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.

Year 2024 in review - Regional aneasthesiaReview Article

Nalos D., Merjavý P.

Anest. intenziv. Med. 2024;35(5):326-328 | DOI: 10.36290/aim.2024.057  

This review article presents a report on the 41^st Congress of the European Society of Regional Anaesthesia in Prague. This is followed by an overview of information from published works this year that interested the authors of the review. The largest space is devoted to new knowledge of possible traumatic involvement of peripheral nerves and the theory of the spread of local anesthetic based on histological examinations. The next part is devoted to the standardization of block nomenclature based on anatomical relationships and other current topics.

Year 2024 in review - Respiratory failure and lung supportReview Article

Máca J., Burša F., Sklienka P.

Anest. intenziv. Med. 2024;35(5):320-325 | DOI: 10.36290/aim.2024.050  

As in the previous year, very few original prospective clinical papers concerning respiratory failure and pulmonary lung support, including artificial lung ventilation and veno-venous form of extracorporeal membrane oxygenation, have been published so far over this year, 2024. In the first part, the manuscript focuses on selected pathophysiological aspects of acute hypoxemic respiratory failure. In the second part, the text continues with a description of several publications that deal with the issue of the use of invasive ventilation support in the form of artificial lung ventilation. The third part deals with a non-invasive form of ventilation support....

Year 2024 in review - Anaesthesiology in obstetricsReview Article

Štourač P., Bláha J., Kosinová M., Mannová J., Nosková P., Harazim H., Pešková K., Seidlová D.

Anest. intenziv. Med. 2024;35(5):314-319 | DOI: 10.36290/aim.2024.046  

The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year It summarizes new challenges in the field of obstetric anesthesia including the use of AI and simulations in this area. It also presents new developments in systemic and neuroaxial obstetric analgesia, Caesarean Section anaesthesia and emergencies in peripartum period.

Year 2024 in review - Paediatric Anaesthesia and intensive careReview Article

Klabusayová E., Bönischová T., Harazim H., Kovář M., Vafek V., Kosinová M., Štourač P.

Anest. intenziv. Med. 2024;35(5):311-313 | DOI: 10.36290/aim.2024.052  

The aim of the article "Year 2024 in review - Paediatric Anaesthesia and intensive care" is to clearly summarize the latest findings in this field published over the past year, thereby allowing readers to be more easily oriented in the subject matter. The publications mentioned in this review article are of high quality and can provide readers with knowledge that enhances the quality of their daily clinical practice in anaesthesia and intensive care.

Year 2024 in review - General anaesthesiaReview Article

Bláha J., Nguyenová Q. G., Bartošová T.

Anest. intenziv. Med. 2024;35(5):305-310 | DOI: 10.36290/aim.2024.059  

Searching for the term "general anesthesia", PubMed lists 1530 clinical trials, reviews, systematic reviews, or meta-analyses in the last year. It is impossible to select "all the most important", so this text has focused on only 4 areas that the authors consider as key. The first is opioid-free anesthesia (OFA) and its growing role in today's anesthesiology. OFA involves anesthetic techniques that, although they can reduce the incidence of PONV, postoperative opioid consumption, and speed recovery, require closer monitoring of hemodynamics and analgesic dosing because of the risk of bradycardia and prolonged postoperative stay. The second topic is...

Year 2024 in review - chronic pain therapyReview Article

Fricová J.

Anest. intenziv. Med. 2024;35(5):301-304 | DOI: 10.36290/aim.2024.060  

The article presents a selection of interesting events such as World Pain Day, especially in the wake of the European Pain Day, which follows every third Wednesday in October. The Euro-Pean Union's influence on pain management is mentioned in a recent paper on painkillers, but the EU's interest in chronic pain is still rather marginal. IASP, the International Society for Pain Management, has declared 2024 the Global Year of Gender Differences in Pain. IASP has sought to shed light on this important topic during the global year and to bring about a change in attitude and understanding among doctors and patients. How gender differences may interact with...

Year 2024 in review - Pre­‑hospital emergency careReview Article

Škulec R.

Anest. intenziv. Med. 2024;35(5):297-300 | DOI: 10.36290/aim.2024.045  

In this article, the author presents a set of annotated papers published in 2024 in the world literature that are significantly related to pre-hospital emergency care. Publications from the setting of emergency departments are not included.

Year 2024 in review - Emergency medicineReview Article

Škulec R.

Anest. intenziv. Med. 2024;35(5):292-296 | DOI: 10.36290/aim.2024.053  

In this article, the author presents a set of annotated papers published in 2024 in the world literature that are significantly related to emergency medicine. Publications from the pre-hospital setting are not included in the selection.

Year 2024 in review - SepsisReview Article

Karvunidis T., Královcová M.

Anest. intenziv. Med. 2024;35(5):288-291 | DOI: 10.36290/aim.2024.049  

This year's summary comments an antimicrobial treatment of serious infections based on selected publications. In the context of recent studies and meta-analyses, it discusses the method of administration of β-lactam antibiotics, new issues on their safety, and also considers the appropriate duration of such therapy.

Year 2024 in review - Cardiac anaesthesia and postoperative careReview Article

Michálek P., Říha H., Kunstýř J., Pořízka M.

Anest. intenziv. Med. 2024;35(5):281-287 | DOI: 10.36290/aim.2024.041  

Perioperative and postoperative care in cardiac and thoracic aortic surgeries carries a significant number of specific scenarios differing from other surgical specialties. Cardiac anesthesia is an independent sub-specialty in most developed countries. Generally, modern cardiac surgery tends to move towards less invasive procedures such as partial sternotomy, mini-thoracotomy, thoracoscopy, or hybrid procedures in cooperation with interventional cardiologists. This review article comments on the novel information within the last year. The topics of mini-invasive cardiac surgery, recent guidelines in cardiac perioperative care, novel drug studies, and...

Year 2024 in review - Cardiovascular issues in intensive care and perioperative medicineReview Article

Smékalová O., Klimovič A., Kletečka J., Zatloukal J., Beneš J.

Anest. intenziv. Med. 2024;35(5):274-280 | DOI: 10.36290/aim.2024.054  

As in previous years, we are also trying to acquaint our readers with the news that was published during the last 12 months in a narrative review article. In addition to the exciting topics of pharmacological circulation support, we focus more on several national and international recommendations in this year's review. We do not present the translation of these recommendations in extenso, but instead, we emphasize some essential points, which we try to place in the context of existing evidence.

Ohlédnutí za doc. MUDr. Jarmilou Drábkovou, CSc. (1934–2024)Social section

Černý V., Horáček M., Cvachovec K., Ševčík P.

Anest. intenziv. Med. 2024;35(4):265-266 | DOI: 10.36290/aim.2024.047