Anaesthesiology intensive therapy最新文献

{"title":"Identification of risk factors for post-intensive care syndrome in family members (PICS-F) among adult patients: a systematic review.","authors":"Zbigniew Putowski,&nbsp;Natalia Rachfalska,&nbsp;Karolina Majewska,&nbsp;Katarzyna Megger,&nbsp;Łukasz Krzych","doi":"10.5114/ait.2023.130831","DOIUrl":"https://doi.org/10.5114/ait.2023.130831","url":null,"abstract":"<p><strong>Introduction: </strong>Relatives of critically ill patients who either die or survive the intensive care unit (ICU) may develop substantial mental health problems that are collectively defined as post-intensive care syndrome in family (PICS-F).</p><p><strong>Material and methods: </strong>By using a systematised search strategy we included studies that focused on PICS-F in relatives of adult ICU patients and reported the risk factors associated with its development. The search was conducted within PubMed, Embase, SCOPUS, clinicaltrials.gov, and Cochrane Library on the 23 August 2022. PRISMA 2020 guidelines were implemented for appropriate reporting. The objective was to document all possible risk factors associated with the development of PICS-F.</p><p><strong>Results: </strong>We included 51 papers covering 9302 relatives. The frequency of PICS-F varied between 2.5 and 69%. We identified 51 different risk factors of PICS-F, among which we distinguished patient-related ( n = 16), relative-related ( n = 27), and medical staff-related ( n = 8) risk factors. Among 21 studies of the highest quality, we identified the 33 variables associated with the development of PICS-F, of which younger age of a patient, death of a patient, depression in relatives during the ICU stay, history of mental disorders in relatives, being a female relative, being a spouse, and having low satisfaction with communication and care in the ICU were the most commonly reported risk factors.</p><p><strong>Conclusions: </strong>PICS-F is a highly frequent phenomenon that can be exacerbated by several risk factors. Special attention should be paid to relatives of younger patients with worse prognosis and with the following relative-related risk factors: female sex, being a spouse, and history of mental health disorders. Finally, the medical staff play a role in preventing the PICS-F development, not only by maintenance of proper communication, but also by early identification of relatives prone to PICS-F.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/d4/AIT-55-51319.PMC10496103.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111959","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":"Management of chronic low back pain: news on the lumbar medial branch block and the importance of the biopsychosocial model.","authors":"Marie-Laure Nisolle, Arnaud Bourguignon","doi":"10.5114/ait.2023.134272","DOIUrl":"10.5114/ait.2023.134272","url":null,"abstract":"","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569653","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":"Continuous lumbar erector spinae plane block as an alternative to epidural analgesia in pain treatment in patients undergoing hip replacement surgery – a prospective pilot study","authors":"Agata Hanych, Paweł Kutnik, Przemysław Pasiak, Aleksandra Zakrzewska-Szalak, Oksana Wichowska, Mariusz Jednakiewicz, Adam Nogalski, Paweł Piwowarczyk, Michał Borys","doi":"10.5114/ait.2023.132517","DOIUrl":"https://doi.org/10.5114/ait.2023.132517","url":null,"abstract":"Background Postoperative pain associated with hip replacement surgery can be severe, decreasing the patient’s mobility and satisfaction with perioperative treatment. Regional techniques are commonly used as postoperative analgesia in hip surgery patients. Methods We performed a prospective pilot study on patients undergoing hip replacement surgery. We anesthetized each participant with spinal technique and allocated patients according to postoperative analgesia to the continuous epidural group and the continuous lumbar erector spinae plane block (ESPB) group. We measured postope-rative oxycodone consumption with patient-controlled analgesia (PCA) demands. At several points, we evaluated the patients’ pain at rest and during activity on the visual analog scale (VAS, 0–10), their quadriceps femoris’ muscle strength on the Lovett scale (0–5), and their ability to sit, stand upright, and walk on the Timed Up and Go test. Moreover, we assessed the patients’ recovery through the Quality of Recovery 40 (QoR-40) questionnaire on the first postoperative day. Results We found lower oxycodone consumption via PCA in the epidural