Anaesthesiology intensive therapy
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The aim of this study was to review all published articles in the literature in English regarding percutaneous cervical cordotomy in cancer pain. Percutaneous cordotomy may be used to relieve unilateral pain below the level of the neck arising from a variety of causes. ⋯ Reports were also located through references of articles. This review leads us to conclude that percutaneous cervical cordotomy can be recommended even before considering the use of strong opioids.
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Anaesthesiol Intensive Ther · Jan 2016
Safety of intensivist-led bedside decannulation of internal jugular bi-caval dual-lumen veno-venous extracorporeal membrane oxygenation cannulas and report of technique.
In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported in the literature. ⋯ It is safe for intensivists to decannulate the Avalon Elite VV-ECMO cannula in the ICU using our purse-string suture technique. Performing these decannulations at the bedside compared to operating room may have positive clinical ramifications that include improved patient safety, timely patient care and reduced operating room costs.
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Anaesthesiol Intensive Ther · Jan 2016
Observational StudyAn acid-base disorders analysis with the use of the Stewart approach in patients with sepsis treated in an intensive care unit.
Patients with sepsis admitted to the intensive care unit often present with acid-base disorders. As the traditional interpretation might be clinically misleading, an alternative approach described by Stewart may allow one to quantify the individual components of acid-base abnormalities and provide an insight into their pathogenesis. The aim of our study was to compare the traditional and Stewart approaches in the analysis of acid-base disturbance. ⋯ The use of the Stewart model may improve our understanding of the underlying pathophysiological mechanism and the true etiology of the derangements of acid-base disorders. Indeed, it proves that patients may suffer from mixed arterial blood gas disorders hidden under normal values of SBE and pH.
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Anaesthesiol Intensive Ther · Jan 2016
Randomized Controlled TrialAnaesthesia for carotid endarterectomy. Ultrasound-guided superficial/intermediate cervical plexus block combined with carotid sheath infiltration.
Carotid endarterectomy carries a significant risk of intraoperative brain ischaemia. Various methods for intraoperative cerebral function monitoring can be utilized, but the assessment of the patient's consciousness remains the easiest and most available method, requiring that the patient remain awake and under local/regional anaesthesia. The aim of this study was to compare infiltration anaesthesia with an ultrasound-guided superficial/combined cervical plexus block for patient safety and comfort. ⋯ Compared with infiltration anaesthesia, an US-guided superficial/combined cervical plexus block is an effective method for improving the comfort of the patient and the surgeon. The technique is safe, relatively simple and easy to master and requires little time to perform.
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Anaesthesiol Intensive Ther · Jan 2016
Case ReportsIntra-abdominal hypertension complicating pancreatitis-induced acute respiratory distress syndrome in three patients on extracorporeal membrane oxygenation.
Severe acute pancreatitis is associated with sever multiorgan failure from 15 to 50%, depending on the series. In some of these patients, conventional methods of ventilation and respiratory support will fail, demanding the use of extracorporeal membrane oxygenation (ECMO). Abdominal compartment syndrome is potentially harmful in this cohort of patients. We describe the successful treatment of three patients with severe acute pancreatitis who underwent respiratory ECMO and where intra abdominal pressure was monitored regularly. ⋯ Monitoring intraabdominal pressure is a valuable adjunct to decision making while caring for these high-risk critically ill patients.