Anestezjologia intensywna terapia最新文献_第2页

[Effects of parenteral lipid emulsions on immune system response]. 肠外脂质乳对免疫系统反应的影响。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Monika Jędrzejczak-Czechowicz, Marek L Kowalski

引用次数: 0

[Does the time of admission to ITU affect mortality?]. [加入国际电联的时间是否影响死亡率?]。

Anestezjologia intensywna terapia Pub Date : 2011-10-01

Magdalena A Wujtewicz, Aleksandra Suszyńska-Mosiewicz, Wioletta Sawicka, Arkadiusz Piankowski, Anna Dylczyk-Sommer, Radosław Owczukl, Maria Wujtewicz

{"title":"[Does the time of admission to ITU affect mortality?].","authors":"Magdalena A Wujtewicz, Aleksandra Suszyńska-Mosiewicz, Wioletta Sawicka, Arkadiusz Piankowski, Anna Dylczyk-Sommer, Radosław Owczukl, Maria Wujtewicz","doi":"","DOIUrl":"","url":null,"abstract":"Background: Among many factors that may affect mortality among ITU patients, the time of admission has been reported to play some, but ill-defined role. In the retrospective study, we analysed the time of admission, severity of the underlying disease, clinical status on admission and mortality among adult patients treated in a single ITU over a six-year period.Methods: We compared the mortality of patients who were admitted during daytime (7 a.m. to 6:59 p.m.) and at night (7 p.m. to 6:59 a.m.). We also compared those admitted on weekdays (Monday 7 p.m. to Friday 6:59 a.m.) to those admitted during weekends (Friday 7 p.m. to Monday 7 a.m.). The patients condition was assessed using the APACHE II scale. Brain dead organ donors and readmissions were excluded from the analysis.Results: The retrospective study involved the data of 1789 patients. Mortality was higher in patients who were admitted during the night and during weekends, when compared to daytime and weekdays, respectively. Mortality was also higher in patients admitted directly from the operating theatre after emergency surgery, but only during nights and weekends. The following independent factors in ITU mortality have been identified: length of ITU stay (OR 1.015; % CI 1.005-1.024), admission from a hospital ward (OR 1.39; 95% CI 1.04-1.86) and APACHE II score (OR 1.177; 95% CI 1.156-1.198).Conclusion: Time of admission has not been identified as a single independent factor of ITU mortality, but admissions at night and during weekends were associated with higher mortality, probably because of emergency conditions.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 4","pages":"230-3"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30467367","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 role of sex steroids in prevention of post-ischaemic brain injury]. [性类固醇在预防缺血性脑损伤中的作用]。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Cezary Pakulski

引用次数: 0

[Effects of choice of anaesthesia on the patients image of the anaesthesiologist]. 【麻醉方式的选择对麻醉医师对患者形象的影响】。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Magdalena Kwiatosz-Muc, Witold Lesiuk

{"title":"[Effects of choice of anaesthesia on the patients image of the anaesthesiologist].","authors":"Magdalena Kwiatosz-Muc, Witold Lesiuk","doi":"","DOIUrl":"","url":null,"abstract":"Background: The social status of physicians has been traditionally high in Poland, over recent years, we have noticed increased patient expectations in relation to the newest technology and the highest possible competence. The patient s image of medical personnel may influence his or her opinion about the quality of the service and of the medical centre. At the same time, we have noticed signs of decreasing trust, and an increased number of legal claims against doctors. The purpose of this study was to compare the image of anaesthesiologists, as perceived by patients who underwent Caesarean section either with general or spinal anaesthesia.Methods: Five hundred and thirteen parturients were asked to complete a questionnaire about their view of the attending anaesthesiologist, assessing the doctors attitude with 7-degree visual-analogue scale.Results: Four hundred and twelve valid forms were returned. Women who received spinal anaesthesia rated their anaesthesiologist higher than those who had general anaesthesia. Among the most important factors that influenced their opinion were: competence, calmness, trustfulness, accurate and detailed information, patience and kindness. Feelings of intimacy and privacy were less important, but the length of the preoperative visit was found to be a relevant factor. Anaesthesiologists providing spinal anaesthesia were rated higher, probably because they were spending more time with awake patients than those who had chosen general anaesthesia. The latter may also have been in a hurry, because of co-existing emergencies.Conclusion: We conclude that patients satisfaction depends mainly on the time spent with their doctors before anaesthesia and during the procedure. Regional anaesthesia may increase the patients trust and satisfaction, when compared with general anaesthesia.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 3","pages":"144-7"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30220275","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

