Anestezjologia intensywna terapia最新文献

Balancing sedation and ICU delirium management for better patient outcomes 平衡镇静和ICU谵妄管理以获得更好的患者结果

Anestezjologia intensywna terapia Pub Date : 2019-03-31 DOI: 10.5603/AIT.A2019.0007

K. Kotfis

{"title":"Balancing sedation and ICU delirium management for better patient outcomes","authors":"K. Kotfis","doi":"10.5603/AIT.A2019.0007","DOIUrl":"https://doi.org/10.5603/AIT.A2019.0007","url":null,"abstract":"A growing body of evidence suggests that patients treated in intensive care units (ICUs) are not only at risk of suffering from the severity of their underlying condition, but also from harmful and potentially iatrogenic problems, namely intensive care delirium and weakness [1]. This may be associated with an unfavourable long-term prognosis leading to physical, functional, cognitive and emotional breakdown after discharge from the ICU, as well as increased mortality and morbidity [2, 3]. The majority of critically ill patients are at risk of leaving the ICU incapable of independ-ent living and become a burden to their families and society. Therefore, the aim for an intensivist should be to provide critically ill patients with the maximum level of humane care and the minimum number of necessary interventions [4, 5]. In practice, this means adequate pain control, goal-directed sedation, assessment and adequate treatment of delirium, early mobility and the proper amount of overnight sleep [6]. In this issue of AIT, the findings of an observational cohort study, an im-portant evidence regarding assessment-guided sedation practices. In study, performed a group of 714 ventilated ICU patients, the investigators compared the outcome of two patient populations from before patients) and after patients) a the","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45064872","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}

引用次数: 1

[Patient satisfaction with anaesthesia and pre-anaesthetic information]. [患者对麻醉和麻醉前信息的满意度]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Tomasz Gaszynski, Jakub Jakubiak, Katarzyna Woźniak, Tamara Trafidło, Paweł Ratajczyk, Wojciech Gaszyński

{"title":"[Patient satisfaction with anaesthesia and pre-anaesthetic information].","authors":"Tomasz Gaszynski, Jakub Jakubiak, Katarzyna Woźniak, Tamara Trafidło, Paweł Ratajczyk, Wojciech Gaszyński","doi":"","DOIUrl":"","url":null,"abstract":"Background: Patient satisfaction with perioperative care plays an important role in the assessment of quality of care. Written evaluation forms are commonly used all over the world for this purpose. The aim of this study was to assess the quality of perioperative care, with special attention being directed to anaesthesia-associated side effects.Methods: Forty-two adult patients, of both sexes, scheduled for abdominal surgery, were asked to complete a questionnaire consisting of 11 questions on anaesthesia, side effects and the general quality of perioperative care. The results were analysed using the X2 test, and p < 0.05 was considered significant. The Pearson correlation coefficient was used for comparison.Results: There was a strong correlation between the quality of the pre-anaesthesia visit, including the information obtained on possible complications and alternative methods of anaesthesia, and the assessment of quality of the anaesthesia service. Post-anaesthesia care facilities were also found to be of major importance for patients.Conclusions: Adequate, detailed and easily understandable information plays a crucial role in patients satisfaction with anaesthesia. Special attention should be paid to the most common side effects and complications. Residents should be trained in communication in the early stages of their training.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"214-9"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467370","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}

引用次数: 0

[The clinical spectrum of connective tissue diseases - a single intensive care experience]. [结缔组织疾病的临床谱-一次重症监护经验]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Danuta Gierek, Marcin Jezienicki, Tomasz Cyzowski, Henryka Chmurzewska, Eugeniusz Kucharz, Anna Kotulska, Józefa Dabek

