Anaesthesiology intensive therapy最新文献

{"title":"Utilisation and outcomes of a mobile (ambulance and air transport) venovenous extracorporeal membrane oxygenation (VV-ECMO) program in Poland during the COVID-19 pandemic - a retrospective, two-centres, case-series study.","authors":"Elżbieta Rypulak, Marta Szczukocka, Tomasz Czarnik","doi":"10.5114/ait.2024.139526","DOIUrl":"10.5114/ait.2024.139526","url":null,"abstract":"<p><strong>Introduction: </strong>Many patients required mechanical ventilation support due to severe COVID-19 pneumonia. A significant proportion of mechanically ventilated patients also required venovenous extracorporeal membrane oxygenation (VV-ECMO) due to refractory hypoxemia. A high demand for VV-ECMO support during the pandemic was challenging due to many factors, including limited resources and lack of established transfer protocols. This study aims to present the organisation and outcomes of a mobile VV-ECMO program in two high-volume centres in Poland during the COVID-19 pandemic.</p><p><strong>Material and methods: </strong>This retrospective, two-centre case series study, which lasted 36 months, was conducted between March 10, 2020, and January 31, 2023. The data of all patients transferred using venovenous extracorporeal membrane oxygenation (VV-ECMO) were analysed, including five women in the perinatal period with severe respiratory failure attri-buted to the COVID-19 virus. The analysis encompassed baseline patient demographics, Sequential Organ Failure Assessment (SOFA) scores, admission laboratory parameters, ECMO therapy, duration of mechanical ventilation, and patient survival to ICU discharge.</p><p><strong>Results: </strong>We assessed 86 patients who met the ELSO inclusion criteria and were transported during VV-ECMO support. Mortality in the analysed group was high (80.3%). Despite high mortality, VV-ECMO appeared to be a safe procedure in COVID-19 patients with severe ARDS. No complications were noted in more than half of the analysed procedures. Despite the above, many severe complications were observed, including stroke or cerebral haemorrhage (9.8%) and limb or gut ischemia (1.6%). The most common problems co-existing with VV-ECMO treatment were bleeding complications (34.4%).</p><p><strong>Conclusions: </strong>The ICU mortality rate among patients requiring VV-ECMO for COVID-19 in high-volume ECMO centres was high but not associated with the type of transportation.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"141-145"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endotracheal tube cuff pressure assessment: expectations versus reality.","authors":"Valentyn Sadovyi, Iurii Kuchyn, Kateryna Bielka, Vasyl Horoshko, Dmytro Sazhyn, Liubov Sokolova","doi":"10.5114/ait.2024.145411","DOIUrl":"10.5114/ait.2024.145411","url":null,"abstract":"<p><strong>Background: </strong>Damage to the trachea, although rare, is a serious complication in anesthesiology and intensive care. The main mechanism of such injury is a direct mechanical action associated with excessive pressure in the cuff of the endotracheal tube (ETT). The aim of the study was to evaluate the actual pressure in the cuffs during surgical interventions, correlate this measure with the subjective assessment of the anesthesiologist, and compare different methods of inflating the ETT cuff.</p><p><strong>Methods: </strong>Ninety patients were randomly divided into two equal groups. In the study group, the \"minimum leakage\" technique was used to inflate the cuff. In the control group, the adequacy of pressure was determined by palpation of the cuff balloon. In both groups, the actual pressure was then measured using a mechanical manometer connected to the cuff.</p><p><strong>Results: </strong>The average ETT cuff pressure was 30.4 ± 4.9 cmH 2 O (2.98 ± 0.48 kPa) in the study group and 68.9 ± 23.3 cmH 2 O (6.75 ± 2.28 kPa) in the control group. The pressure in the ETT cuffs was within the standard safe range (i.e. 20-30 cmH 2 O) in 2/45 (4.4%) and 23/45 (51.1%) patients in the control and the study group, respectively.</p><p><strong>Conclusions: </strong>In the majority of cases, the pressure achieved via evaluation by the me-thod of palpation of the control cuff was not adequate. Among various non-mechanical methods of measuring and controlling pressure in the cuff of the intubation tube, the minimum occlusion volume technique deserves attention.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"241-245"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected malignant hyperthermia reaction during renal transplantation: a case report.","authors":"Calim Neder Neto, Mariana F Lima, Laila A Viana, José M Pestana, Helga C A da Silva","doi":"10.5114/ait.2024.145234","DOIUrl":"10.5114/ait.2024.145234","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"256-260"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of multidrug-resistant organisms in intensive care unit patients and rate of subsequent bacteraemia: a 5-year study.","authors":"Moncompu Subramanian Ramachandran, Indunil Sandaradura, Vineet Nayyar","doi":"10.5114/ait.2024.146641","DOIUrl":"10.5114/ait.2024.146641","url":null,"abstract":"<p><strong>Introduction: </strong>Multidrug-resistant organism (MRO) bacteraemia is associated with significant mortality. A limited number of studies have examined the relationship between MRO colonisation and subsequent bacteraemia in critically ill patients.</p><p><strong>Material and methods: </strong>All patients with a positive surveillance swab result and a positive blood culture result for MROs admitted to the Westmead intensive care unit (ICU) between 1 January 2014 and 31 March 2019 had their results matched with ICU data extracted from the ICU database and analysed for the risk of bacteraemia among swab positive patients.