Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jul 2014
Case ReportsHyperglycaemia and ketosis in a non-diabetic patient--an unusual cause of delayed recovery.
We report a case of hyperglycaemia and ketosis developing in a non-diabetic patient who underwent a neurosurgical procedure under general anaesthesia. A 52-year-old non-diabetic female patient underwent excision of acoustic neuroma under general anaesthesia. Pancreatic function was not disturbed and she received a single dose of dexamethasone (8 mg) and paracetamol (1 g). ⋯ After 24 hours, when blood glucose had normalised and ketosis abated, she could be weaned from mechanical ventilation and extubated. The patient did not receive any drugs known to cause such a condition. To the best of our knowledge, hyperglycaemia and ketosis developing in a non-diabetic patient causing delayed recovery and extubation is here reported for the first time.
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Anaesthesiol Intensive Ther · Jul 2014
Case ReportsSymptoms of hypovolemic shock during the induction of general anaesthesia in a patient with large vascular malformation--an adverse effect of propofol and sevoflurane?
Venous malformations are the second most common congenital vessel anomaly. In our hospital, we conduct up to 30 sclerotherapies with 1-3% aethoxysclerol annually in children of all ages. The procedure is invasive and painful and therefore requires general anaesthesia. ⋯ Volatile anaesthetics and propofol decrease the systemic vascular resistance and cause vasodilatation. Our patient presented with hypotonic shock due to the redistribution of blood to the dilated venous malformation, which developed after the use of standard concentration of sevoflurane. Intravenous anaesthetics were administered during induction and might have increased that effect. Although we found no similar reports, we believe that patients with vast venous malformations can experience such complications after the use of volatile anaesthetics, especially in high concentrations.
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Anaesthesiol Intensive Ther · Jul 2014
Observational StudyPrognostic value of serum galactomannan in mixed ICU patients: a retrospective observational study.
Little is known about serum galactomannan (GM) testing in (mostly non-neutropenic) mixed intensive care unit (ICU) patients. The aim of this study was to look for the incidence of invasive aspergillosis (IA) in critically ill patients, to validate previously reported GM thresholds, and to evaluate the prognostic value of GM. ⋯ We found a high incidence of proven and probable IA in a group of mixed ICU patients (10%) and the presence of IA was associated with a high mortality. The serum GM antigen detection test may not be useful in the diagnosis of IA in mixed ICU patients, according to the results of the ROC analysis. We could not define a useful threshold.
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Anaesthesiol Intensive Ther · Jul 2014
The effectiveness of the APACHE II, SAPS II and SOFA prognostic scoring systems in patients with haematological malignancies in the intensive care unit.
Cancer-related mortality remains the second most common cause of death in Poland. In many cases, the occurrence of treatment-related complications requires admission to the intensive care unit (ICU). The aim of this study was to assess the clinical application of the APACHE II, SAPS II and SOFA scales to evaluate the risk of death in patients with haematological malignancies treated in the ICU. ⋯ Of all the applied patient assessment scales, only the SAPS II score was found to be useful in subjects with haematological malignancies hospitalised in the ICU.
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Anaesthesiol Intensive Ther · Jul 2014
Radiofrequency neurotomy for the treatment of chronic pain: interference with implantable medical devices.
Radiofrequency is widely used in the treatment of chronic pain for its efficacy and low incidence of side effects and complications. Despite this, it is commonly believed that this kind of treatment could interfere with medical implantable devices. Potential interference between implanted devices such as pacemakers, defibrillators and spinal cord stimulators and the radiofrequency of neurotomy is an important concern for physicians caring for patients with these devices. ⋯ There are several theoretical concerns about radiofrequency treatments in patients with implantable electrical medical devices. However, there is no experimental evidence of electrical interference with the implanted devices. Our long experience strongly suggests that by following simple precautions, patients can benefit from radiofrequency pain-relieving procedures without any adverse events.