Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Apr 2013
Observational StudyResidual neuromuscular block in elderly patients after surgical procedures under general anaesthesia with rocuronium.
Incomplete recovery of neuromuscular function following the administration of medium-acting, non- -depolarising agents is one of the most feared complications in anaesthesia. We assessed the incidence of postoperative residual curarisation (PORC) after general anaesthesia with rocuronium in elderly and young patients, and we evaluated possible complications of postoperative residual curarisation. ⋯ Residual paralysis remains a major problem in geriatric clinical anaesthesia. Neuromuscular function monitoring is obligatory, and pharmacological reversal of relaxation should be advised in geriatric patients after using relaxants for general anaesthesia.
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Neuromuscular blocking agents are a substantial element of anaesthesia in almost every surgical field. Nevertheless, their use has been associated with rises in mortality and morbidity. Of importance are: the general health state of the patient, liver and renal function, metabolism and excretion, active metabolites, side effects of muscle relaxants and, above all, residual paralysis. ⋯ In contrast to anticholinergic agents, which enhance the acetylcholine amount in the postsynaptic part of the neuromuscular junction, sugammadex encapsulates myorelaxing agent removing it from the junction. Sugammadex binds specifically only muscle relaxants of aminosteroid structure. In this paper, we present the current understanding of the characteristics, dosing, indications and side effects of sugammadex.
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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