Anaesthesiology intensive therapy
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The basic form of renal replacement therapy is haemodialysis. The duration and efficacy of this treatment depends on well-functioning vascular access. ⋯ According to the recommendations of the NKF DOQI (National Kidney Foundation Disease Outcomes Quality Initiative), the first choice of access is the right internal jugular vein, and the next are the left internal jugular, femoral and subclavian vein. In this article, we present approaches to the abovementioned veins for haemodialysis cathether insertion as well as catheter tip positioning in the venous system to prevent serious complications.
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Anaesthesiol Intensive Ther · Jul 2013
Case ReportsThe Clarus Video System stylet for awake intubation in a very difficult urgent intubation.
Awake fibreoptic intubation (AFI) is a standard method of airway management in a case of anticipated difficult intubation. It is usually performed using flexible fibroscopes. ⋯ In this case, the AFI procedure was performed successfully using a rigid intubation stylet: the Clarus Video System. One of the advantages of rigid stylets is that they are very easy to use, and in the hands of anaesthesiologists not very familiar with fibroscope intubation, they can be an alternative to flexible fibroscopes in AFI procedures.
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Anaesthesiol Intensive Ther · Jul 2013
ReviewPerioperative management of cardiac surgery patients who are at the risk of acute kidney injury.
Acute kidney injury is one of the most frequent and clinically important of all postoperative complications in cardiac surgery. It is estimated that almost half of subjects suffer from a deterioration of kidney function after a cardio-pulmonary by-pass. ⋯ Because acute decompensation in heart function leads to acute kidney damage, therefore cardiac surgery-associated acute kidney injury may be recognised as a type 1 cardio-renal syndrome from a pathophysiological point of view. This paper aims to review the current data on the diagnosis of acute kidney injury and preventive strategies that can be implemented in cardiac surgery perioperative care.
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Ultrasound has been revolutionising our specialty. The introduction of new, portable machines and goal-directed protocols has led many anaesthetists to use this diagnostic tool in their daily practice. ⋯ In order to perform a credible ultrasound examination, a proper level of competence is required. In this review article, the authors present various critical ultrasound applications.
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Anaesthesiol Intensive Ther · Jul 2013
Randomized Controlled Trial Comparative StudyNew generation pulse oximetry in the assessment of peripheral perfusion during general anaesthesia - a comparison between propofol and desflurane.
A pulse oximeter is a standard device for perioperative monitoring. It is well known that the early detection of tissue hypoxia is of great importance. It has been made easier due to a new generation pulse oximetry device from Masimo. This enables measurements of the peripheral perfusion index (PI) in real time. It has been found that volatile anaesthetics such as sevoflurane and desflurane increase the perfusion index. As we know, no data is available about perfusion index during propofol/remifentanil total intravenous anaesthesia. ⋯ Both intravenous propofol/remifentanil and desflurane/fentanyl general anaesthesia increase peripheral perfusion. An increase in end-tidal desflurane concentration raises peripheral perfusion.