Anestezjologia intensywna terapia最新文献_第7页

Anestezjologia intensywna terapia Pub Date : 2010-10-01

Jacek Wadełek

引用次数: 0

[Guidelines for safe paediatric anaesthesia of the Committee on Quality and Safety in Anaesthesia, Polish Society of Anaesthesiology and Intensive Therapy]. [波兰麻醉和强化治疗学会麻醉质量和安全委员会的安全儿科麻醉指南]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Andrzej Piotrowski

引用次数: 0

[Pre-oxygenation in morbidly obese patients]. [病态肥胖患者预充氧]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Tomasz Gaszyński

{"title":"[Pre-oxygenation in morbidly obese patients].","authors":"Tomasz Gaszyński","doi":"","DOIUrl":"","url":null,"abstract":"Background: Spontaneous respiration with 100% oxygen prior to induction of anaesthesia (preoxygenation) may enable safe management of an apnoeic phase. In the majority of patients, three minutes of inhalation of 100% of oxygen should result in almost complete (>90%) saturation of FRC. However, this may not be true in morbidly obese, because of their limited FRC and oxygen reserve.Methods: This was a prospective, non-randomised study in morbidly obese patients (BMI >40 kg m2). All patients were positioned in a 25 degrees head-up position, and were asked to breathe 100% O2 (flow rate 8 L min(-1)) via a tight face mask. We measured the time from the beginning of inhalation of 100% O2, to achievement of E(T)O2 >90%.Results: Forty-three patients with a mean BMI of 47 kg m(-2) were enrolled to the study. The mean time to E(T)O2 >90% was 295 sec, but in only 25% of patients was the time shorter than 3 min. Based on the results obtained, we estimated that the safe time for pre-oxygenation in 95% of morbidly obese patients should be 450 sec.There was no correlation between BMI, weight, age, and the time taken to achieve E(T)O2 > 90%.Conclusion: We recommend pre-oxygenating morbidly obese patients for longer than those with standard body weight. Eight minutes of 100% oxygen inhalation should be effective in the majority of these patients.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"42 3","pages":"133-6"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29748773","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

[Iatrogenic pleuropneumonia complicating central venous cannulation in a very low birth weight infant]. [医源性胸膜肺炎并发中心静脉置管一例极低出生体重儿]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Marlena Jakubczyk, Magdalena Chrzanowska, Małgorzata Apanasiewicz, Małgorzata Chrupek, Roman Kaźmirczuk, Marika Reszczyńska, Andrzej I Prokurat, Zbigniew Szkulmowski, Krzysztof Kusza

{"title":"[Iatrogenic pleuropneumonia complicating central venous cannulation in a very low birth weight infant].","authors":"Marlena Jakubczyk, Magdalena Chrzanowska, Małgorzata Apanasiewicz, Małgorzata Chrupek, Roman Kaźmirczuk, Marika Reszczyńska, Andrzej I Prokurat, Zbigniew Szkulmowski, Krzysztof Kusza","doi":"","DOIUrl":"","url":null,"abstract":"Background: Central venous cannulation is necessary for long-term parenteral nutrition in premature infants. Peripherally inserted long catheters are commonly used in these patients but even this relatively simple technique can end in serious complications. We present a case in which perforation of the vena cava and migration of the catheter to the intrapleural space resulted in multiple organ failure and death.Case report: A 700 g bw. infant, born at 28 weeks of gestation, was referred to our centre because of suspected bowel perforation. In the referring hospital, the infant had a central venous catheter inserted peripherally. The catheter migrated to the right intrapleural space, and parenteral formula was delivered over several hours to the right pleura, resulting in hydrothorax with serious compression of the lung and atelectasis. Emergency laparotomy did not reveal any pathology and a chest tube was inserted into the right pleura; the effusion fluid contained a large number fat particles. The child's condition worsened and he died 16 days after surgery because of multiple organ failure and sepsis.Conclusion: Accidental migrations of central venous catheters to the pleural space have been described by many authors. It can result in severe pneumonia, cardiac tamponade or sepsis and is often fatal. We conclude that central venous catheters in premature infants should be inserted under ultrasonography or fluoroscopy. Catheters should never be forced along vessels; their size ought to be adjusted to age, and a free outflow of blood should be obtained before they are used.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"42 3","pages":"147-50"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29748776","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

[Sugammadex--two years in clinical practice]. [Sugammadex-两年临床实践]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Lidia Glinka, Dariusz Onichimowski, Paweł Sieniuta, Artur Korecki

引用次数: 0

[About Museum of Anaesthesiology]. 【关于麻醉博物馆】。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Witold Jurczyk

