Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2015
Case ReportsApplication of V-A ECMO therapies for short-term mechanical circulatory support in patients with cardiogenic shock.
The aim of the study was to present our experience with short-term mechanical circulatory support by veno-arterial extracorporeal membrane oxygenation (V-A ECMO). A series of cases is described involving patients with symptoms of severe cardiogenic shock successfully treated with V-A ECMO. ⋯ The number of cases in which ECMO has been successfully applied in patients with cardiogenic shock and in deep hypothermia is increasingly high; therefore, it seems advisable to elaborate ECMO guidelines to be used in such situations. V-A ECMO is an effective and recognized method of treatment of patients in cardiogenic shock and deep hypothermia.
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Anaesthesiol Intensive Ther · Nov 2014
ReviewThe use of bio-electrical impedance analysis (BIA) to guide fluid management, resuscitation and deresuscitation in critically ill patients: a bench-to-bedside review.
The impact of a positive fluid balance on morbidity and mortality has been well established. However, little is known about how to monitor fluid status and fluid overload. This narrative review summarises the recent literature and discusses the different parameters related to bio-electrical impedance analysis (BIA) and how they might be used to guide fluid management in critically ill patients. ⋯ BIA can help guide fluid management, resuscitation and de-resuscitation. The latter is especially important in patients not progressing spontaneously from the Ebb to the Flow phase of shock. More research is needed in critically ill patients before widespread use of BIA can be suggested in this patient population.
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Anaesthesiol Intensive Ther · Nov 2014
ReviewThe role of abdominal compliance, the neglected parameter in critically ill patients - a consensus review of 16. Part 2: measurement techniques and management recommendations.
The recent definitions on intra-abdominal pressure (IAP), intra-abdominal volume (IAV) and abdominal compliance (Cab) are a step forward in understanding these important concepts. They help our understanding of the pathophysiology, aetiology, prognosis, and treatment of patients with low Cab. However, there is still a relatively poor understanding of the different methods used to measure IAP, IAV and Cab and how certain conditions may affect the results. ⋯ A large overlap exists between the treatment of patients with abdominal hypertension and those with low Cab. The Cab plays a key role in understanding the deleterious effects of unadapted IAV on IAP and end-organ perfusion and function. If we can identify patients with low Cab, we can anticipate and select the most appropriate surgical treatment to avoid complications such as IAH or ACS.