{"title":"[The clinical spectrum of connective tissue diseases - a single intensive care experience].","authors":"Danuta Gierek, Marcin Jezienicki, Tomasz Cyzowski, Henryka Chmurzewska, Eugeniusz Kucharz, Anna Kotulska, Józefa Dabek","doi":"","DOIUrl":"","url":null,"abstract":"Background: Systemic connective tissue diseases are relatively rare disorders of unknown origin, possibly related to autoimmunity. In the retrospective study, we analysed the records of nine patients suffering from connective tissue disorders who were treated during a two-year period in an intensive therapy unit.Methods: Hospital medical records, observational charts and all other available medical documents were analysed.Results: The clinical courses of 9 patients were studied. They included 4 with scleroderma, 3 with systemic lupus erythematosus, and 2 with inflammatory myopathy. They were admitted to the ITU because of sepsis and/or pneumonia, pulmonary haemorrhage, or cardiovascular failure. Three patients (2 with systemic sclerosis, 1 with systemic lupus erythematosus) died.Conclusions: A multidisciplinary approach to treatment is a key factor in the successful management of patients with rare diseases, such as connective tissue pathologies. Frequent infections with respiratory and/or circulatory complications are the most common causes of severe morbidity in these patients.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"225-9"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467375","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}

引用次数: 0

[Suexametonium in paediatric anesthesia - an ambiguous issue]. [苏塞美溴铵在儿科麻醉中的应用——一个模棱两可的问题]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Marcin Rawicz

引用次数: 0

[Anaesthesiology in the Polish Armed Forces in the West during World War II]. [二战期间在西方的波兰武装部队的麻醉学]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Aleksander Rutkiewicz, Izabela Duda, Ewa Musioł

引用次数: 0

[Thromboelastography]. [Thromboelastography]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Dominika Woźniak, Barbara Adamik

引用次数: 0

Impact of the perioperative care model on mortality of patients treated in general surgery wards. 围手术期护理模式对普外科病房患者死亡率的影响。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Mariusz Piechota

{"title":"Impact of the perioperative care model on mortality of patients treated in general surgery wards.","authors":"Mariusz Piechota","doi":"","DOIUrl":"","url":null,"abstract":"Background: The risk of perioperative death in general surgery wards depends on many factors, including the underlying disease, type of surgical intervention and model of perioperative management. The aim of the study was to determine the reasons for major differences in mortality rates recorded in general surgery wards of the three university hospitals.Methods: The retrospective study was carried out and involved the data of 32 231 surgical patients. In one of the hospitals, postoperative patients were treated in the recovery room supervised by anaesthetists; in the remaining two, perioperative care was delivered by surgical ward staff. A multiple regression model with random effects was used to adjust for differences in three death risk groups of patients according to underlying diseases: low, moderate and high.Results: In the hospital with postoperative care administered by anaesthetic staff the mortality rate was 0.45 whereas in the two remaining ones with postoperative patients supervised by surgical staff - 1.86 and 2.52. In each group, increased mortality was observed among patients receiving therapy in general surgery wards after transfer from another hospital ward.Conclusion: The major factor determining the mortality rates in general surgery wards is the model of perioperative management.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"208-13"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467061","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}

引用次数: 0

[Tricuspidal valve rupture after blunt chest trauma]. [钝性胸外伤后三尖瓣破裂]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Wojciech Dąbrowski, Andrzej Nestorowicz, Jarosław Wośko, Przemysław Zadora, Adrzej Tomaszewski, Cezary Jurko

