Anesteziologie a intenzivní medicína, 2002 (vol. 13), issue 1
Deep Hypohermic Circulatory Arrest for the Ascending Aortic and Aortic Arch Surgery in Patients with Acute Type a Aortic DissectionArticles
T. Vaněk, P. Brůček, Z. Straka
Anest. intenziv. Med. 2002;13(1):4-6
The authors present their experiences with 11 patienxs with the aortic dissection, in whom urgent replacement of the ascending aorta and aortic arch was performed with deep hypohermic circulatory arrest. Early mortality was 36.4 % and 3 of 4 patients who died had low cardiac output syndrome before surgery. Severe reeurologic complication was observed in one patienx who was hemiparetic before surgery (9.1 %).
Hypocholesterolaemia in Critically Ill PatientsArticles
B. Bakalář, J. Pachl, Z. Zadák, R. Hyšpler, J. Crhová
Anest. intenziv. Med. 2002;13(1):7-9
The auchors presem review in which they deal with the physiological importance, the reasons for onset and the clinical impact of hypocholesterolaemia in critically ill patients. They ask the question abouc effects of the artificial nucritional solucions without cholesterol in the field of nutrition of critically ill patients.
Changes in Cholesterol Metabolism within a Few Days tlfter Severe TraumaArticles
B. Bakalář, Z. Zadák, J. Pachl, R. Hyšpler, J. Pažout
Anest. intenziv. Med. 2002;13(1):10-11
We evaluated cholesterol and its precursors metabolism in 70 patiems within a few days after polytrauma. We observed low serum cholesterol levels (< 3.5 mmoUl) in all the patients, but these low values were not observed in the patients from the comrol group (P > 0.001). The reasons for hypocholesterolaemia were haemodilution during the earliest 24 hours after trauma, low rafe of cholesterol and its precursors synthesis and the consumption of serum cholesterol in an unknown proces. Average time for which hypocholesterolaemia lasted was 9±3.2 days.
New Possibilities of Interpretation of ICP/CPP Ratio in Severe Head-brain InjuryArticles
J. Pokorný, T. Hyánek
Anest. intenziv. Med. 2002;13(1):12-15
The authors discuss the importance of relationship between ICP and CPP which is subsequenxly formulaxed as indu The relationship between those two criteria seems to provide better characteristics of the situation in the cranium during the head-brain injury. The index allows for evaluation of the severity of dysfunction and for optimalization of intracranial hypertension therapy, in accordance with the results obtaireed from simultaneous monitoring of cerebral haemodynamics and tissue oxygenation as well as selected biochemical parameters.
New Evaluation Criteria in the Concept of Intracranial Hypertension TherapyArticles
J. Pokorný, T. Hyánek
Anest. intenziv. Med. 2002;13(1):16-20
The authors discuss balic diagnostic and therapeutic procedures in head-brain injury treatment procedures. Those are divided finto two phases: before and after CT scan and implemenxation of ICP monitoring. During the hrst phase, diagnostic and therapeutic procedures are based on clinical assessmenx; during the latter phase, procedures are based on ICP and CPP monitoring. Based on regression analysis of both parameers, the authors postulaxe a conclusion Chat stresses the importance of ICP/CPP index which is supposed to be not ohly a criterion of inxracranial dysfunction but also a parametrr upon which a rational therapeutic approach can be defireed....
Inhaled Nitric Oxide and Intracranial Pressure in Brain Injured PatientsArticles
J. Pokorný, T. Hyánek, M. Mayer
Anest. intenziv. Med. 2002;13(1):21-27
The authors discuss the possibility to affect inxracranial milieu by nitric oxide (NO) inhalation in brain injury complicated by ARDS. Following parameters esere evaluated: ICP, CPP, ICP/CPP index at stable conditions (MAP, PaOz, PaCOz, body temperature) according to the concenxration and duration of inhalaxion of NO. Based opon the stability of the parameters, we can conclude Chat NO inhalation in the aforementioned setting does not reegatively affect intracranial milieu.
Head-brain Injury as a Part of PolytraumaArticles
P. Hude, R. Hájek, H. Bosáková, D. Řehořková
Anest. intenziv. Med. 2002;13(1):28-31
Since November 1998, all patients with head-brain injury admitted to the Department of Anaesthesia and Imensive Care, Trauma Hospital Brno are enrolled to prospective study and treated according to the protocol issued by i1S-Aitken Brain Trauma Foundaxion. Ourpaper presems the clinical situation of severe head-brain injury combined with polytrauma. Pitfalls of the treatmem, monitoring and hnal outcome are presented in the paper.
Spinal Trauma in Critical CareArticles
R. Hájek, P. Hude, H. Bosáková, D. Řehořková, P. Horký, P. Wendsche, J. Kočiš
Anest. intenziv. Med. 2002;13(1):32-37
The review of pathophysiology, diagnostic procedures and princppecs of care for spinal trauma in critical setting is outlireed, based on the authors' long-term experience with treatment of spinal trauma patients. There is described the association between spinal trauma and other organ dysfunction, especially ventilaxion. There are stressed preventive measures focused on attenuaxion of secondary spinal cord injury.
The Continual Renal Replacement Therapies on Intensive Care Unit in RakovníkArticles
L. Klik
Anest. intenziv. Med. 2002;13(1):38-43
The paper shortly summarizes the cominual renal replacemem therapies, including the indications for starting, showing the pluses and minuses of their use in the comparison with imermitent techniques. Auchor shows his own empirience with cominual technigues. In the end describes a sport casuistry of the pacient treaced for acuce renal failure after the long-term cardiac arrest.
The Importance of Correct Primary Expert Care in Craniotrauma in the Prehospital CareArticles
J. Knor
Anest. intenziv. Med. 2002;13(1):44-47
This article discusses in connection with a prehospital care-common case the importance of correct primary expert care in craniotrauma and its importance in the chain of survival. It summarizes the diagnostic possibilities and usual therapeutic management in this type of injury and says Chat emergency medicine physician has to make quick decisions and life-saving procedures under time pressure. The error or delay in this phase of health care managemem are fatal and irreversible.