Beta-blokátory v intenzivní a urgentní medicíně: update 2025 

prof. MUDr. Vladimír Černý, Ph.D., FCCM, FESAIC, doc. MUDr. Roman Škulec, Ph.D.

Anest. intenziv. Med. 2025;36(Suppl.A)

Prof. George Silvay 1935–2025Obituary

Cvachovec K., Černý V.

Anest. intenziv. Med. 2025;36(2):151

Zajímavosti z literaturyHighlights from the literature

Horáček M., Klučka J.

Anest. intenziv. Med. 2025;36(2):142-150

Algorithm for the diagnosis of malignant hyperthermiaNew guidelines

Štěpánková D., Klincová M., Schröderová I., Zídková J., Gaillyová R., Fajkusová L., Štourač P.

Anest. intenziv. Med. 2025;36(2):120-138

Collaboration between ČSARIM and NIKEZ – a unique opportunity to impact clinical practice?Editorial

Černý V.

Anest. intenziv. Med. 2025;36(2):65 | DOI: 10.36290/aim.2025.029

Commentary on the standard operating procedure NIKEZ Algorithm for the diagnosis of malignant hyperthermia in the Czech Republic and its practical consequencesCorrespondence

Štěpánková D., Klincová M., Schröderová I., Zídková J., Gaillyová R., Fajkusová L., Vyškovský R., Štourač P.

Anest. intenziv. Med. 2025;36(2):139-141 | DOI: 10.36290/aim.2025.018

Preventive procedures for ventilator-associated pneumonia - current recommendationsNew guidelines

Zoubková R., Światkowská M., Glac T., Madziová S., Haltofová A., Rusková K., Nytra I., Pospíšilová J., Kučerová Z., Ševčík P.

Anest. intenziv. Med. 2025;36(2):110-119 | DOI: 10.36290/aim.2025.022

Ventilator-associated pneumonia is one of the most common nosocomial infections in intensive care units. Overall, it affects approximately one in 100 patients in intensive care and up to 1 in 10 patients with mechanical ventilation. Influenceable sources of infection include effective preventive measures implemented in clinical practice based on the education of nurses. These are usually simple measures such as using a semirecumbent position, taking care of oral hygiene, checking the pressure in the obturation ballon, or suctioning secretions in the subglottic space. The aim of the text is to provide current recommendations regarding preventive measures...

Stanovisko výboru ČSARIM Etapy anesteziologické a operační péče - terminologie a definiceReports from professional societies

Balík M., Beneš J., Bláha J., Černá Pařízková R., Černý V., Duška F., Dostál P., Gabrhelík T., Mach D., Michálek P., Stern M., Ševčík P., Štourač P., Truhlář A., Vymazal T.

Anest. intenziv. Med. 2025;36(2):108-109 | DOI: 10.36290/aim.2025.024

Stanovisko výboru ČSARIM Zachování dostupnosti sukcinylcholinu v klinické praxiReports from professional societies

Balík M., Beneš J., Bláha J., Černá Pařízková R., Černý V., Duška F., Dostál P., Gabrhelík T., Mach D., Michálek P., Stern M., Ševčík P., Štourač P., Truhlář A., Vymazal T.

Anest. intenziv. Med. 2025;36(2):107 | DOI: 10.36290/aim.2025.025

Stanovisko výboru ČSARIM Zachování dostupnosti desfluranu v klinické praxiReports from professional societies

Balík M., Beneš J., Bláha J., Černá Pařízková R., Černý V., Duška F., Dostál P., Gabrhelík T., Mach D., Michálek P., Stern M., Ševčík P., Štourač P., Truhlář A., Vymazal T.

Anest. intenziv. Med. 2025;36(2):106 | DOI: 10.36290/aim.2025.026

Long-term vascular access in anesthesiology and intensive care medicine and tunnelizationShort Communication

Brožek T., Dovjak P., Chovanec V., Kletečka J., Nosková P., Astapenko D.

