Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2018
Use of noninvasive mechanical ventilation with pressure support guaranteed with average volume in de novo hypoxaemic respiratory failure. A pilot study.
This study was designed to determine the results associated with the use of noninvasive mechanical ventilation (NIV) using the BiPAP S/T-AVAPS ventilation strategy in subjects with mild to moderate de novohypoxaemicrespiratory failure. ⋯ The BiPAP S/T-AVAPS ventilatory mode can be used in subjects with de novo hypoxaemic respiratory failure with special vigilance concerning exhaled tidal volumes and inspired pressure.
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Anaesthesiol Intensive Ther · Jan 2018
ReviewUltrasound assessment of gastric emptying and the risk of aspiration of gastric contents in the perioperative period.
The risk of aspiration of gastric contents in the perioperative period constitutes a serious clinical problem and it is connected with increased mortality. At present, the risk of aspiration is assessed only on the basis of an interview and information obtained from the patient. Such assessment is not always reliable while the concomitance of some additional factors influencing the delay of gastric emptying significantly decreases its sensitivity. Using bedside ultrasound imaging in an assessment of gastric contents is a method which supports an objective, simple and quick assessment of the risk of aspiration, helps one to optimise perioperative anaesthetic management, and should constitute a routine element of the perioperative patient assessment.
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Anaesthesiol Intensive Ther · Jan 2018
Frailty is associated with an increased mortality among patients ≥ 80 years old treated in Polish ICUs
The increasing population of very old intensive care patients (VIPs) is a major challenge currently faced by clinicians and policymakers. Reliable indicators of VIPs' prognosis and purposefulness of their admission to the intensive care unit (ICU) are urgently needed. ⋯ Measuring frailty in critically ill older adults can facilitate making more informed clinical decisions and help avoid futile interventions.
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Either analgosedation or central nervous system dysfunction may be a side effect of implemented pharmacological treatment, as well as a consequence of intentional or unintentional poisoning. In traumatic lesions or anoxia of the central nervous system, a question arises after a recommended follow-up period about the effects of xenobiotics on nervous system function. ⋯ The aim of this paper was to describe the aspects of diagnostic toxicology which are essential for improved determination of the type and amount of exogenous substances present in biological fluids of intensive care patients. We present examples of clinical cases in order to discuss the most common discrepancies in interpretation related to the ordering of toxicology tests.