than in the ESPB group (9.1 (mean) mg (5.2–13.0) (confidence interval) vs. 15.5 mg (9.8–21.3), P = 0.049). Patients in the ESPB group had more demands with PCA than participants in the epidural group (10.5 (median) (6–16) (interquartile range) vs. 25 (16–51), P = 0.016). We did not find differences between the groups in the other outcomes or in terms of postoperative complications. Conclusions The results suggest that the continuous lumbar ESPB group is equivalent to epidural analgesia as a pain treatment technique in patients undergoing hip replacement surgery.","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135706375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose caudal versus dorsal penile nerve block for postoperative analgesia after circumcision: a randomized comparative study.","authors":"Mayar Hassan El Sersi, Mohamed Sidky Mahmoud Zaki, Samar Sobhi Elnaggar, Ramy Mahrose","doi":"10.5114/ait.2023.132869","DOIUrl":"https://doi.org/10.5114/ait.2023.132869","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric male circumcision is a painful surgical procedure, which is usually carried out under general anaesthesia. Regional analgesic techniques, including dorsal penile nerve block (DPNB) and caudal nerve block (CNB), are superior to opioid and non-opioid systemic analgesia for postoperative pain control after circumcision.</p><p><strong>Material and methods: </strong>The purpose of our study was to compare the efficacy, duration of postoperative analgesia, and complications of DPNB, CNB, and the combination of 2 blocks. Eighty-one male patients aged from 3 to 12 years scheduled for circumcision were distributed into 3 groups, each consisting of 27 patients; group 1 (DPNB group), group 2 (CNB group), and group 3 for combined blockade. This study compared the 3 groups in terms of intraoperative vital signs: heart rate and blood pressure, postoperative Wong-Baker score, and complications (nausea, vomiting, pruritus, urinary retention, and constipation).</p><p><strong>Results: </strong>The intraoperative haemodynamics did not differ between the 3 groups of the study. There is significant difference in the Wong-Baker scale postoperatively at 1, 3, and 24 hours, being significantly less in the CNB group and combined blockade group than in the DPNB group, but there was no significant difference between the CNB group and the combined blockade group. The incidence of complications showed no significant intergroup difference, except for urinary retention being lower with DPNB.</p><p><strong>Conclusions: </strong>Both caudal and combined blockade were superior to DPNB for intraoperative and postoperative analgesia after circumcision. CNB and combined blockade was associated with significantly higher incidence of urinary retention compared to DPNB. Also, there was no additional benefit to the analgesic efficacy from combining both blocks.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138797779","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":"Reporting SOFA in research: we should always present each of the SOFA subscores.","authors":"Zbigniew Putowski, Marcelina Czok, Kamil Polok, Bertrand Guidet, Christian Jung, Raphael Romano Bruno, Dylan de Lange, Susannah Leaver, Rui Moreno, Bernhard Wernly, Hans Flaatten, Wojciech Szczeklik","doi":"10.5114/ait.2023.134188","DOIUrl":"10.5114/ait.2023.134188","url":null,"abstract":"<p><strong>Introduction: </strong>The Sequential Organ Failure Assessment (SOFA) score is the sum of 6 components, each representing one organ system with dysfunction classified on a 4-point scale. In research, usually by default, the total SOFA score is taken into account, but it may not reflect the severity of the condition of the individual organs. Often, these values are expected to predict mortality.</p><p><strong>Material and methods: </strong>In this study, we reanalysed 2 cohorts of critically ill elderly patients to explore the distribution of SOFA subscores and to assess the between-group differences. Both cohorts were adjusted to maintain similarity in terms of age and the primary cause of admission (respiratory cause).</p><p><strong>Results: </strong>In total, 910 (non-COVID-19 cohort) and 551 patients (COVID-19 cohort) were included in the analysis. Both cohorts were similar in terms of the total SOFA score (median 5 vs. 5 points); however, the groups differed significantly in 4/6 SOFA subscores (respiratory, neurological, cardiovascular, and coagulation subscores). Moreover, the cohorts had different fractions of organ failures (defined as a SOFA subscore ≥ 3).