Anest. intenziv. Med. 2025;36(2):102-105 | DOI: 10.36290/aim.2025.021

Long-term venous accesses are now an integral part of complex patient care. They have also found their way into the field of anesthesiology and intensive care. Mostly, long-term access is inserted in specialized outpatient clinics or vascular access centers, often under the supervision of anesthesiologists. This short review article discusses the types of long-term accesses, the possibilities of their use in our field, and tunneling, which moves the so-called exit site into a safe zone and thus, together with ultrasound navigation during insertion, allows the vascular access to be tailored exactly to the patient and to deviate from the old dogmatic...

Fatal intravascular haemolysis caused by Clostridium perfringens - case report and literature reviewCase Report

Harazim M.

Anest. intenziv. Med. 2025;36(2):97-101 | DOI: 10.36290/aim.2025.020

This case report documents a case of fulminant bacteraemia caused by Clostridium perfringens in a 76-year-old healthy man, which led to massive intravascular haemolysis, refractory septic shock and death within a few hours. Typical CT findings of gas in the liver and laboratory evidence of massive hemolysis led to suspicion of toxin-producing infection, which was confirmed post mortem by culture and PCR detection of alpha-toxin. The case report describes the extremely rapid course of the disease and highlights the need for urgent consideration of this diagnosis in septic states with hemolysis. We discuss the pathophysiology and diagnostic possibilities...

Anaphylactoid syndrome of pregnancy (amniotic fluid embolism)Case Report

Bundzáková K.

Anest. intenziv. Med. 2025;36(2):91-96 | DOI: 10.36290/aim.2025.013

Anaphylactoid syndrome of pregnancy is a rare but fatal obstetric complication that results in sudden cardiovascular collapse, altered consciousness, respiratory failure, and disseminated intravascular coagulation [1]. This case report describes a 25-year-old woman in labor who, on preoperative ultrasound, had intrauterine fetal death with placental abruption and who experienced sudden cardiac arrest during an emergency cesarean section. Despite immediate resuscitation and intensive care, the patient died. Autopsy confirmed the presence of fetal elements in the pulmonary vasculature, definitively establishing the diagnosis of anaphylactoid pregnancy...

Therapeutic drug monitoring - a path to more effective antibiotic therapyReview Article

Juhás V., Šudáková A., Harazim M.

Anest. intenziv. Med. 2025;36(2):84-90 | DOI: 10.36290/aim.2025.015

Therapeutic drug monitoring (TDM) is a key tool in optimizing antibiotic therapy in critically ill patients. The variability of pharmacokinetics and pharmacodynamics (PK/PD) in this population often requires an individualized approach that goes beyond standard dosing schedules. Early implementation of TDM, especially during the first 48 hours of treatment, is essential to achieve target therapeutic antibiotic concentrations. The correct administration strategy, using prolonged or continuous infusions of the administered antibiotics, plays a significant role in achieving optimal PK/PD parameters. At our institution, we have observed a high variability...

Malignant hyperthermia "up­‑to­‑date practically" - non­‑systematic review articleReview Article

Štěpánková D., Klincová M., Schröderová I., Bönischová T., Tomášková V., Havránková N., Štourač P.

Anest. intenziv. Med. 2025;36(2):74-83 | DOI: 10.36290/aim.2025.014

Malignant hyperthermia (MH) is a rare, hereditary, life-threatening pharmacogenetic disease induced by some commonly used anaesthetics. This review article aims to summarise, from a practical point of view, the news and current recommendations in the field of MH so that the anaesthesiologist-intensivist can easily use them in daily practice. The theoretical introduction is only brief, as it serves to gain an essential awareness of the issue of MH. As a matter of priority, we will look at the most common situations where a doctor may encounter MH. We will focus on the anaesthesiology clinic and the recognition of risk factors. In the operating room,...

Adverse events risk score assessment of anaesthesia nurse activities in the context of the Czech RepublicOriginal Article

Bejvančická P., Brabcová I.

Anest. intenziv. Med. 2025;36(2):68-73 | DOI: 10.36290/aim.2025.016

Objective: Anaesthesia care is burdened with a certain level of risk. The nurse is an essential part of the anaesthesia team. It is necessary to implement appropriate risk management strategies in the nursing. The aim of this study was to define the nurses' activities in anaesthesia care and evaluate risk score of adverse events for individual activities. Design: Delphi study. Descriptive study. Materials and methods: The 1st phase of the research included 2 Delphi rounds, the expert panel consisted of 20 anaesthesia nurses with overlap in management or education in anaesthesiology. The consensus level was set at 80% agreement of experts. A Likert...

