Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2019
Level of stress and strategies used to cope with stress by physicians working in intensive care units.
The physicians of intensive care units (ICUs) encounter patients who are critically ill and have severe injuries and require life-saving interventions. Working in such a stressful environment may be highly stressful. A high level of stress among intensive care units' staff is commonly reported. The aim of this study was to explore doctors' perceptions of their stress and identify the coping processes associated with this task. ⋯ Approximately a half of surveyed physicians presented symptoms of a high level of stress, which indicates that it is a very important problem. Further investigations of stress and coping strategies among ICU physicians are necessary.
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Anaesthesiol Intensive Ther · Jan 2019
Case ReportsAcute primary abdominal compartment syndrome due to Clostridium difficile induced toxic megacolon: a case report and review of the literature.
Without timely diagnosis, acute primary abdominal compartment syndrome (ACS) is a potentially fatal syndrome and often goes unrecognized until severe symptoms appear. Early diagnosis may significantly improve the prognosis of these patients. ⋯ Monitoring of intra-abdominal pressure allows early detection of abdominal compartment syndrome and is warranted in patients with C. difficile infection and/or toxic megacolon. Early decompression can lead to improved outcomes in patients with severe shock and organ failure.
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Anaesthesiol Intensive Ther · Jan 2019
Observational StudyChanges in topographic electroencephalogram during deepening levels of propofol sedation based on alertness/sedation scale under bispectral index guidance.
Sedation has been associated with numerous changes on electroencephalogram (EEG) but there is a need to clarify specific alterations in relation to deepening levels of sedation with different agents. We aimed to evaluate the effect of deepening levels of sedation induced by propofol and how they compare to natural sleep. ⋯ There are distinct changes associated with deepening levels of propofol induced sedation that distinguish it from natural sleep. This suggests that different mechanisms are involved in them and warrants further investigations to clarify the nature of these changes.
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Anaesthesiol Intensive Ther · Jan 2018
ReviewPoint-of-care gastrointestinal and urinary tract sonography in daily evaluation of gastrointestinal dysfunction in critically ill patients (GUTS Protocol).
There is currently a lack of universally accepted criteria for gastrointestinal (GI) failure or dysfunction in critical care. Moreover, the clinical assessment of intestinal function is notoriously difficult and thus often goes unrecognized, contributing to poor outcomes. A recent grading system has been proposed to define acute gastrointestinal injury (AGI) in conjunction with other organ function scores (e.g., SOFA). ⋯ Moreover, it is possible to examine the urinary tract and kidney function. Real-time ultrasound with the GUTS protocol is a simple, inexpensive, bedside imaging technique that can provide anatomical and functional information of the GI tract. Further studies are needed to investigate the utility of GUTS with other parameters, such as GI biomarkers, AGI class, and clinical outcomes.