Anesteziologie a intenzivní medicína, 2003 (vol. 14), issue 5
Cricothyroidotomy Training on Cadavers: a Prospective StudyArticles
V. Černý, J. Schreiberová, O. Pavlínek
Anest. intenziv. Med. 2003;14(5):214-217
Objective:Cricothyroidotomy plays on important role in emergency pathway of the difficult airway algorithm, howeveremergent cricothyroidotomy is performed infrequently and can be difficult because of the lack of training and skill retention.The aim of the study was to assess cricothyroidotomy training on cadavers in anaesthesiologists.Design: prospective observational questionnaire based study.Settings: Tertiary Care Hospital, Hradec Králové.Material and methods: All participants performed cricothyroidotomy training procedure on cadavers under the guidance ofthe physician skilled in cricothyroidotomy. Each participant had to perform one...
Prevalence of Severe Sepsis in the Czech Republic: Prospective Multicentre One-day StudyArticles
V. Černý, I. Novák, V. ©rámek
Anest. intenziv. Med. 2003;14(5):218-222
Objective:Sepsis represents a substantial health care and economical problem and there is no epidemiological data aboutthe prevalence of sepsis and severe sepsis in intensive care units (ICU) in the Czech Republic. The aim of the study was todetermine the prevalence of severe sepsis in ICU patients and to create nationwide network for future research projects.Design: A nationwide questionnaire-based one-day point prevalence study.Setting: Charles University, Medical Faculty and Faculty Hospital Hradec Králové and Faculty Hospital in Plzeň, Masaryk'sUniversity and Faculty Hospital in Brno.Material and methods: The study was conducted on April...
Monocytic Deactivation and Production of Tumour Necrosis Factor-α ex vivo: Prognostic Parametersin Patients of ICUArticles
M. Průcha, I. Herold, R. Zazula, L. Dubská, B. Kavka
Anest. intenziv. Med. 2003;14(5):223-227
Objective:Dysbalance in immune system play an important role in pathogenesis of sepsis and systemic inflammatoryresponse syndrome (SIRS). Lowered expression of HLA-DR on monocytes coupled with decreased production of tumornecrosis factor-α ex vivo after stimulation with lipopolysaccharide are characteristic features of immunoparalysis.Thestudyaimed to determine importance and feasibility of their evaluation in patients with SIRS, sepsis and septic shock.Design: Retrospective, cohort study.Setting: Multidisciplinary intensive care unit.Material and methods: 67 patients meeting the criteria for diagnosis of systemic inflammatory response...
Evaluation of Therapeutic Protocol Aimed at Effectinevess of Close Blood Glucose Control inthe Critically IllArticles
V. ©rámek, L. Dadák, K. Mičkalová, J. ©neidr, I. Babáková
Anest. intenziv. Med. 2003;14(5):228-232
Objective:To evaluate the impact of therapeutic protocol for glycaemia correction in the critically ill.Design: Prospective, intervention study in one centre.Setting: Department of Anaesthesia and Intensive Care, St. Anna's University Hospital, Brno, Czech Republic.Material and method: Evaluation of glycaemia and insulin therapy during five day test in 8-bed general ICU. Evaluation ofcompliance with the therapeutic protocol and glycaemic values obtained by two methods (biochemical analyser andglucometer).Results: Nurses followed the protocol in 71 out of 106 relevant cases (compliance 67 %). In case the hyperglycaemia wasmeasured, a significant...
CRRT and Citrate Anticoagulation in Critically IllArticles
I. Novák, A. Krouľecký, M. Matějovič, J. Raděj, R. Rokyta, jun.
Anest. intenziv. Med. 2003;14(5):233-236
Systemic heparinization is associated with a higher risk of bleeding when used to maintain patency of the extracorporealcircuit during continuous renal replacement therapy (CRRT) in critically ill patients. Regional anticoagulation can beachieved with citrate. Citrate is more frequently used in CRRT to provide regional anticoagulation of the in patients with thehigh risk of bleeding. The citrate is infused into the extracorporeal circuit before the hemofilter where chelates ionisedcalcium, thus inhibiting coagulation. The majority of the citrate and chelated calcium is filtrated and/or enters the dialysateand is removed from the circuit. Therefore,...
Controversy in Choice of Haemodynamic Monitoring: Invasiveness or Accuracy(Possibilities of Haemodynamic Monitoring during Anaesthesia and Postoperative Care)Articles
M. Ročeň, P. Vychodil, O. Machalová, K. Cvachovec
Anest. intenziv. Med. 2003;14(5):237-241
Monitoring of haemodynamics and oxygen transport in anaesthesia, postoperative care and intensive medicine may revealdisturbances of circulation and tissue oxygenation. It should enable fast, effective and rational therapy of monitoreddisorders.Since the 1970s, physicians can monitor and evaluate haemodynamics and oxygen transport in different critical situationsusing pulmonary artery catheter. In the last three decades, the development of innovative medical technologies permittedtransition from more invasive to less invasive methods and from a static to a dynamic assessment of clinical status in realtime.In a review article, authors comment on the...
System PiCCO: Pulse Contour Cardiac OutputArticles
V. ©rámek
Anest. intenziv. Med. 2003;14(5):242-246
System PiCCO the enables haemodynamic measurement by means of a normal central line and special thermodilutionartery catheter introduced into the large systemic artery - i.e. it avoids pulmonary artery cannulation (PAC). Cardiac output(CO) measured with intermittent transpulmonary thermodilution and continuous pulse curve analysis correlates closelywith thePACthermodilution.Volumometric parameters of cardiac preloadmeasured withPiCCOare more accurate in cardiacpreload assessment than cardiac filling pressures (central venous pressure,CVP and pulmonary artery occlusion pressure,PAOP). In patients on controlled ventilation,dynamic preload parameters...