[Cost of anaesthesia at the university hospital]. [大学医院麻醉费用]。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Mirosław Gibek, Piotr Danielewicz, Andrzej Kłbler

{"title":"[Cost of anaesthesia at the university hospital].","authors":"Mirosław Gibek, Piotr Danielewicz, Andrzej Kłbler","doi":"","DOIUrl":"","url":null,"abstract":"Background: The costs of anaesthesia in Polish hospitals are usually calculated as a percentage of the cost of the surgical procedure, or as a percentage of the total cost of the operating theatre. These methods cannot be accurate, since they do not take into consideration, the specifics of anaesthesia. Therefore, a new method of calculation, based of the actual use of materials and manpower, has been introduced in our institution.Methods: Anaesthesia procedures were divided into nine categories, according to risk of anaesthesia, type of surgery, type of anaesthesia, and working hours of the anaesthetic personnel. Each category was priced in points which expressed the actual value of the service provided, and the resulting totals were allocated to surgical specialties.Results: The costs of anaesthesia calculated by the new method differed markedly from previous calculations. The number of anaesthetics between 2008 and 2010 increased by 20%, while the cumulative costs of anaesthesia rose by only 13%, when compared to the previous method of calculation. Changes in anaesthesia costs, in various surgical specialties, varied from -49% to +65%, and were not related to the number of procedures.Conclusion: The new scoring system made it possible to calculate actual anaesthesia costs in various surgical specialties. It is logical and practical and merits recommendation.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 3","pages":"153-6"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30217616","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

[Cardiac arrest during serve Pneumocystis jiroveci infection in an immune-compromised patient after splenectomy]. [脾切除术后免疫功能低下患者急性肺囊虫感染期间心脏骤停]。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Krzsztof Tracz, Anna Kuczewska, Jacek Kulesza

引用次数: 0

No differences in job perceptions amongst Dutch nurse anaesthetists with and without nursing background. 有和没有护理背景的荷兰麻醉师护士的工作认知没有差异。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Vera Meeusen, Karen Van Dam, Chris Brown-Mahoney, Andre Van Zundert, Hans Knape

{"title":"No differences in job perceptions amongst Dutch nurse anaesthetists with and without nursing background.","authors":"Vera Meeusen, Karen Van Dam, Chris Brown-Mahoney, Andre Van Zundert, Hans Knape","doi":"","DOIUrl":"","url":null,"abstract":"Background: In the Netherlands, the employment as a \"nurse anaesthetist\" is comparable to that of a registered nurse anaesthetist in the Scandinavian countries and Poland. However, the Dutch healthcare system employs nurse anaesthetists both with and without nursing backgrounds. This study has investigated whether a nursing background influences the attitudes and perceptions of nurse anaesthetists in the Netherlands.Methods: A survey was distributed to all nurse anaesthetists working in Dutch hospitals to discover differences in their perceptions of their work context, job satisfaction, and work climate, as well as health and turnover intention. The questionnaire also sought basic information on socio-demographic factors and psychosomatic symptoms. Descriptive statistics, factor analyses and independent T-tests were computed.Results: Overall 923 of a total of 2,000 questionnaires were completed and analysed (response rate of 46%). Independent T-tests showed no significant differences between nurse anaesthetists with and those without nursing backgrounds in all the areas examined.Conclusion: Dutch nurse anaesthetists with and without nursing backgrounds reported similar perceptions of and information about their work context, job satisfaction, work climate, psychosomatic symptoms, burnout, sickness absence, general health and turnover intention. Both academic tracks appeared to produce individuals who functioned similarly as professionals.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 3","pages":"157-62"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30217617","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

[Review of the effectiveness of an empirical antibiotic therapy in suspected ventilator-associated pneumonia]. [一种经验性抗生素治疗疑似呼吸机相关性肺炎的有效性综述]。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Maria Kozioł-Montewka, Iwona Jaworska-Gromaszek, Jadwiga Biernacka, Aneta Pluta, Justyna Niedźwiadek, Danuta Kaczor, Jerzy Ligięza, Sławomir Rudzki

