Oxid dusný (N2O) - je jeho místo nevyhnutelně samozřejmé?Articles

J. Rupreht, M. Dzoljic

Anest. intenziv. Med. 2001;12(1):3-6

Hemodynamics during First Hours after Surgery Using Cardiopulmonary Bypass - Crystalloid versus Blood CardioplegiaArticles

R. Brát, J. Tošovský, L. Derych, S. Velkoborský, R. Zezula

Anest. intenziv. Med. 2001;12(1):7-9

We sought to determine if hemodynamic parameters after surgery using cardiopulmonary bypass are affected by the type of cardioplegic solutionused - crystalloid or blood. Sixty patients with left ventricle ejection fraction < 35 % scheduled for coronary artery bypass surgery were randomizedinto two groups. In the first group cold blood cardioplegia was used, in the other cold crystalloid cardioplegia was used. We collected hemodynamicdata before the procedure and at one, two, four and six hours after weaning from cardiopulmonary bypass, and on the first postoperative day. We alsocollected clinical data reflecting perioperative myocardial preservation.No...

Patient Positioning and Kinetic Therapy in the Critically Ill Patient:Pathophysiology, Methods and IndicationsArticles

S. Kleinschmidt

Anest. intenziv. Med. 2001;12(1):10-14

Acute respiratory failure is characterized by arterial hypoxaemia, requiring endotracheal intubation and respiratory therapy. Therapeutic strategiesinclude the therapy of the underlying disease (e.g. sepsis, trauma), various techniques of ventilation, fluid replacement and enteral or parenteralnutrition. In recent years, supplementary techniques of patient positioning such as intermittent prone position or continuous axial rotation therapyhave been successfully introduced into clinical practice in order to reduce ventilator-associated lung damage and to improve pulmonary gas exchange.For a rational and beneficial use of these techniques in the therapy...

Optimal Ventilation Mode of Total Liquid Ventilation on Animal ModelArticles

M. Šeda, M. Fedora, M. Klimovič, P. Dominik, R. Nekvasil

Anest. intenziv. Med. 2001;12(1):15-18

Objective:To find an optimal mode of total liquid ventilation (TLV) with respect to the blood gases exchange while minimizing adverse effects ofTLV upon circulation.Type of study: Laboratory experiment on animal model.Setting: The laboratory of experimental pathophysiology, Medical Faculty, Masaryk University, Brno.Subjects: 20 laboratory rabbits.Method: After premedication, tracheostomy was performed in all animals. EKG, central venous pressure and arterial pressure were monitored.After initial conventional mechanical ventilation, rabbits were randomly allocated into three groups and total liquid ventilation was started in differentmodes:...

Total Liquid Ventilation Improves Oxygenation in an Experimental Model of Acute Respiratory Distress SyndromeArticles

M. Klimovič, M. Fedora, M. Šeda, P. Dominik, R. Nekvasil

Anest. intenziv. Med. 2001;12(1):19-22

Objective:To assess gas exchange during total liquid ventilation (TLV) in an experimental model of acute respiratory distress syndrome (ARDS).Type of study: Laboratory experiment on animal model.Setting: The laboratory of experimental pathophysiology, Medical Faculty, Masaryk University, Brno.Subjects: 12 laboratory animals - rabbits.Method: After premedication, tracheostomy was performed in all animals. EKG, central venous pressure and arterial pressure were monitored.After conventional mechanical ventilation rabbits were randomly allocated into two groups: 1 st group with intact lungs and 2nd group with experimentalARDS. The animals in...

Combination of Partial Liquid Ventilation and High Frequency Oscillatory Ventilation in Acute Respiratory Distress Syndrome ModelArticles

M. Fedora, M. Šeda, M. Klimovič, P. Dominik, R. Nekvasil

Anest. intenziv. Med. 2001;12(1):23-27

Objective:To evaluate the effect of combination of partial liquid ventilation (PLV) and high frequency oscillatory ventilation (HFO) on blood gasesexchange in acute respiratory distress syndrome (ARDS) model.Type of study: Laboratory experiment on animal model.Setting: The laboratory of experimental pathophysiology, Medical Faculty, Masaryk University, Brno.Subjects: 18 laboratory animals - rabbits.Method: After premedication, tracheostomy was performed in all animals. ECG, central venous pressure and arterial pressure were monitored.After initial conventional mechanical ventilation, rabbits were randomly allocated into two groups: 1st group...

The History and Presence of Liquid VentilationArticles

M. Šeda, M. Fedora, M. Klimovič, P. Dominik, R. Nekvasil

Anest. intenziv. Med. 2001;12(1):28-36

The paper presents a review on history of liquid ventilation, physics and chemistry of perfluorocarbones, mechanisms of action and liquid ventilationtechniques in current state of art in both experimental and clinical studies.

The Role of Enteral Nutrition in the Treatment of Critically Ill PatientsArticles

E. Havel, L. Sobotka, J. Maňák, J. Cerman, V. Bláha, Z. Zadák

Anest. intenziv. Med. 2001;12(1):37-42

The positive role of enteral nutrition (EN) is widely accepted in the treatment of critically ill patients. Enteral nutrition support induces in a significantreduction of infectious complications and reduces the overall hospital stay. EN saves gut barrier function, enhances gut blood flow and IgA secretionon bronchial and mucosal surface in experimental animal studies. On the other hand, the application of EN may not safe for critical care patients. Themain danger of EN is development of malnutrition, regurgitation and aspiration of nutrients. The late diagnosis of gut dysfunction is characterised bygut distension, hemodynamic instability and ventilatory...

Audit of Care for Trauma Patients: One-year Service in the University Hospital SettingArticles

B. Bakalář, J. Pachl, J. Šturma, M. Šidák, K. Höschlová

Anest. intenziv. Med. 2001;12(1):43-46

One hundred and eighty patients were admitted for primary care to Department of Anaesthesia and Intensive Care, Charles University Hospital Královské Vinohrady, Prague 10, during the year 1999. Eighty-one patients (45%) were admitted with polytrauma, fifty-nine (33%) for head-braininjury, twenty-two (12%) for multiple injuries and eighteen (10%) for other injuries. One hundred and fifty-six patients (86.7%) were admitted withone or more vital functions failure. Forty patients died (22%). This result is 13% better compared to predictive model based on TRISS, P = 0.0018.This represent twenty-four saved lives.

Lethal Intoxication with AmphetaminesArticles

P. Nohel, R. Kraus

Anest. intenziv. Med. 2001;12(1):47-48

Drug abuse becomes more common than ever before. Pervitin (methamphetamine) and other stimulants belong to the most abused "hard" drugsin our country. Severe intoxication with amphetamine derivates may present as hyperpyrexia, rhabdomyolysis, acute renal insufficiency, coagulopathyand multiorgan failure. Dantrolene administration in those cases is discussed. Considering the pros and cons, early administration is probably advisableas a part of maximally intensive care for a young intoxicated patient. Early administration of antithrombin III should be a part of the DIC treatmentprotocol.

Emergency Department (A+E department) in Big Hospital - Medical and Educational DestinationArticles

J. Drábková

Anest. intenziv. Med. 2001;12(1):49-51

Emergency (A+E) departments have not yet been accepted as a regular element of Czech hospitals with the task to take care of emergency patientsreferred from the out-of-hospital areas and to teach theory and practice of emergency medicine. No sole model can be realized, the types of hospitalsare very different.Big hospitals in compact buildings are most convenient for both clinical and educational ta sks. Developing algorithms and standards have to bechecked in all hospitals. This feed-back can help to evaluate a final beneficial system for patients and to implement it into the contracts with healthinsurance companies.