Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Apr 2013
Theorethical principles of fluid managment according to physicochemical Stewart approach.
Interpreting acid base disturbances according to the physicochemical Stewart approach allows the cause of such abnormalities to be discovered. This method is based on three independent variables: SID (strong ion difference), mainly sodium and chloride; weak acids concentration - Atot, mainly albumins and phosphate; and carbon dioxide tension - pCO₂. These three independent variables are responsible for the change of water dissociation and for the change in H+ concentration and, consequently, the change in serum pH value. ⋯ Administering a fluid with a SID greater than the HCO₃ concentration causes a pH increase towards alkalosis. Likewise, administering a a fluid with a SID lower than the HCO₃ concentration causes a pH decrease towards acidosis. It seems that knowledge of the electrolyte concentration and the SID value of an administered fluid is an important factor regarding acid base disturbances.
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Anaesthesiol Intensive Ther · Apr 2013
Health-care associated infection in the newly-opened intensive care unit.
Health-care associated infections (HAI) are common complications in ICU patients as an effect of high invasive device utilization rate. The aim of the study was to analyze the epidemiology of ventilator - associated pneumonia (VAP), blood stream infections (BSI), urinary tract infections (UTI) and surgical site infections (SSI) in newly opened medical-surgical intensive care unit. ⋯ The incidence of VAP was higher than the mean values reported for USA, western Europe and similar to the mean value reported for developing countries. BSI and UTI rate was comparable to those given in NNIS and HELICS reports. Effective prevention strategies should be introduced in order to reduce high VAP rates