenziv. Med. 2017;28(2):144