Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2015
Awareness and knowledge of intra-abdominal hypertension and abdominal compartment syndrome: results of an international survey.
Surveys have demonstrated a lack of physician awareness of intra-abdominal hypertension and abdominal compartment syndrome (IAH/ACS) and wide variations in management of these conditions, with many intensive care units (ICUs) reporting that they do not measure intra-abdominal pressure (IAP). We sought to determine the association between publication of the 2006/2007 World Society of the Abdominal Compartment Syndrome (WSACS) Consensus Definitions and Guidelines and IAH/ACS clinical awareness and management. ⋯ This survey showed that although most responding clinicians claim to be familiar with IAH and ACS, knowledge of published consensus definitions, measurement techniques, and clinical management are inadequate.
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Anaesthesiol Intensive Ther · Jan 2015
Randomized Controlled TrialThe use of sugammadex for the reversal of vecuronium-induced neuromuscular block following intracranial surgery.
Total intravenous anaesthesia with propofol and remifentanil is widely used in neuroanaesthesiology and enables the quick recovery and early neurological assessment of patients. The administration of muscle relaxants carries a risk of residual relaxation following surgery. The administration of a suitable dose of sugammadex reverses the neuromuscular block irrespective of its depth and has none of the side effects associated with acetylcholinesterase inhibitors. The aim of the present study was to evaluate the usefulness of sugammadex for the reversal of vecuronium-induced effects following intracranial surgery. ⋯ The use of sugammadex following craniotomy accelerates the achievement of optimal extubation conditions.
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Anaesthesiol Intensive Ther · Jan 2015
Does epidural anaesthesia reduce the incidence of postoperative oxygen desaturation episodes in patients undergoing open abdominal aortic aneurysm repair?
Postoperative desaturation can lead to severe hypoxaemia and even tissue hypoxia, followed by cardiological and neurological complications. Opioid usage is the one of the most important risk factors of postoperative desaturation and hypoxemia. Epidural anaesthesia is recommended for vascular surgery for many reasons; the reduction or elimination of opioid doses is one reason. The aims of the study were to evaluate the incidence of desaturation episodes in patients after surgical procedures with abdominal aortic clamping, to determine whether the episodes in question lead to clinical symptoms of hypoxia and to determine whether epidural anaesthesia decreases the incidence of desaturation episodes. ⋯ Epidural anaesthesia did not protect against postoperative desaturation. Though oxygen therapy was used, desaturation was observed in approximately 90% of patients.
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Anaesthesiol Intensive Ther · Jan 2015
Cooled radiofrequency system relieves chronic knee osteoarthritis pain: the first case-series.
Knee osteoarthritis is a frequent cause of chronic knee pain. Therapeutic solutions include intra-articular injections with short-term pain relief and surgical therapy. Radiofrequency (RF) of genicular nerves has been previously reported with varying success. Cooling tissue adjacent to the electrode (cooled RF) increases the radius of lesion. We present here the first retrospective data on pain relief and changes in function after such cooled RF denervation. ⋯ The majority of patients with chronic knee pain experienced a clinically relevant degree of pain relief and improved function following cooled RF of genicular nerves at one, three, six and 12 months follow-up.
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Anaesthesiol Intensive Ther · Jan 2015
Apnea test in the determination of brain death in patients treated with extracorporeal membrane oxygenation (ECMO).
Extracorporeal Membrane Oxygenation (ECMO) is a well-established method of support in patients with severe respiratory and/or circulatory failure. Unfortunately, this invasive method of treatment is associated with a high risk of neurological complications including brain death. Proper diagnosis of brain death is crucial for the termination of futile medical care. ⋯ Hypercapnia achieved via this method should allow an apnea test to be conducted in the typical manner. In the case of profound desaturation and an inadequate increase in the arterial CO₂ concentration, the sweep gas flow rate may be increased to obtain the desired oxygenation level, and exogenous carbon dioxide may be added to achieve a target carbon dioxide level. Incorporation of an apnea test for ECMO patients is planned in the next edition of the Polish guidelines on the determination of brain death.