Zajímavosti z literaturyHighlights from the literature

Horáček M., Málek J., Klučka J.

Anest. intenziv. Med. 2025;36(1):55-61 | DOI: 10.36290/aim.2025.010

ČSARIM v roce 2025 – kde se nacházíme v polovině mandátu výboru?Editorial

Černý V.

Anest. intenziv. Med. 2025;36(1):4-5 | DOI: 10.36290/aim.2025.008

Česká společnost intenzivní medicíny (ČSIM) jako partnerská organizace Evropské společnosti intenzivní medicíny (ESICM)Editorial

Balík M.

Anest. intenziv. Med. 2025;36(1):3 | DOI: 10.36290/aim.2025.005

Premedication in children: what if it fails?Correspondence

Frelich M., Stašová B., Fišerová D., Astapenko D., Jor O.

Anest. intenziv. Med. 2025;36(1):52-54 | DOI: 10.36290/aim.2025.003

Angiotensin II - mechanism of action, current evidence and position paper of the interdisciplinary working group on its use in intensive care settingsNew guidelines

Balík M., Beneš J., Černý V., Kula R., Matějovič M., Říha H., Tencer T.

Anest. intenziv. Med. 2025;36(1):46-51 | DOI: 10.36290/aim.2025.004

The medicinal product Giapreza containing angiotensin II for intravenous administration has been registered in the Czech Republic since 2023. The article describes the mechanism of action of the drug, summarizes the current scientific evidence of its efficacy and safety, and presents the opinion of an interdisciplinary working group on the use of angiotensin II in intensive care units, especially in patients with refractory vasoplegic shock. The text has been endorsed by the Czech Society of Intensive Medicine, the Czech Society of Anesthesiology and Intensive Medicine, and the Czech Acute Cardiac Care Association.

Iliocostalis plane block (ICPB): technical reportShort Communication

Nalos D., Beňo L., Škvára D.

Anest. intenziv. Med. 2025;36(1):43-45 | DOI: 10.36290/aim.2025.002

The article describes a variant of the erector spinae plane block (ESPB) on the chest. The application site is between the fascia of the iliocostalis muscle and the serratus posterior superior muscle. The distribution of the local anesthetic is medial to the distribution of the anesthetic in the case of erector spinae plane block (ESPB). The lateral direction is evidence of the spread of applied LA up to the mid-axillary line. The extent of analgesia is similar to that of ESPB. The application site is well identifiable and lies more superficially and far from the backbone structures than the ESPB application site. The block will look for indications...

Nursing Care of a Central Venous CatheterShort Communication

Kletečka J., Vlasáková A., Nosková P., Astapenko D.

Anest. intenziv. Med. 2025;36(1):39-42 | DOI: 10.36290/aim.2025.007

Nursing care for central venous catheters has undergone significant advancements in recent years due to new materials that reduce infection risk, enhance patient comfort, and allow for less frequent dressing changes. A key innovation is the use of sutureless fixation systems, which eliminate skin trauma caused by sutures while maintaining sufficient catheter stability. Other advanced methods, including transparent dressings, chlorhexidine-releasing dressings, and cyanoacrylate glue for exit site closure, help reduce bacterial colonization and infection risk. This review article focuses on the various materials used and the correct procedures for initial...

Our experience with VV ECMO­‑assisted surgery: case report seriesCase Report

Chovanec Z., Pestal A., Berkova A., Cervenak V., Penka I., Cundrle I.

Anest. intenziv. Med. 2025;36(1):34-38 | DOI: 10.36290/aim.2025.001

Veno­‑venous extracorporeal membrane oxygenation (VV ECMO) is a technique of extracorporeal support that facilitates blood gas exchange, enabling the complete replacement of lung function for a specified duration, such as during surgery. By using this method, we are able to provide surgical treatment to highly selected patients who would otherwise be unable to undergo thoracic surgery, including tracheal/carinal surgery and high­‑risk one­‑lung ventilation due to previous lung resection or severe lung impairment. This case series presents our experience with elective and acute ECMO­‑assisted thoracic surgery (excluding lung...

