Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2019
Randomized Controlled TrialEpileptiform EEG patterns during different techniques of induction of general anaesthesia with sevoflurane and propofol: a randomised trial.
The aim of the study was to assess the influence of volatile induction of general anaesthesia with sevoflurane using two different techniques and intravenous anaesthesia with propofol on the possible presence of epileptiform electroencephalograph patterns during the induction of general anaesthesia. ⋯ Our study shows that the BIS score variations do not detect epileptiform activity, which was associated with both low and high scores. The sevoflurane concentration reached either sedative or toxic concentrations.
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Anaesthesiol Intensive Ther · Jan 2019
Observational StudySeptic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome - a preliminary analysis.
Intra-abdominal hypertension (IAH) is relatively frequent in critical patients. According to the most recent consensus of the World Society of Abdominal Compartment Society (WSACS), there are no predictive factors for IAH diagnosis. Risk factors are the only motivators to date for early IAH diagnosis. Abdominal compartment syndrome (ACS) is defined as sustained intra-abdominal pressure (IAP) maintained above 20 mm Hg (> 3 kPa), with or without abdominal perfusion pressure below 60 mm Hg (< 8 kPa), associated with a new organ dysfunction. Sepsis is a recognized cause of secondary ACS, but to date there is no correlation with admission SOFA (sequential organ failure assessment) score and ACS onset incidence. The objective of the present study is to determine the profile of extra-abdominal septic shock patients with IAH/ACS admitted to the intensive care unit (ICU) and correlating with admission SOFA score. Better understanding of this population may bring to light clinical predictive factors for IAH/ACS early diagnosis. ⋯ The incidence of ACS in patients with extra-abdominal septic shock admitted to a university teaching hospital MICU was higher than those found in the literature. Higher admission and consecutive SOFA score of more than 7 was associated with higher ACS incidence and higher mortality rate.
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Anaesthesiol Intensive Ther · Jan 2019
Level of stress and strategies used to cope with stress by physicians working in intensive care units.
The physicians of intensive care units (ICUs) encounter patients who are critically ill and have severe injuries and require life-saving interventions. Working in such a stressful environment may be highly stressful. A high level of stress among intensive care units' staff is commonly reported. The aim of this study was to explore doctors' perceptions of their stress and identify the coping processes associated with this task. ⋯ Approximately a half of surveyed physicians presented symptoms of a high level of stress, which indicates that it is a very important problem. Further investigations of stress and coping strategies among ICU physicians are necessary.
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Anaesthesiol Intensive Ther · Jan 2019
Case ReportsAcute primary abdominal compartment syndrome due to Clostridium difficile induced toxic megacolon: a case report and review of the literature.
Without timely diagnosis, acute primary abdominal compartment syndrome (ACS) is a potentially fatal syndrome and often goes unrecognized until severe symptoms appear. Early diagnosis may significantly improve the prognosis of these patients. ⋯ Monitoring of intra-abdominal pressure allows early detection of abdominal compartment syndrome and is warranted in patients with C. difficile infection and/or toxic megacolon. Early decompression can lead to improved outcomes in patients with severe shock and organ failure.