Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2015
ReviewUltrasound guided axillary brachial plexus plexus block. Part 2 - technical issues.
Axillary brachial plexus block is one of the most frequently employed peripheral blocks. The popularity of axillary block stems from its success as a safe and relatively easy technique with numerous applications. The technique of axillary block has evolved. ⋯ Axillary block under US-guidance can be performed using a traditional perivascular method and by placing a selective blockade of individual nerves that supply the surgical area. Regardless of the selected method, it enables the incorporation of individual patient anatomical variation in an anaesthesia plan. This paper discusses the technical details and efficacy issues of US-guided axillary brachial plexus block techniques.
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Anaesthesiol Intensive Ther · Jan 2015
ReviewFrom therapeutic hypothermia towards targeted temperature management: a decade of evolution.
More than a decade after the first randomised controlled trials with targeted temperature management (TTM), it remains the only treatment with proven favourable effect on postanoxemic brain damage after out-of-hospital cardiac arrest. Other well-known indications include neurotrauma, subarachnoidal haemorrhage, and intracranial hypertension. When possible pitfalls are taken into consideration when implementing TTM, the side effects are manageable. ⋯ Uncertainty remains concerning cooling method, timing, speed of cooling and rewarming. New data indicates that TTM is safe and feasible in cardiogenic shock, one of its classic contra-indications. Moreover, there are limited indications that TTM might be considered as a therapy for cardiogenic shock per se.
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Anaesthesiol Intensive Ther · Jan 2015
ReviewIntra-abdominal hypertension and abdominal compartment syndrome in burns, obesity, pregnancy, and general medicine.
Intra-abdominal hypertension (IAH) is an important contributor to early organ dysfunction in trauma and sepsis. However, relatively little is known about the impact of intra-abdominal pressure (IAP) in general internal medicine, pregnant patients, and those with obesity or burns. The aim of this paper is to review the pathophysiologic implications and treatment options for IAH in these specific situations. ⋯ Although non-operative measures come first, surgical decompression must not be delayed if these fail. Percutaneous drainage of ascites is a simple and potentially effective tool to reduce IAP if organ dysfunction develops, especially in burn patients. Escharotomy may also dramatically reduce IAP in the case of abdominal burns.
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Anaesthesiol Intensive Ther · Jan 2015
ReviewNutritional therapy in paediatric intensive care units: a consensus statement of the Section of Paediatric Anaesthesia and Intensive Therapy the Polish Society of Anaesthesiology and Intensive Therapy, Polish Society of Neonatology and Polish Society for.
Providing nutritional therapy via the gastrointestinal tract in patients in paediatric intensive care units (PICUs) is an effective method for delivering energy and other nutrients. In the event of contraindications to using this method, it is necessary to commence parenteral nutrition. In the present study, methods for nutritional treatments in critically ill children are presented, depending on the clinical situation.
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Anaesthesiol Intensive Ther · Jan 2015
Randomized Controlled TrialBalanced hydroxyethyl starch solution and hyperglycaemia in non diabetics - a prospective, randomized and controlled study.
There are very few studies that have examined the effect of hydroxyethyl starch (HES) solutions on blood glucose level. The study was aimed to compare the effects on blood glucose levels in patients undergoing lower limb surgeries under neuraxial block, receiving HES with those receiving 0.9% saline. ⋯ A balanced HES solution administered intravenously did not cause an increase in blood glucose concentrations compared to those who received 0.9% saline.