Lijec̆nic̆ki vjesnik
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Lijec̆nic̆ki vjesnik · Jan 2010
Practice Guideline[News in hemodynamic monitoring, resuscitation and intensive care of patients after cardiac surgery: "Guidelines for resuscitation in cardiac arrest after cardiac surgery" of the European Association for Cardio-Thoracic Surgery].
In order to simplify and to standardize procedures during cardiac arrest in patients after cardiac surgery and for professional medical staff education, working group of the European Association for Cardio-Thoracic Surgery issued in 2009 "Guideline for resuscitation in cardiac arest after cardiac surgery". There are several differences between these guidelines and guidelines for general population: in ventricular fibrillation, three sequential attempts at defibrillation should precede external cardiac massage; in asystole or extreme bradycardia, pacing should precede external cardiac massage. Where the above measures fail, and in pulseless electrical activity, early resternotomy is advocated. ⋯ Also protocols for excluding reversible airway and breathing complications and for safe emergency resternotomy are given. These guidelines in very simple and professional way define rules for resuscitation of patients after cardiac surgery. It is a useful manual which will certainly find its place in daily work of professional medical staff involved in healthcare of these patients.
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Lijec̆nic̆ki vjesnik · Jan 2010
Introducing Broselow colour coded system for paediatric emergency management in a non paediatric general hospital.
Paediatric emergency management is a very stressful clinical event especially when it occurs in a non paediatric hospital. Low self confidence, non familiarity with drug dosages and proper equipment selection are the main cause of professional insecurity. In this paper, after a short review dealing with main differences between child and adult patient, we consider the advantages offered by Broselow method approach to paediatric emergences. Finally we describe the strategy we followed to introduce Broselow method in our Institution.
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Lijec̆nic̆ki vjesnik · Jan 2010
[Hypothermia after cardiac arrest--underused method that saves lives].
Cardiorespiratory arrest causes ischemia and lesion of all organ systems, but the central nervous system is the most vulnerable. It is known that only few minutes of hypoperfusion and ischemia can cause irreversible damage to the brain which is the major frustration of reanimatology. ⋯ Methods for induction and maintenance of hypothermia are numerous and various, basically divided into invasive and non-invasive, each with its own advantages and disadvantages which are described in this paper. Despite recognised positive effects of mild therapeutic hypothermia after resuscitation from cardiac arrest, the method is not fully implemented as a standard method in post-resuscitation period.
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Lijec̆nic̆ki vjesnik · Jan 2010
Continous monitoring of central venous oxygen saturation in children and infants.
Maintenance of adequate tissue oxygenation is an important task in intensive care units. There are many variables which are measured for this purpose. Central venous oxygen saturation (ScvO2) monitoring has some advantages over the mixed venous oxygen saturation (SvO2) monitoring in children and infants as there is no need to insert a pulmonary catheter. The clinical usefulness seems promising.
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Crystalloid solutions are considered a good choice for lower scale blood loss (up to 20%). The usage of colloids facilitates faster and more durable blood volume substitution. ⋯ It is therefore important to know that HES 130/04, a new generation colloid solution, is linked to a lower frequency of side effects. Nonetheless, it seems that the individual approach and procedure-specific choices are more important than other factors.