{"title":"[Tricuspidal valve rupture after blunt chest trauma].","authors":"Wojciech Dąbrowski, Andrzej Nestorowicz, Jarosław Wośko, Przemysław Zadora, Adrzej Tomaszewski, Cezary Jurko","doi":"","DOIUrl":"","url":null,"abstract":"Background: Blunt chest trauma is frequently associated with cardiac contusion and structural damage, most cases only being recognized after death. We report a case of multiple organ trauma, where cardiac failure, caused by tricuspid valve rupture, was markedly delayed.Case report: A 21 yr old man was admitted to hospital after a car accident. He was suffering from cerebral contusion and oedema, pulmonary contusion, and a left pneumothorax. He also had multiple fractures of the facial bones, orbit, L4 vertebra and left tibia. He was tracheotomised, and a subdural sensor was inserted for continuous monitoring of intracranial pressure. He was sedated and ventilated for two weeks. On the 12th day, his jaw was reconstructed, and immediately after surgery, mild signs of cardiac failure were observed, which were attributed to cardiac contusion. Two weeks after admission, the patient was weaned from the ventilator, and three days later, his facial bones were reconstructed. Four days later, the signs of cardiac failure reappeared. Transoesophageal echocardiography revealed rupture of a head of papillary muscle, with 4th degree tricuspid insufficiency and enlargement of the right ventricle. The ruptured muscle was reconstructed under extracorporeal circulation, and the patient made a satisfactory recovery.Discussion: Acute tricuspid valve insufficiency, albeit rare, may occur in patients with blunt chest trauma. Sedation and lack of physical activity may delay the definite diagnosis, especially when only transthoracic echocardiography is used. Cardiac arrhythmias, diastolic murmur, or signs of congestive cardiac failure in a chest trauma patient may all suggest some structural damage; therefore, transoesophageal echocardiography should be performed as early as possible in such situations.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"239-43"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467372","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}

引用次数: 0

[Effect of red blood cell transfusions on the frequency of infections in the ITU]. [红细胞输注对ITU感染频率的影响]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Jarosław Mamak, Lech Krawczyk

{"title":"[Effect of red blood cell transfusions on the frequency of infections in the ITU].","authors":"Jarosław Mamak, Lech Krawczyk","doi":"","DOIUrl":"","url":null,"abstract":"Background: It has been suggested that red blood cell transfusions may affect the outcome and frequency of infection in patients treated in ITU settings. We have therefore retrospectively analysed the records of one hundred and sixty-three patients treated in a large tertiary intensive care unit, in order to find any relationship between red blod cell transfusions and the frequency of nosocomial infections.Methods: The patients were allocated to two groups: T - those who were transfused and N - those who were not. Among the transfused patients, two further subgroups were selected: those who were transfused within 48 h before any signs of infection were observed (n), and those in whom the transfusion was more than 48 h before infection was noted (t).Results: There was a statistically significant difference between groups T and N (50.9% vs 38.1% infected patients), but not between subgroups t and n.Conclusions: Nosocomial infections were more frequently observed in patients who required red blood cell transfusion. Red blood cell transfusion cannot be regarded a sole factor affecting nosocomial infection rates.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"220-4"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467062","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}

引用次数: 0

[Pain treatment in the emergency department: what do patients think?]. 急诊科的疼痛治疗:患者怎么看?

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Sylweriusz Kosiński, Bogusława Siudut

{"title":"[Pain treatment in the emergency department: what do patients think?].","authors":"Sylweriusz Kosiński, Bogusława Siudut","doi":"","DOIUrl":"","url":null,"abstract":"Background: Pain on admission, especially after trauma, is the most common complaint (over 80%) of patients in the emergency department. During a four-week period, an anonymous, voluntary survey on the quality of pain management was conducted among adult patients reporting to the emergency department.Methods: Five hundred questionnaires were distributed during admission, and 260 were returned. Patients were asked about localisation and severity of pain (NRS - Numerical Rating Scale), the quality and speed of assistance in the emergency department, and the effectiveness of analgesia.Results: Ninety percent of patients reported pain of varying intensity. The median pain scores on admission were 5.2, 7.3 during management, and 3.8 on discharge. Over 90% of patients were questioned about pain, but only 20% received some medication. Nevertheless, 80% of those surveyed were satisfied, and there was no correlation between the severity of pain and administration of analgesics. Fifty percent of patients received analgesics for home use, and 66% were instructed about further treatment.Conclusions: Despite the frequency and intensity of pain, analgesics were rarely offered in the emergency department. A surprisingly high level of satisfaction was reported, despite suboptimal pain management. This indicates either that non-pharmacologic methods of pain treatment play an important role, or that the severity of pain is overestimated by patients.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"234-8"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467369","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}

引用次数: 0