Medicina
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The objective of this study was to evaluate usage possibilities of magnesium sulfate in anesthesiology. ⋯ Even though the precise data is not available yet, we can conclude that when magnesium sulfate is used as an adjuvant for anesthesia, the reduced doses of painkiller medicines are needed and their action is strengthened. In addition, magnesium does not prolong the activity of painkiller substances.
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Although albumin (A) may be considered an ideal natural colloid, the clinical importance efficacy of A administration in the treatment of critical illness have changed considerably of late years. This article reviews data about the use of A at present. ⋯ There are at the present time no clear indications for A administration. Albumin can be used only as a second-choice infusion solution when other products are not indicated, are contraindicated or have been used up their maximum dose.
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Review Comparative Study
[Procalcitonin: a new infection marker. Its use in intensive care].
In daily routine diagnosis, there are few parameters available to monitor critically ill patients and to control the course of therapy in severe inflammations. There are also few reliable parameters differentiating acute bacterial infection from other types of inflammation. Most of the presently used indicators of the inflammatory response, like body temperature, white cell count, erythrocyte sedimentation rate or C reactive protein are unspecific parameters with changing reliability. ⋯ The incidence of noninfectious systemic inflammatory response syndrome associated with coronary artery bypass surgery and the potential role of several inflammatory parameters as early markers of pulmonary dysfunction induced by cardiopulmonary bypass were investigated. Procalcitonin seems to be appropriate parameter indicating the early development of severe noninfectious systemic inflammatory response syndrome and for predicting pulmonary dysfunction secondary to cardiopulmonary bypass. Hence, the review of the data of different authors may lead to the conclusion that because of wide spectrum of indications procalcitonin concentration can be used for differential diagnosis of bacterial versus non-bacterial inflammation, as monitoring parameter in critically ill patients, the course of disease, treatment control evaluating the effectiveness of antibacterial treatment, for evaluation of high risk patients to see if there are no postoperative bacterial complications as a prognostic indicator.
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Randomized Controlled Trial Comparative Study
[Combined anesthesia for esophageal resection operations].
To view combined anesthesia benefits versus general anesthesia and to compare postoperative epidural analgesia and patient-controlled analgesia with intravenous morphine. ⋯ Combined anesthesia and epidural analgesia improve overall outcome, provide better postoperative pain relief, shorten the intubation time and intensive care stay in patients undergoing esophageal resection operations.
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The dangers of opioid overdose have been recognized for as long as the use of opium itself. When used correctly for medical purposes, opioids are remarkably safe and effective agents. ⋯ In a number of countries the use of heroin and other opioids in nonmedical contexts in associated with on increasing rate of overdose and often of fatal opioid overdose. This review article discusses opioid-receptor pharmacology, which is necessary for understanding of the signs and symptoms of opioid ingestion and management principles, clinical and toxic effects mediated with the opioids, the diagnosis and management guidelines in opioid intoxication, a clinical prediction rule to identify patients who can be safely discharge from hospital, the problems of the significant morbidity and mortality associated with opioid overdose.