Fatal ecstasy (MDMA) intoxication with extreme hyperpyrexia, rhabdomyolysis, and disseminated intravascular coagulopathyCase Report

Mynář M., Samek J., Břízová P., Zátopková L., Hejna P., Turek Z.

Anest. intenziv. Med. 2025;36(1):29-33 | DOI: 10.36290/aim.2024.065

Ecstasy (MDMA - 3,4-methylenedioxymethamphetamine) is a synthetic psychoactive amphetamine with stimulatory effects on the user's sympathetic nervous system. The prevalence of MDMA misuse has been widely increasing in young people below 20 years of age. For first-time users, MDMA is considered the most dangerous drug in terms of serious complications such as extreme hyperpyrexia, rhabdomyolysis, disseminated intravascular coagulopathy, and brain edema. The presented case study describes fatal MDMA intoxication in young men with rapid onset of extreme hyperpyrexia above 42 °C, massive rhabdomyolysis, DIC, and multiple organ failure leading to death....

Alveolar-arterial oxygen difference in intensive careReview Article

Kutěj M., Haiduk F., Sagan J., Máca J.

Anest. intenziv. Med. 2025;36(1):22-28 | DOI: 10.36290/aim.2025.006

The alveolo-arterial oxygen difference (P_(A-a)O₂) describes the difference between alveolar and arterial oxygen tension. The primary purpose of P_(A-a)O₂ is to distinguish between extra- and intra-pulmonary causes of hypoxemia. P_(A-a)O₂ has come to the forefront again in the context of the SARS-CoV-2 (COVID-19) coronavirus pandemic, where relatively simple methods of patient triage and therapeutic approaches have been sought. In the intensive care setting, where it is almost always obvious whether the cause of hypoxemia is extrapulmonary or intrapulmonary, the importance of P_(A-a)O₂...

Post­‑sepsis syndromeReview Article

Fischer J., Hortová­‑Kohoutková M., Frič J., Šrámek V., Helán M.

Anest. intenziv. Med. 2025;36(1):15-21 | DOI: 10.36290/aim.2024.064

Sepsis as a life-threatening organ dysfunction caused by a deregulated immune response to infection remains one of the greatest human health-related concerns globally and even though huge advances in diagnostics and treatment of sepsis have been made, around 11 million sepsis-related deaths are reported every year worldwide. Only half of the sepsis survivors can achieve complete recovery 2 years after discharge, one-third die, and the remaining one-sixth suffer from long-term complications known as post-sepsis syndrome. It involves physical symptoms - fatigue, muscle weakness, dysphagia, and chronic pain; neuropsychiatric consequences - anxiety, depression,...

Ultrasound assessment of diaphragmatic movement post selective superior trunk block versus conventional interscalene block in shoulder arthroscopyOriginal Article

Sultan W. A., Metwally A. A., Soliman A. M., Mahdy W., Afify N.

Anest. intenziv. Med. 2025;36(1):8-14 | DOI: 10.36290/aim.2025.012

Study objective: Our aim was to evaluate the incidence of hemidiaphragmatic paralysis after selective superior trunk block compared to conventional interscalene block. Study design: A prospective double­‑blinded randomized controlled trial. Setting: University Hospital of Faculty of Medicine. Material and Method: Sixty­‑eight patients who were scheduled for shoulder arthroscopy were divided into two equal groups. The interscalene group received ultrasound­‑guided interscalene block and the superior trunk group received ultrasound­‑guided selective superior trunk block. A total volume of 15 ml of 0.25% bupivacaine was injected...

EditorialEditorial

doc. MUDr. Jiří Málek, CSc.

Anest. intenziv. Med. 2024;35(5):271 | DOI: 10.36290/aim.2024.062

Year 2024 in review - Acute pain managementReview Article

Málek J.

Anest. intenziv. Med. 2024;35(5):329-335 | DOI: 10.36290/aim.2024.051

This article presents a selected review of articles and topics published in the field of acute pain management over the past approximately 14 months. It focuses on new developments in systemic analgesia, pain management procedures, and selected international guidelines.