{"title":"[Review of the effectiveness of an empirical antibiotic therapy in suspected ventilator-associated pneumonia].","authors":"Maria Kozioł-Montewka, Iwona Jaworska-Gromaszek, Jadwiga Biernacka, Aneta Pluta, Justyna Niedźwiadek, Danuta Kaczor, Jerzy Ligięza, Sławomir Rudzki","doi":"","DOIUrl":"","url":null,"abstract":"Background: Ventilator-associated pneumonia (VAP) occurs in approximately 10-20% of mechanically ventilated patients, and is associated with an extremely high mortality rate (up to 70%). The purpose of the study was to determine the susceptibility spectrum of Klebsiella, Pseudomonas and Acinetobacter strains isolated from VAP patients.Methods: We analysed 81 strains of microorganisms isolated from bronchoalveolar lavages (BAL) of VAP patients. The minimal inhibitory concentrations (MIC) of antibiotics recommended for empirical therapy were determined using an automated VITEK 2 system, and for the MIC of doripenem - the Etest assay. Results were analysed following the guidelines of the Clinical and Laboratory Standards Institute.Results: For infections caused by the group of bacteria under investigation, the most successful regimen was monotherapy with carbapenems (doripenem, meropenem and imipenem). Cephalosporins (cefepim and ceftazidim) were less effective in vitro. The worst results were obtained with the combination of piperacillin/tazobactam with aminoglycosides (amikacin or gentamicin) or fluoroquinolones (ciprofloxacin).Conclusions: Antibiotic monotherapy proved to be more effective in VAP patients than combined therapy; the best results were achieved with carbapenems. Doripenem showed strong activity in vitro against P. aeruginosa and Klebsiella sp. and should be considered for empirical VAP therapy; however, carbapenems may be less effective against Acinetobacter baumannii. The wide range of bacteria, and their broad range of susceptibility to antibiotics, suggests the need for modification of current recommendations.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 3","pages":"163-8"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30217618","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

[How to approach ECMO therapy]. [如何进行ECMO治疗]。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Piotr Knapik, Hanna Misiołek

引用次数: 0

[Arterial embolisation for post-traumatic retroperitoneal bleeding]. 动脉栓塞治疗创伤后腹膜后出血。

Anestezjologia intensywna terapia Pub Date : 2011-07-01

Izabela Budzisz, Grzegorz Wasilewski, Dariusz Onichimowski, Lidia Glinka

{"title":"[Arterial embolisation for post-traumatic retroperitoneal bleeding].","authors":"Izabela Budzisz, Grzegorz Wasilewski, Dariusz Onichimowski, Lidia Glinka","doi":"","DOIUrl":"","url":null,"abstract":"Background: Road traffic accidents resulting in multiple organ trauma are among the leading causes of mortality among people under 45 years of age. Those with pelvic injury are at special risk, because of difficult haemostasis and massive bleeding of mixed origin. Various methods of treatment have been used, including laparotomy, direct clamping and ligation of affected vessels, retroperitoneal packing, and external/internal pelvic stabilisation. In selected cases, angioembolisation of various vessels can be usedCase reports: A 24-year-old male patient was admitted after a road traffic accident, in which he suffered multiple injuries to the skull, abdomen and pelvis. An emergency laparotomy was performed, revealing ruptures of the spleen, mesentery, right ureter, and bladder, and a giant haematoma in the retroperitoneal space. The spleen was removed, and the traumatised organs temporarily repaired. The pelvis and femoral bones were stabilised externally. After surgery, the patient was transferred to the ITU; he was haemodynamically unstable due to coagulopathy and persistent bleeding from the superior gluteal artery. On the fourth day, angioembolisation of the latter was performed using three occluding coils that resulted in immediate control of the bleeding and haemodynamic stabilisation.Discussion and conclusion: In selected cases of severe bleeding from a traumatic pelvic injury, angioembolisation can be used as a lifesaving technique, especially in patients with coagulopathy after ineffective surgical interventions.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"43 3","pages":"174-7"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30217620","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