</p><p><strong>Conclusions: </strong>This analysis revealed significant differences in SOFA subscores between the COVID-19 and non-COVID-19 respiratory cohorts, highlighting the importance of considering individual organ dysfunction rather than relying solely on the total SOFA score when reporting organ dysfunction in clinical research.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10801450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569664","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":"Echocardiography and Ultrasound Committee statement for the accreditation programme in point-of-care ultrasonography in Poland.","authors":"Mateusz Zawadka,&nbsp;Paweł Andruszkiewicz,&nbsp;Wojciech Gola,&nbsp;Adrian Wong,&nbsp;Mirosław Czuczwar","doi":"10.5114/ait.2023.128704","DOIUrl":"https://doi.org/10.5114/ait.2023.128704","url":null,"abstract":"<p><p>Ultrasonography is becoming an essential part of the management of critically ill patients. There has been a sufficient body of evidence to support the incorporation of point-of-care ultrasound (POCUS) in anaesthesia and intensive care medicine training programme. Recently the European Society of Intensive Care Medicine reco-gnized POCUS as an essential skill for European Intensive Care Medicine specialists and updated Competency Based Training in Intensive Care (CoBaTrICe). Following European training standards, the Ultrasound and Echocardiography Committee of the Polish Society of Anaesthesiology and Intensive Therapy issued this Position Statement for recommendations for the accreditation process in POCUS in Poland.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/e7/AIT-55-50859.PMC10415610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10446661","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 on \"Awake craniotomy with dexmedetomidine during resection of brain tumours located in eloquent regions\".","authors":"Lukasz Surowka,&nbsp;Jolanta Piwowarska,&nbsp;Tomasz Dziedzic,&nbsp;Paweł Andruszkiewicz","doi":"10.5114/ait.2023.129310","DOIUrl":"https://doi.org/10.5114/ait.2023.129310","url":null,"abstract":"with","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/df/AIT-55-51048.PMC10415597.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10447178","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":"Reply to the Commentary on \"Integrated ultrasound protocol in predicting weaning success and extubation failure: a prospective observational study\".","authors":"Riddhi Kundu,&nbsp;Rajeshwari Subramaniam,&nbsp;Dalim Baidya","doi":"10.5114/ait.2023.129317","DOIUrl":"https://doi.org/10.5114/ait.2023.129317","url":null,"abstract":"Dear Editor, We would like to thank Blanco et al. [1] for their comments on our study. In our study protocol, we measured the lung ultrasound score (LUS) before and after the performance of spontaneous breathing test (SBT). However, we measured the diaphragmatic thickness fraction (DTF) and velocity time integral (VTI) change to passive leg raising (PLR) after SBT only. We are unsure whether measuring them twice at the beginning and end of an SBT would help us to predict weaning failure more reliably. It has been considered that diaphragmatic dysfunction is unlikely to manifest in the short duration of SBT due to accessory muscles compensating for diaphragmatic weakness in the initial period [2]. However, it would be interesting to see how VTI changes to a PLR manoeuvre would change after an SBT. We chose to study the VTI response to PLR given its ease of bedside measurement and its ability to predict preload responsiveness, which has been found to mimic the workload imposed by increased venous return during spontaneous breathing. During a passive leg raise, an increase in venous return is caused by the translocation of blood from the legs and splanchnic circulation towards the heart. This leads to a sequential increase in preload of the right followed by the left ventricle. A normally functioning RV would respond to this increase in preload with an increase in stroke volume, which would lead to an increased preload of the left DOI: https://doi.org/10.5114/ait.2023.129317","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/cc/AIT-55-51051.PMC10415603.