Anesteziologie a intenzivní medicína, 1999 (vol. 10), issue 4
Natriuretic peptidesArticles
A. Jabor
Anest. intenziv. Med. 1999;10(4):147-150
The group of natriuretic peptides is formed by atrial natriuretic peptide (ANP), natriuretic peptide type B (BNP), natriuretic peptide type C (CNP)and urodilatin. They possess natriuretic, diuretic and vasodilatory effects; they also affect other actions. They regulate the circulation volume via renalexcretion of water and natrium cation. Blood pressure regulation is achieved by direct mechanism and through renin-angiotensin-aldosteron axis withsubsequent effects on vasculature.Natriuretic peptides are important for understanding the nature of many diseases, and could be used for diagnostic, monitoring and therapeuticprocedures. BNP levels could be...
Homeostatic Indications for Administration of DiureticsArticles
M. Balík, A. Kazda, L. Dohnal
Anest. intenziv. Med. 1999;10(4):151-156
The effect of diuretics upon the natrium and water homeostasis and renal bicarbonate metabolism is seldom monitored and utilized in the intensivecare setting. The study deals in detail with the impact of diuretics upon the natrium and water homeostasis and their effects on acid-base balance. Theadministration of diuretics is enough invasive from the point of view of homeostatic monitoring with the aid of renal function tests. Therefore this studyis the integral part of the monitoring system which is based on the use of the computer programme "KIDNEY".The authors monitored effects of furosemide (18 patients), hydrochlorothiazide (8 patients), spironolactone...
Educational possibilities in water and electrolyte dysbalancesArticles
A. Jabor, A. Kazda
Anest. intenziv. Med. 1999;10(4):157-161
The authors present their comprehensive approach to evaluation of water and electrolyte dysbalances based upon synthesis of Siggard-Andersenmodel (Sodium-Potassium Double Chart), Shoker's clearance approach [evaluation of ADH-kidney axis using electrolyte free water clearance (EWC)]and clinical evaluation of necessary input parameters (hydratation state, estimation of potassium stores). The addition of own algorithms enables theprediction of patient condition after water and salt supplementation. Comprehensive approach has a priority, while based on feasible models.Educational aspects have a capacity to be applied in real clinical situations.
The principle and development of adaptive support ventilation modeArticles
R. Kerekeš, J. Kofránek
Anest. intenziv. Med. 1999;10(4):162-166
Besides the control of adequate gas exchange, the closed-loop control modes focus on effective and comfortable weaning from mechanical ventilation.They solve the problem of adaptation of a ventilator setting to variations in pulmonary mechanics. Such modes are able to assist a patient all the timehe is connected. The advantage of adaptive support ventilation (ASV) mode is noninvasive measurement of patient's work of breathing without usingan esophageal catheter and maintaining of an optimal breathing pattern to eliminate the adverse effects of mechanical ventilation.
Results of head injury treatment in childrenArticles
M. Filaun, B. Petrák, I. Lišková, K. Dlask
Anest. intenziv. Med. 1999;10(4):167-168
Authors present in retrospective study results of head injury treatment in children from long term view using Glasgow Outcome Scale. Group of 74children treated in PICU in Motol in years 1992 - 1996 was evaluated. Input criteria was extension reaction on pain stimuli. Standard staircasetherapeutical protocol was used. Intracranial pressure was monitored in epidural way in all patients. Patients with need of surgical intervention werenot in this group involved. 30 children died after injury (40,5%), 44 children survived (59,5%). Value of patients with good outcome 3 month afterinjury was 27 per cent, 6 month after injury was 41 per cent and 1 year after...
Nitric oxide: its metabolism and importance for an organismArticles
J. Racek, I. Novák, V. Holeček, V. Šrámek
Anest. intenziv. Med. 1999;10(4):169-173
Nitric oxide is produced by various forms of nitric oxide synthases (NOS). Nitric oxide exerts various physiologic functions; NO producesvasodilation, inhibits thrombocytes aggregation, effects immune response and serves as a signal messenger. Nitric oxide with superoxide generatesperoxynitrite which destructs proteins by nitration. Nitric oxide can be applied in ARDS, septic shock, ischemic conditions, diabetes, inflammatoryconditions, rheumatoid arthritis and other clinical settings. It is used also in inhalational therapy.
Preventive measures to counteract intravascular devices related infectionArticles
P. Ševčík, R. Kraus, I. Sas, V. Zvoníček
Anest. intenziv. Med. 1999;10(4):174-179
Intravascular device related infections remain a serious problem in critical care setting. Center for Disease Control and Prevention in Atlanta hasdeveloped a novel guidelines for prevention of these infections in 1996. These guidelines were elaborated upon the basis of more than 400 publishedpapers. We present the core sections of those guidelines. The first part covers the definitions, epidemiology, microbiology, pathogenesis and strategiesto prevent catheter related infections. Second part is focused on concrete interventions in clinical practice - general precautions, those focused onperipherally inserted venous catheters, central venous and arterial...
Pulmonary artery catheter in paediatric care - therapeutical benefit or futility?Articles
M. Klimovič, M. Fedora, M. Šeda, R. Nekvasil, P. Dominik
Anest. intenziv. Med. 1999;10(4):180-182
Aim:To objectively assess if pulmonary artery catheterization is justified in defined paediatric critical care population subgroups.Design: Prospective observational study.Patients: Two subgroups of patients were enrolled in the study: 1) patients with severe refractory shock non-reactive to fluid resuscitation; 2) patientsmeeting criteria for ARDS.Method: We compared the results in time "0" and after 24 hours after pulmonary artery catheter insertion.Measurements and parameters followed: Thermodilution pulmonary artery catheters Arrow 4F or 7F were used. The data were collected usingDatex AS/3 monitor. In patients with severe refractory...