Depth of anaesthesia monitoringAnaesthesiology - Review articles

J. Divák, M. Frelich, R. Kula

Anest. intenziv. Med. 2016;27(6):349-357  

Monitoring in the course of general anaesthesia (GA) may be divided into the monitoring of individual GA components (hypnotic, analgesic and muscle relaxation), and monitoring of the function of organ systems, which also includes monitoring of the depth of GA.Depth of GA is defined as a decrease of the central nervous system (CNS) activity, and a decrease of the CNS ability to react to external stimuli. Insufficient GA depth is associated with a high risk of perioperative awareness and can lead to serious consequences for the patient, including the post-traumatic stress reaction and serious post-operative psychological consequences. The incidence...

Management of sepsis-induced disseminated intravascular coagulopathy using antithrombin and heparin, and the use of thromboelastometry in establishing the diagnosis of heparin resistanceIntesive Care Medicine - Case Report

M. Durila, P. Salaj, H. Součková, M. Astraverkhava, J. Beroušek

Anest. intenziv. Med. 2016;27(6):358-363  

Severe sepsis is often accompanied by disseminated intravascular coagulation (DIC) and multiple organ dysfunction. Increased activation of coagulation is characteristic for this syndrome and therefore, from the pathophysiological point of view, it would be logical to intervene at the initiation of coagulation by the administration of antithrombin and heparin. Evidence from randomized studies offering clear instructions on the usage of these drugs is lacking though. In our case report we describe the management of septic DIC with antithrombin and heparin without bleeding complication. We have found that in order to stop the consumption of the coagulation...

Ultrasound-guided blockade of the second and third trigeminal branches in geriatric patientsAnaesthesiology - Case Reports

D. Nalos, P. Kačer

Anest. intenziv. Med. 2016;27(6):364-366  

This small clinical case series describes a technique of ultrasound-guided blockade of the second and third branches of the trigeminal nerve for facial surgery in geriatric patients.Four geriatric patients (3 females and 1 male), average age of 74.5 years, were indicated for cancer surgery on the face at the Department of Surgery, Masaryk Hospital, in Ústi nad Labem. Anaesthesia of the second and third branches of the trigeminal nerve was performed by application of 8 ml 0.5% bupivacaine in the fossa pterygopalatina. The use of ultrasound allowed visualization of the trigeminal nerve branches, the maxillary artery and other vascular structures...

Regional anaesthesia and haemostasis-modifying drugs - latest recommendationsAnaesthesiology - Review articles

M. Jelínek

Anest. intenziv. Med. 2016;27(6):367-374  

Performing regional anesthesia in patients receiving anticoagulants or antiplatelet medications includes higher risk of bleeding complications. Spinal epidural haematoma after neuraxial puncture represents the most serious complication. Many world-wide and national societies of anaesthesiologists have published their guidelines on the management of antithrombotic therapy in relation to regional anaesthesia. The aim of this article is to compare the current guidelines.

Preventive immobilisation of the cervical spine in pre-hospital emergency care in trauma patients: updateReview Article

R. Jančálek

Anest. intenziv. Med. 2016;27(6):375-379  

Cervical spine or spinal cord injury occurs in 2-3% of trauma patients. Preventive immobilization of the cervical spine during prehospital care in trauma patients is common clinical practice because of the secondary spinal cord injury risks due to patient manipulation. The potential negative impacts of immobilization with hard cervical collar have led to the rise of the concept of selective cervical spine immobilization. Cervical immobilization of trauma patients who are (i) awake, alert, and are not intoxicated; (ii) who are without neck pain or tenderness; (iii) who do not have abnormal neurological examination; and (iv) who do not have any significant...

Thrombophilic conditions during pregnancyAnestezie v gynekologii a porodnictví - Přehledový článek

J. Mannová, M. Penka, P. Štourač

Anest. intenziv. Med. 2016;27(6):380-389  

The risk of venous thromboembolic events is high during pregnancy due to both the physiologic changes of pregnancy and the additional impact of inherited or acquired thrombophilias. The women with thrombophilia are at increased risk not only of pregnancy-related venous thromboembolism (VTE), but also other pregnancy-related complications, including early and late miscarriage, intrauterine growth retardation, placental abruption and pre-eclampsia. Depending on the type of thrombophilia, personal and family history of VTE and history of complications during pregnancy, prophylactic treatment with low molecular weight heparin or unfractionated heparin...

Critical airway obstruction during general anaesthesia caused by anterior mediastinal mass managed by ECMO and tracheobronchial stentingCase Report

K. Netri, J. Votruba, J. Rulíšek, L. Kraus, P. Michálek

Anest. intenziv. Med. 2016;27(6):390-394  

Acute compression of the trachea and the large bronchi during anaesthesia can very quickly lead to development of life-threatening hypoxia, if alternative methods of oxygenation are not established immediately. The case report describes the course and management of a sudden collapse of the lower part of the trachea and main bronchi in a young patient who was indicated for the extirpation of deep cervical lymph nodes under general anesthesia. He developed very high inspiratory pressures with a significant reduction in lung volumes and desaturation, which was caused by compression of the airway due to a lymphoma mass in the anterior mediastinum. In order...

Statistics in biomedical research ISpecial article

K. Langová, J. Zapletalová, L. Ličman

Anest. intenziv. Med. 2016;27(6):395-399  

Statistics are increasingly prevalent in medical practice. Nowadays much concern is devoted in hospital utility statistics, audit, resource allocation, number of new cases (for example AIDS), and so on. Journals nad magazines for doctors are full of statistical material of this sort, as well as the finding of individual research studies. Statistical issues are implicit in all clinical practice when making diagnosis and choosing an appropriate treatment. It is increasingly common to see statistical result from research papers quoted in promotional material for drugs and other medical therapies.The article focuses on particular steps of a research...

Atestační otázky oboru anesteziologie a intenzivní medicína. Péče o pacienta po anesteziiPostgraduate education

V. Černý

Anest. intenziv. Med. 2016;27(6):400-401  

Linezolid, inhibice monoaminoxidázy a klinické konsekvencePostgraduate education - Selected Topics in Clinical Physiology

V. Černý, D. Astapenko

Anest. intenziv. Med. 2016;27(6):402-403  

Guidelines for the Management of Severe Traumatic Brain Injury, Fourth EditionGuidelines

V. Černý

Anest. intenziv. Med. 2016;27(6):404-406  

Docent MUDr. Václav Fessl, CSc. (1932-2016)Personalia

Anest. intenziv. Med. 2016;27(6):407  

Zajímavosti, tipy a trikyZajímavosti, tipy a triky

V. Černý

Anest. intenziv. Med. 2016;27(6):408-409