引用次数: 0

[Reporting on data from cardiopulmonary resuscitation]. [心肺复苏数据报告]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Małgorzata Marmaj, Danuta Gierek, Józefa Dabek, Małgorzata Kuczera, Janusz Skowron

引用次数: 0

[Antimicrobial therapy in severe infections with multidrug-resistant Gram-negative bacterias]. [多重耐药革兰氏阴性菌严重感染的抗菌治疗]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Wiesława Duszyńska

引用次数: 0

[The use of hypothermia in intensive therapy]. [低温在强化治疗中的应用]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Izabela Pagowska-Klimek, Wojciech Krajewski

{"title":"[The use of hypothermia in intensive therapy].","authors":"Izabela Pagowska-Klimek, Wojciech Krajewski","doi":"","DOIUrl":"","url":null,"abstract":"The authors discuss the usefulness of therapeutic hypothermia for neuroprotection in patients with hypoxic cerebral damage. Although first reports on this method were published more than 50 years ago, it gained wider popularity at the end of 20th century. This popularity was related to the fact that deep hypothermia (below 30 degrees C) was displaced by mild hypothermia using higher temperatures (32-35 degrees C). The therapeutic benefit of mild hypothermia is based on the decrease of cerebral metabolism (5-7% per one degree Celsius). The ATP consumption by neurons is decreased despite the lack of glucose and oxygen associated with cardiac arrest, and membrane function is longer preserved. Hypothermia also prevents cerebral oedema, both of vascular and cytotoxic origin, and other reactions associated with reperfusion injury. Recently, the American Heart Association and European Resuscitation Council recommended the use of mild hypothermia (32-34 degrees C) in adult patients after ventricular fibrillation. Some clinical data also indicates that induced hypothermia reduces cerebral hypoxic ischemic injury. Randomized clinical trials in newborns with hypoxic ischemic encephalopathy confirm improved neurological outcomes and survival at 18 months of age with therapeutic hypothermia. The use of hypothermia after craniocerebral and spinal trauma, or ischemic brain damage is controversial, and not widely recommended. The authors describe various methods of inducing hypothermia in clinical settings; perhaps the most effective is intravenous infusion of cold fluids together with superficial cooling. Side effects and complications are discussed. They conclude that mild hypothermia can be regarded as a useful therapy in adult patients after VF cardiac arrest, and in neonates with hypoxic cerebral brain damage.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"42 3","pages":"167-73"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29748703","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

[Costs of subarachnoid vs. general anaesthesia for caesarean section]. [剖宫产的蛛网膜下腔麻醉与全身麻醉的成本比较]。

Anestezjologia intensywna terapia Pub Date : 2010-07-01

Magdalena Kwiatosz-Muc, Leszek Wdowiak, Andrzej Nestorowicz, Michał Kowalczyk

{"title":"[Costs of subarachnoid vs. general anaesthesia for caesarean section].","authors":"Magdalena Kwiatosz-Muc, Leszek Wdowiak, Andrzej Nestorowicz, Michał Kowalczyk","doi":"","DOIUrl":"","url":null,"abstract":"Background: Modern medicine is becoming increasingly aware of economic-organizational aspects. In the field of anaesthesiology, the number of agents used markedly increases due to continuous pharmacological progress. A high proportion of them are expensive. The aim of the study was to compare hospital costs of general vs. subarachnoid anaesthesia for Caesarean section.Methods: Costs were assessed from the perspective of a service provider. Direct costs were measured using the micro-cost method based on detailed data of the resources used during anaesthetic procedures. Non-medical costs were calculated by the direct allocation method (costs of auxiliary units). Unit costs of hospitalization were determined using the \"top-to-bottom\" assessment. Costs related to anaesthetic staff work were calculated by the micro-cost method based on duration of anaesthesia. Sensitivity analysis was performed.Results: Mean direct cost of general anaesthesia for Caesarean section was lower than of subarachnoid anaesthesia. Mean personnel cost of subarachnoid anaesthesia was found to be higher compared to general anaesthesia. Costs of pharmaceuticals for general anaesthesia were lower than for subarachnoid one. Costs of medical materials related to the method used were significantly higher in subarachnoid anaesthesia.Conclusions: Subarachnoid anaesthesia takes more time than general one, which results in higher costs of medical staff work. Avoiding inhalation anaesthetics (sevoflurane) makes indirect costs of general anaesthesia lower compared to subarachnoid anaesthesia.","PeriodicalId":88221,"journal":{"name":"Anestezjologia intensywna terapia","volume":"42 3","pages":"124-8"},"PeriodicalIF":0.0,"publicationDate":"2010-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29748771","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