Anaesthesiology intensive therapy
-
Anaesthesiol Intensive Ther · Jan 2015
ReviewCardiac Ultrasonography in the critical care setting: a practical approach to asses cardiac function and preload for the "non-cardiologist".
Cardiac ultrasonography has become an indispensible tool in the management of hemodynamically unstable critically ill patients. Some consider it as the modern stethoscope. Echocardiography is non-invasive and safe while the modern portable devices allow to be used at the bedside in order to provide fast, specific and vital information regarding the hemodynamic status, as well as the function, structure and anatomy of the heart. ⋯ Echocardiography is also the perfect tool to evaluate right ventricular function with tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging, together with inferior vena cava dimensions and systolic pulmonary artery pressure and right ventricular systolic pressure measurement. Finally, methods to assess fluid responsiveness with echocardiography are discussed with the inferior vena cava collapsibility index and the variation on left ventricle outflow tract peak velocity and velocity time integral. Cardiac ultrasonography is an indispensible tool for the critical care physician to assess cardiac preload, afterload and contractile function in hemodynamically unstable patients in order to fine-tune treatment with fluids, inotropes and/or vasopressors.
-
Anaesthesiol Intensive Ther · Jan 2015
Severe sepsis in intensive care units in Poland--a point prevalence study in 2012 and 2013.
Severe sepsis is associated with a high mortality rate, but the detailed epidemiology of sepsis is not well known in Polish hospitals. The aim of the study was to determine the prevalence and incidence of severe sepsis in Polish intensive care units (ICUs). ⋯ Severe sepsis was observed in one-fourth of patients treated in ICUs in Poland. However, the actual number of severe sepsis patients is at least 2 times higher because many patients with severe sepsis were treated outside accredited ICUs. Severe sepsis constitutes a major health problem in Poland.
-
Anaesthesiol Intensive Ther · Jan 2015
Prospective assessment of standardized mortality ratio (SMR) as a measure of quality of care in intensive care unit--a single-centre study.
The standardized mortality ratio (SMR) is a recognized indicator of critical care quality. This ratio is used to compare actual hospital mortality of all patients treated in a Intensive Care Unit (ICU) with predicted mortality. The aim of the study was prospective analysis of SMR as a measure of quality of care in single ICU. ⋯ In groups of patients with low and high risk the values of SMR indicated favourable quality of care. Study results should prompt to carry out detailed analysis of the course of treatment of patients at average risk of death. Analysis of the course of treatment and qualification criteria for surgery in patients undergoing elective surgery is also indicated.