Anesteziologie a intenzivní medicína, 2004 (vol. 15), issue 4
Fluid Therapy during Anaesthesia: Comparison of Standard and Extensive Method of HaemodynamicMonitoringArticles
M. Ročeň, P. Přikryl, W. Zenkner, O. Machalová, P. Vychodil, K. Cvachovec
Anest. intenziv. Med. 2004;15(4):181-185
Objective:Impact of two different types of haemodynamic monitoring (transesophageal doppler/routine) on fluid therapymanagement during general anaesthesia and early postoperative course in high risk surgical patients.Design: Prospective, comparative study in one centre.Setting: University Hospital Prague-Motol.Material and Method: 50 patients (ASA ≥ III)who underwent surgery under general anaesthesia admitted to ICU were enrolledin the study. 25 patients were routinely monitored,transesophageal doppler was used and fluid therapy guidance was basedon its results in 25 patients.Results: The tested group comprised of 13 men, 12 women (61.8...
Difficult Airways: a Touchestone of Quality of Anaesthesia CareArticles
K. Škarvan
Anest. intenziv. Med. 2004;15(4):186-190
Anaesthetists occasionally encounter difficulties in securing the airways in their practice. These difficulties are eitheranticipated or unanticipated and include difficult laryngoscopy, difficult or failed intubation and "can't intubate, can'tventilate situation". A wrong and inapt management of difficult airways puts the patients at risk of serious morbidity,hypoxaemic brain damage and death. In order to decrease the risk, anaesthetists must know the guidelines and algorithmsfor difficult airway management and must be able to apply them as needed. Anaesthetists acquire and refresh theirknowledge and practical skills both by training on manikins and...
Dialysis Disequilibrium Syndrome as a Complication of Haemodialysis in a Cardiac SurgeryPatientArticles
T. Vaněk, Z. Bukovská, P. Brůček, Z. Straka, R. Jarešová
Anest. intenziv. Med. 2004;15(4):191-194
Our aim is to draw attention to a currently relatively rare but serious complication of haemodialysis. The development ofa dialysis disequilibrium syndrome in a chronic dialysis patient who underwent a cardiac surgery procedure - aortic valvereplacement - is described.
Hallucinations as a Rare Complication of Morphin Administration for Postoperative AnalgesiaArticles
J. Málek, V. Štukavec, Z. Pelák
Anest. intenziv. Med. 2004;15(4):195-196
A case of a 47 years old patient without complicating diseases with disturbing auditory hallucinations after 24 hoursmorphine treatment is described. Morphine was administered for postoperative analgesia after probatory laparotomy ina dose of 10mg SC every 4 hours. The hallucinations were associated with a weak external stimulation (noise from monitorsand air conditioning) and were presented as a harmonic music (Russian choirs). Sometimes, the patient had visualsensations after closing his eyes. Most probably, the cause was morphine, because after its withdrawal and substitutionwith tramadol hallucinations disappeared during 24 hours. Similar cases...
Radiofrequency Pain TreatmentArticles
T. Gabrhelík, P. Michálek
Anest. intenziv. Med. 2004;15(4):197-203
Radiofrequency (RF) pain treatment utilizes an alternating electric field of high frequency to impact nervous tissue. Theanalgetic effect is reached by neuroablation, termic destruction of nerve fibers (RF termoablation).However, analgetic effectis also caused by temporary electrophysiological changes in pain perception resulting from an exposure of nervous tissueto the electric field, so called neuromodulation (pulsed RF). Pulsed RF is an isothermic, non-destructive method of paintreatment which resulted in using the method in wider spectrum of diagnoses. Indications for RF are spinal pain,interventions on the vegetative nerve system and peripheral...
Correlation of Cardiac Output Measurement with Transoesophageal Echocardiography and Bolus Termodilution Technique in Patients with Various Degree of Tricuspid RegurgitationArticles
M. Balík, P. Plášil, J. Pažout, M. Otáhal, M. Fric, J. Pachl
Anest. intenziv. Med. 2004;15(4):204-208
Objective:The aim of the article is to suggest a practical approach to the cardiac output (CO) measurement with combineduse of echocardiography and thermodilution in patients with various valve disorders.Design: Prospective observational study.Setting: 20-bed general intensive care unit in the university hospital.Material and Methods: 27 mechanically ventilated patients with no significant aortic valve disease were included. Patientswere measured twice using simultaneously transesophageal echocardiography (TEE) and pulmonary artery catheter (PAC)for CO.Results: Continuous doppler measurements were taken in the left ventricular outflow tract...