Anesteziologie a intenzivní medicína, 2001 (vol. 12), issue 3
Combination of Mivacurium and Isoflurane or Sevoflurane for Laparoscopic ProceduresArticles
M. Svítek, J. Polívková
Anest. intenziv. Med. 2001;12(3):106-108
In the set of 49 patients we assessed the consumption of mivacurium administered as continuous infusion in combination with isoflurane orsevoflurane. The depth of neuromuscular blockade during the procedure was monitored by accelerometry. In the group A, anaesthesia was maintainedwith fentanyl-midazolam, in the group B sevoflurane and in the group C isoflurane. The combination of mivacurium and sevoflurane resulted ina significant decrease of the muscle relaxant dose, without slowing the neuromuscular block recovery.
Short-term Neuromuscular Blocking Agents in BronchologyArticles
T. Beran
Anest. intenziv. Med. 2001;12(3):109-111
Between September, 1998 and April, 2000 we performed a study to compare suxamethonium and mivacurium in 140 general anaesthesia proceduresfor diagnostic and interventional bronchoscopic procedures using normal-frequency jet ventilation. Eighty patients were randomized to receivesuxamethonium, sixty patients were randomized for mivacurium use. Laryngeal muscles relaxation was comparable in both groups. The lower frequencyof complication was in the mivacurium group; the complications were also less severe. Financial burden associated with one general anaesthesia of24 minutes duration was comparable in both groups. Regarding the above mentioned results,...
Comparison of Remifentanil and Alfentanil for Analgosedation during ColonoscopyArticles
M. Svítek, J. Bohumínská
Anest. intenziv. Med. 2001;12(3):112-116
Endoscopic procedures in the gastrointestinal tract represent an unpleasant and painful experience for a patient. Analgosedation allows foralleviation from dyscomfort associated with the procedure; the procedure can be performed easier and faster. Combination of midazolam withremifentanil or alfentanil, respectively, provided analgosedation deep enough for colonoscopy. This combination of drugs was associated with theleast adverse effects. Recovery was faster in the group with remifentanil; the next hour, the results were comparable in both groups. Patients weredischarged four hours after completion of the procedure. Combination of midazolam and remifentanil...
Postcannulation Stenosis of the Trachea: Possible Sequal of Airways Maintenance in Intensive CareArticles
J. Koudela, M. Marel
Anest. intenziv. Med. 2001;12(3):117-119
Postcannulation stenosis of the trachea remains serious medical problem. Its frequency has been increasing with improvement of intensive care.The authors describe one case of postcannulation stenosis. In discussion is stated the pathogenetic mechanism, prevention and therapy of benignpostcannulation stenosis.
Echocardiography as a Part of Haemodynamic Monitoring in Intensive CareArticles
M. Balík, J. Pažout, M. Fric, M. Šidák
Anest. intenziv. Med. 2001;12(3):120-124
Introduction:The routine application of transthoracal (TTE) and transesophageal echocardiography (TEE) extends diagnostic and consequentlytherapeutic opportunities of haemodynamic disorders. Pulmonary artery catheter (PAC) enables objective measurement and continuous monitoringof the selected parameters according to the type of the catheter. There is obvious contrib ution of TTE/TEE not only for the changes in therapy in 40%of patients without PAC but even in 40-50% of patients with already inserted PAC regardless to the main diagnosis. Methods: The authors attempted to define the haemodynamic diagnosis where PAC is indicated even after...
Inhalation of the Nitric Oxide (NO) in Patients with ARDS - Responders and NonrespondersArticles
V. Šrámek, I. Novák, R. Rokyta, M. Matějovič, R. Kraus
Anest. intenziv. Med. 2001;12(3):128-129
During 1998-1999 inhaled nitric oxide (NO) was tested in 23 ARDS patients (13 in Pilsen centre, 10 in Brno centre) with the mean age of 48 years(range 20-74 years). Oxygenation index (OI = paO2/FiO2) before the NO test (10-20 ppm for 30 minutes) was 100± 46 mmHg and 11 patients (48%)responded to inhaled NO with a significant OI increase (3 20%). Responders had lower APACHE II on admission (16.9 ± 5.4 vs. 26.3 ± 10.1; p
Tolerability of Feeding with Nasogastral Tube in Critically Ill PatientsArticles
J. Firment, M. Grochová, B. Bočev, A. Studená
Anest. intenziv. Med. 2001;12(3):130-133
Authors have evaluated retrospectively 182 critically ill patients with total or supplemental enteral nutrition. They used this type of nutrition in79,9% patients hospitalised longer than 5 days. They found significant difference in early tolerability of enteral nutrition between survived (1,9 ± 1,2days) and deceased (2,4 ± 1,4 days) patients. Authors found similar difference in enteral energy intake 3rd - 5th day and every day in nitrogen intakebetween survived and deceased patients. The most frequent complication was high grade residual in stomach, which was in 36% of patients, i.e. 49% of all complications.