</p><p><strong>Results: </strong>There were 3,878 (2,388 males, 1,490 females) assessable admissions during the period. The median APACHE II (Acute Physiology and Chronic Health Evaluation) score was 17. A total of 9,681 swab results were collected from 3,878 patients. Of the 3,878 patients, 818 were positive for MROs, and 3,060 were negative. Thirty-two swab positive patients (3.9%) tested positive for MROs in the blood culture, and 16 (0.52%) in the swab negative group had MROs in their blood cultures. This difference was statistically significant (adjusted [adj] OR 6.33; 95% CI: 3.40-11.76). The swab positive group was also associated with a significantly higher positive blood culture with orga-nisms other than MROs than the swab negatives (11.1% and 6.2%, respectively, adj OR 1.37; 95% CI: 1.04-1.82). The overall mortality was higher in swab positive compared to swab negative patients (20.7% vs. 13.1%, P < 0.001). The overall prevalence of MRO colonisation was 21% in our cohort.</p><p><strong>Conclusions: </strong>The risk of MRO bacteraemia was higher among patients with a positive surveillance swab result for the organism compared to those with a negative swab, but this was not associated with higher mortality in that group.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 5","pages":"277-284"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote, automatic, digital preanesthetic evaluation - are we there yet?","authors":"Michał Pasternak, Wojciech Szczeklik, Szymon Białka, Paweł Andruszkiewicz, Marta Szczukocka, Aleksandra Pawlak, Elżbieta Rypulak, Dawid Pytliński, Michał Borys, Mirosław Czuczwar","doi":"10.5114/ait.2024.138959","DOIUrl":"10.5114/ait.2024.138959","url":null,"abstract":"<p><p>Recent years have witnessed multiple advancements in the field of information technology in medicine. The need to ensure patient and doctor safety during COVID-19 resulted in improved telemedicine adaptation across various fields, including anaesthesiology. In this review, the authors examine the current state of the elements of preanesthetic evaluation and their remote execution using current and future telemedical facilities and technologies, as well as the potential of future advancements in this field.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 2","pages":"91-97"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11284583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior trunk versus interscalene brachial plexus block in humerus surgery: a randomised controlled trial.","authors":"Chandni Sinha, Poonam Kumari, Ajeet Kumar, Amarjeet Kumar, Abhyuday Kumar, Ditipriya Bhar, Arun S K, Chethan Vamshi","doi":"10.5114/ait.2024.142772","DOIUrl":"10.5114/ait.2024.142772","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound (US)-guided interscalene (IS) block is a commonly performed block for shoulder and humerus surgery. Though it provides excellent analgesia, it is associated with hemidiaphragmatic paralysis and dyspnoea. Superior trunk (ST) block has been described, wherein the local anaesthetic is deposited around the ST block (formed by fusion of C5 and C6 nerve roots). This study aimed to determine whether ST block provides similar analgesic efficacy with lower incidence of diaphragmatic paresis in patients undergoing proximal humerus surgery.</p><p><strong>Material and methods: </strong>A total of 62 patients scheduled to undergo unilateral internal fixation (plating) for proximal or mid shaft humerus fracture were randomised to 2 groups. Patients in group I received US-guided ST block while those in group II received US-guided IS block. Both groups received 15 mL of 0.5% bupivacaine. Diaphragmatic excursion was noted at baseline and after 30 minutes after the block. Postoperatively, the numerical rating scale score and requirement of opioids were documented.</p><p><strong>Results: </strong>The incidence of complete/incomplete paresis was statistically significantly lower in the ST group. Thirty eight percent of the patients (11) had complete paresis in the IS group, compared to none in the ST group. Partial paresis was observed in 62% of patients in the IS block group and 19% in the ST block group ( P < 0.001). The percentage reduction of movement was significantly higher in the IS group vs. the ST group ( P < 0.001). There was no difference in pain scores or the amount of opioid consumption between groups.</p><p><strong>Conclusions: </strong>ST block provides similar analgesia to IS block for proximal/mid humerus surgery with better preservation of diaphragmatic function. This could be a viable alternative in patients with compromised respiratory functions scheduled for such surgery.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 3","pages":"194-198"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11484482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: PECS II block versus serratus anterior plane block in modified radical mastectomies.","authors":"Raghuraman M Sethuraman, Shanmuga Priya Arulmozhi, Gayathri Ramesh, Rohan Magoon","doi":"10.5114/ait.2024.142758","DOIUrl":"https://doi.org/10.5114/ait.2024.142758","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 3","pages":"215-216"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative utilization of tranexamic acid in total knee and hip arthroplasty procedures in Poland - a survey-based study.","authors":"Dorota Studzińska, Izabela Pabjańczyk, Kamil Polok, Wojciech Szczeklik","doi":"10.5114/ait.2024.142670","DOIUrl":"https://doi.org/10.5114/ait.2024.142670","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 3","pages":"206-207"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142493067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal central airway obstruction: should preemptive extracorporeal membrane oxygenation be the standard of care?","authors":"Juan Camilo Segura-Salguero, Jonathan Yeung, Lorena Díaz-Bohada, Ludwik Fedorko, Marcin Wąsowicz","doi":"10.5114/ait.2024.145409","DOIUrl":"10.5114/ait.2024.145409","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"252-255"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary alveolar proteinosis flare in the setting of COVID pneumonia.","authors":"Kevin M Chen, Yuli Lim, Jamal Hasoon, Sandeep Markan, Anvinh Nguyen","doi":"10.5114/ait.2024.145184","DOIUrl":"10.5114/ait.2024.145184","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":"56 4","pages":"264-266"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}