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10046803","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":"Erector spinae plane block, neuropathic pain and quality of life after video-assisted thoracoscopy surgery. Pilot, observational study.","authors":"Lorena Díaz-Bohada,&nbsp;Juan C Segura-Salguero,&nbsp;Juan D Aristizabal-Mayor,&nbsp;Nelcy Miranda-Pineda,&nbsp;Ana H Perea-Bello,&nbsp;Marcin Wąsowicz","doi":"10.5114/ait.2023.128643","DOIUrl":"https://doi.org/10.5114/ait.2023.128643","url":null,"abstract":"<p><strong>Background: </strong>The erector spinae plane block (ESPB) is a valuable alternative for pain management after video-assisted thoracoscopy surgery (VATS). The incidence of postoperative chronic neuropathic pain (CNP) is high while the quality of life (QoL) after VATS remains unknown. We hypothesised that patients with ESPB would have a low incidence of acute and CNP and would report a good QoL up to three months after VATS.</p><p><strong>Methods: </strong>We conducted a single-centre prospective pilot cohort study from January to April 2020. ESPB after VATS was the standard practice. The primary outcome was the incidence of CNP three months postoperatively. Secondary outcomes included QoL assessed by the EuroQoL questionnaire three months after surgery and pain control at the Post-Anaesthesia Care Unit (PACU), 12 and 24 hours postoperatively.</p><p><strong>Results: </strong>We conducted a single-centre prospective pilot cohort study from January to April 2020. ESPB after VATS was the standard practice. The primary outcome was the incidence of CNP three months postoperatively. Secondary outcomes included QoL assessed by the EuroQoL questionnaire three months after surgery and pain control at the Post-Anaesthesia Care Unit (PACU), 12 and 24 hours postoperatively.</p><p><strong>Conclusions: </strong>We conducted a single-centre prospective pilot cohort study from January to April 2020. ESPB after VATS was the standard practice. The primary outcome was the incidence of CNP three months postoperatively. Secondary outcomes included QoL assessed by the EuroQoL questionnaire three months after surgery and pain control at the Post-Anaesthesia Care Unit (PACU), 12 and 24 hours postoperatively.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c2/6e/AIT-55-50844.PMC10415606.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071065","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":"The impact of bacterial superinfections on the outcome of critically ill patients with COVID-19 associated acute respiratory distress syndrome (ARDS) - a single-centre, observational cohort study.","authors":"Justyna Sysiak-Sławecka,&nbsp;Oksana Wichowska,&nbsp;Paweł Piwowarczyk,&nbsp;Michał Borys","doi":"10.5114/ait.2023.130833","DOIUrl":"https://doi.org/10.5114/ait.2023.130833","url":null,"abstract":"<p><strong>Introduction: </strong>Bacterial superinfections are common in severely ill COVID-19 patients and could be associated with a significant increase in morbidity and mortality.</p><p><strong>Material and methods: </strong>We assessed 29 critically ill patients treated in a university hospital's intensive care unit (ICU). Each patient required mechanical ventilation due to COVID-19-induced acute respiratory distress syndrome (ARDS). Fifteen patients who required venovenous extracorporeal membrane oxygenation (VV-ECMO) support (ECMO group) were compared to a control group (CON group) of 14 individuals without ECMO. This study aimed to assess the prevalence of superinfection in both studied groups. Moreover, we evaluated mortality, length of stay in the ICU, positive culture results, antibiotics used during treatment, and the impact of immunomodulatory drugs on secondary infections.</p><p><strong>Results: </strong>We did not find a difference in the number of superinfections between the ECMO and CON groups (11 vs. 10, P = 1.0). The mortality rate was 67% in the ECMO group and 64% in the CON group ( P = 1.0). The patients in both groups had similar numbers of positive culture results and days in the ICU prior to the detection of a positive culture. Antibiotics were administered to ten patients in the ECMO and eight patients in the CON group. The mortality rate was 81% in patients with superinfection versus 25% in those without co-infection ( P = 0.009). We found a negative impact of urea concentration on mortality in our cohort, with an odds ratio of 0.942 (0.891-0.996, P = 0.034).</p><p><strong>Conclusions: </strong>Our results suggest that bacterial superinfection in COVID-19 patients negatively impacted survival in the ICU. VV-ECMO support in COVID-19 patients does not seem to improve the outcomes of patients with severe ARDS.</p>","PeriodicalId":7750,"journal":{"name":"Anaesthesiology intensive therapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f6/b6/AIT-55-51320.PMC10496093.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101642","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}