Nutritional Assessment according to Adductor Pollicis Response to Electrical StimulationArticles
J. Firment, M. Grochová, J. Capková, A. Studená
Anest. intenziv. Med. 2001;12(3):137
Authors have used subjective global assessment method for evaluation of nutritional status. T hey measured muscle strength with relaxometry device.They found next correlation coefficients: twitch strength TW% 30 mA (-0,68), loss of body weig ht (0,57), length of ICU stay (0,53), plasmabutyrylcholinestherase (-0,52), days used antibiotics (0,51), occurrence of pneumonia (0,50), days of postoperative hospitalisation (0,46), days withskin stitches (0,45), plasma albumin (-0,38), plasma proteins (-0,34), age (0,26).
Phosphodiesterase Inhibitors in the Therapy of Severe Septic ShockArticles
E. Kasal, I. Chytra, R. Bosman, V. Štruncová
Anest. intenziv. Med. 2001;12(3):138-140
Phosphodiesterase inhibitors (amrinone) can be used in the therapy of heart failure in severe sepsis. Their effect is different than effect of adrenergicinotropics effect, but inotropics are used as the therapy of the first choice. Especially the combination of the both groups of drugs is very effective andcan be helpful for the circulatory stabilization of severe septic shock. In the case presentation favourable circulatory effect of amrinone is presentedin the 19 years old patient with meningococcal severe septic shock.
Is There a Single Predictor for Survival of Patients Suffering from Acute Haemorrhagic Nec rotising Pancreatitis?Articles
V. Šimeček, Z. Bergl, M. Peleška
Anest. intenziv. Med. 2001;12(3):141-142
The authors try to find out a single unifying criterion predicting survival of patients with acute haemorrhagic necrotising pancreatitis, based ona set of twenty-three patients. The followed parameters yield that patients with the most severeform of pancreatitis have a mortality of 100 per cent,even if all therapeutic possibilities including CVVHD and CRAI had been implemented.
Importance of Hemoperfusion during Poisoning of Carbamazepin - a Case ReportArticles
R. Prchlík, S. Maršík
Anest. intenziv. Med. 2001;12(3):143-144
The authors describe toxicity of carbamazepin referring to a case of a patient who was poisoned by a high dose of carbamazepin whose a letal levelhad been exceeded twice. The objective of this memorandum is to remind the importance of hemoperfusion in the treatment of such a poisoning which played the key role in patient's survival.
Diagnosis of Brain Death with TCDArticles
F. Kramář, M. Mohapl, V. Beneš
Anest. intenziv. Med. 2001;12(3):145-147
Transcranial Doppler (TCD) has come into practice since mid 80's to assess brain perfusion in comatose patients. The authors present a set of 40patients enrolled between 9/96 and 2/00 who were suspected to be brain dead according to clinical examination and TCD. 33 patients were scheduledfor angiography. In 29 patients, brain death was pronounced. 23 patients were offered for transplantation programs. The authors conclude that TCDrepresents a method that contributes to diagnosis of brain death. It can be used for select ion prior to angiography. It helps to decide whether angiographyshould be performed or temporarily withhold. It seems to be a valuable...
Emergency Department in a Rural HospitalArticles
V. Kutěj, A. Boháč
Anest. intenziv. Med. 2001;12(3):148-150
We present the experience with two years service of Emergency Department in a rural hospital, and the interconnection of this admission part intothe organizational model of care for acutely ill patients. This texture is determined by the cooperation with out-hospital based Emergency MedicalService System and a rural hospital. There is stressed the need for hospital based Emergency Departments for the new subspecialty Emergency Care,bringing benefit for both prehospital and hospital health care personnel as well as for patients, of course.
Capnometry - Benefit in Out-of-Hospital Emergency CareArticles
L. Syrovátka, I. Deyl
Anest. intenziv. Med. 2001;12(3):151-154
Capnometry is a very sensitive and noninvasive monitoring method, which has full justification in emergency medicine. In out-of-hospitalcircumstances it take possible advantage specific assets of capnometry for quickly and secure identification of correctly endotracheal intubation, nextas a certain sign of successfully CPR. In the course of interhospital intensive or emergency transports it is necessary comprehensive monitoring ofpatients. Capnometry has an important place here, especially in combination with pulse oximetry for monitoring adequate ventilation and for quicklyrecognize undesirable situation during transport, for example: ventilator failure,...