Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2017
Randomized Controlled Trial Comparative StudyComparison of dexmedetomidine and fentanyl to prevent haemodynamic response to skull pin application in neurosurgery: double blind randomized controlled trial.
Skull pin application during craniotomy is a highly noxious stimulus. Therefore, the attenuated effect between dexmedetomidine and fentanyl was investigated. ⋯ The attenuated effect of dexmedetomidine infusion is significantly greater than fentanyl infusion.
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Anaesthesiol Intensive Ther · Jan 2017
ReviewNoninvasive ventilation in difficult endotracheal intubation: systematic and review analysis.
Noninvasive ventilation has been widely used in the management of acute respiratory failure in appropriate clinical settings. In addition to known benefit of alleviating the need for invasive mechanical ventilation, recent literature suggested its beneficial use in the process of endotracheal intubation. ⋯ Large randomized controlled studies focused on alternative approaches to endotracheal intubation in severe hypoxemic respiratory failure are largely missing but there are several retrospective cohort analysis and reports describing the novel technique describing the application of noninvasive ventilation during endotracheal intubation. Noninvasive ventilation can be used as an adjunct intervention that may maintain oxygenation and ventilation, prevent significant hemodynamic instability and provide a pneumatic stent to maintain upper airway patency, thus reducing the risks of intubation-related complications.
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Anaesthesiol Intensive Ther · Jan 2017
Measurement of cricoid pressure force during simulated Sellick's manoeuvre.
Cricoid pressure is a standard anaesthetic procedure used to reduce the risk of aspiration of gastric contents during the induction of general anaesthesia. However, for several years its validity has been questioned. There still remains the question of whether we perform it correctly. The aim of the study was an evaluation of the theoretical knowledge of Sellick's manoeuvre, as well an assessment of practical skill related with it when simulated on a model of the upper airway. ⋯ Sellick's manoeuvre was performed incorrectly in many cases. Half of the participants of our study applied the pressure in the wrong place while the majority of them used an inappropriate amount of force. Thus, the application of cricoid pressure in patients should be preceded with simulation training.
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Anaesthesiol Intensive Ther · Jan 2016
Clinical outcome of critically ill patients with thrombocytopenia and hypophosphatemia in the early stage of sepsis.
Hypophosphatemia and thrombocytopenia may both be independent risk factors for the development of multiple organ failure and correlate well with the severity of sepsis. In the present study we wanted to analyze the potential clinical role and prognostic significance of both early hypophosphatemia and thrombocytopenia on clinical outcomes of critically ill ICU patients with severe sepsis. ⋯ It may be considered that hypophosphatemia and thrombocytopenia in the early stage of sepsis, even when severe and coexisting, reflect the degree of initial illness severity of sepsis. However, further investigations need to be done for a better understanding of the potential clinical role of these features in the septic critically ill population.
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Anaesthesiol Intensive Ther · Jan 2016
A pilot study on pharmacokinetic/pharmacodynamic target attainment in critically ill patients receiving piperacillin/tazobactam.
In critically ill patients, multi-trauma and intensive therapy can influence the pharmacokinetics (PK) and pharmacodynamics (PD) of antibiotics with time-dependent bacterial killing. Consequently, PK/PD targets (%fT>MIC) - crucial for antimicrobial effects -may not be attained. ⋯ Critically ill patients are at risk of drug under- or overdosing without dose up-titration with regard to covariate effects and individual drug pharmacokinetics.