How strongly should clinicians adhere to guidelines?

prof. MUDr. Vladimír Černý, Ph.D., FCCM, FESAIC

Anest. intenziv. Med. 2025;36(3):155 | DOI: 10.36290/aim.2025.044  

The process of pain assessment in intensive care patients from the perspective of non­‑medical health professionals - a cross­‑sectional questionnaire study

Mica P., Pokorná A., Pešáková E.

Anest. intenziv. Med. 2025;36(3):159-166 | DOI: 10.36290/aim.2025.027  

Study goal: Pain in patients in the intensive care unit (ICU) represents a significant clinical problem requiring a systematic approach to treatment, as well as to monitoring and evaluation of the presence or intensity of pain. Patients are often immobilized, exposed to invasive procedures, and other stressors affecting pain intensity. Patients' ability to verbally express pain levels is often limited. Effective assessment of pain intensity, as well as other pain indicators, is crucial to ensure patient comfort and to prevent complications associated with untreated pain. Study type: cross-sectional questionnaire study. Type of workplace: Intensive...

The influence of anxiety and environmental factors on sleep quality in patients hospitalized in intensive care units

Locihová H., Šrámková K., Slonková J., Zoubková R., Maternová K., Šonka K., Jarošová D.

Anest. intenziv. Med. 2025;36(3):167-174 | DOI: 10.36290/aim.2025.032  

Introduction: Sleep is a fundamental component of human health, and its quality can be affected by various psychological and environmental factors. Objective: This study aimed to determine the level of anxiety in patients hospitalized in the intensive care unit (ICU), analyze its relationship with sleep quality, and identify environmental factors that disrupt this quality. Methods: A multicenter cross-sectional study was conducted in ICUs of six selected hospitals in the Czech Republic. The ICU Sleep Questionnaire (SICQ) and the Beck Anxiety Inventory assessed subjective sleep quality and anxiety levels. Results: A total of 267 ICU patients were included....

Immunomodulation in managing sepsis­‑induced immunosuppression: current options and challenges

Tomášková V., Helán M.

Anest. intenziv. Med. 2025;36(3):175-181 | DOI: 10.36290/aim.2025.037  

Despite progress in diagnosis and treatment, sepsis remains a significant challenge to the health care system globally. In recent decades, the level of knowledge in the field of sepsis has undergone a significant shift towards targeted therapy influencing the immune response in an attempt to dampen the early hyperinflammatory state but also to influence later immunoparalysis. Although this sepsis-induced immunosuppression has not been fully understood yet, it is evident that reduced functions of innate and adaptive immunity are associated with a worsened patient outcome. Based on this finding, several pharmacological approaches to immunostimulation...

Proposal for updating terminology in end­‑of­‑life care in intensive care units in the Czech Republic

Maláska J., Doležal T., Kratochvíl M., Štourač P., Doležal A., Sláma O., Zielina M., Rusinová K., výzkumná skupina RIPE‑ICU

Anest. intenziv. Med. 2025;36(3):182-187 | DOI: 10.36290/aim.2025.033  

End-of-life (EOL) care in intensive care units (ICUs) is a complex clinical, legal and ethical challenge where language and terminology play a critical role in supporting decision-making and interdisciplinary collaboration. This article presents a proposal for a document that responds to the need to update and unify the terminology used in EOL care in the Czech Republic. Its aim is not to redefine terms from scratch but to reflect current developments in international discourse and to align terminology with the Czech clinical, legal and ethical context. The document is the result of a consensus process using a modified Delphi method. It was developed...

Bicarbonate in year 2025 - indications, contraindications, pitfalls and future perspectives

Müller J., Raděj J., Karvunidis T., Valešová L., Horák J., Kříž M., Huňková E., Pavlík R., Matějovič M.

Anest. intenziv. Med. 2025;36(3):188-193 | DOI: 10.36290/aim.2025.036  

Hydrogencarbonate (bicarbonate) is a physiologically occurring weak anion that is essential for the regulation of acid-base balance. Sodium bicarbonate solutions of various concentrations are commonly used to correct severe metabolic acidosis and hyperkalemia, However, there is a lack of evidence to support the effectiveness of this intervention, Furthemore, the administration of hypertonic sodium-rich solution may be potentially harmful to certain patient groups. Conversely, the role for bicarbonate in a number of less traditional indications remains to be discovered.

Donation after circulatory death in a regional hospital in Czech Republic: a case report

Kalina M., Jobánek J., Mareš J., Pokorná E.

Anest. intenziv. Med. 2025;36(3):194-197 | DOI: 10.36290/aim.2025.030  

Transplantation is a well-established therapeutic option that saves lives and improves the quality of life of patients. A shortage in organs has led to an increased use of donation after circulatory death. Donation after circulatory death is nowadays used in some way in most countries in the developed world. We present two cases of a successfully conducted donation after circulatory death in a regional hospital with the aim to demonstrate the feasibility and share a successful practice.

Spinal anaesthesia and maternal hypotension: basic pathophysiology and an opinion of an interdisciplinary working group on its management

Bláha J., Heřman H., Kacerovský M., Koucký M., Lukšová M., Nosková P., Nguyenová Q. G., Pařízek A., Seidlová D., Straňák Z., Štourač P.

Anest. intenziv. Med. 2025;36(3):203-210 | DOI: 10.36290/aim.2025.042  

Hypotension after spinal anaesthesia occurs in most parturients undergoing caesarean section. The text describes the mechanism of hypotension, summarises the current evidence for treating this complication, and presents the consensus opinion of an interdisciplinary panel on its management. The text has been endorsed by the Czech Society of Anaesthesiology, Resuscitation, and Intensive Care Medicine, the Czech Gynaecological and Obstetric Society, and the Czech Neonatological Society.

Who is J. B. West?

Málek J.

Anest. intenziv. Med. 2025;36(3):211-212 | DOI: 10.36290/aim.2025.038  

Diagnostika a léčba život ohrožujícího krvácení u dětských pacientů v intenzivní a perioperační péči 2024

Zaoral T., Blatný J., Jonáš J., Lauková K., Nosáľ S., Raffaj D., Kratochvíl M., Slívová I., Černý V.

Anest. intenziv. Med. 2025;36(3):217-225 | DOI: 10.36290/aim.2025.035  

The physiology of acid-base balance

Duška F.

Anest. intenziv. Med. 2025;36(3):198-202 | DOI: 10.36290/aim.2025.034  

Acid-base balance is a key component of internal homeostasis, essential for enzyme function, cellular signaling, and ATP synthesis. The physiological mechanisms that maintain a stable pH in the extracellular fluid include acid production, buffering, and elimination. The body continuously generates both volatile acids (CO₂) and non-volatile acids (e.g., lactate, sulfate, phosphate). CO₂ is excreted by the lungs, while non-volatile acids are partly metabolized and partly excreted by the kidneys. Blood buffering systems-particularly the bicarbonate buffer, hemoglobin, and plasma proteins-help mitigate acute changes in pH. To assess acid-base...

Zásady účelné antibiotické terapie u hospitalizovaných pacientů - Souhrn diskuze a stanovisko mezioborového panelu k systémové implementaci antibiotického stewardshipu

Adámková V., Černý V., Dlouhý P., Malina P., Matějovič M., Šrámek V., Žemličková H.

Anest. intenziv. Med. 2025;36(3):213-216 | DOI: 10.36290/aim.2025.031  

Zajímavosti z literatury

MUDr. Michal Horáček, DEAA, doc. MUDr. Jozef Klučka, Ph.D., MUDr. Tamara Skříšovská, Ph.D., DESAIC

Anest. intenziv. Med. 2025;36(3):226-233