Anestezjologia intensywna terapia
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Anestezjol Intens Ter · Jan 2008
Review[New opioids for general anaesthesia and in- and out-hospital analgesia].
Over the last 30 years, three new opioids of the piperidine family have been introduced to anaesthesia clinical practice: sufentanil, alfentanil and remifentanil. Alfentanil is a derivative of fentanyl, with quicker onset than that of fentanyl and with shorter duration and more intense vagomimetic properties than those of fentanyl and sufentanil. It may cause less intense respiratory depression than equianalgesic doses of fentanyl. ⋯ It is a potent analgesic, recommended for strong postoperative pain. Butorphanol is a potent analgesic that increases heart rate, arterial and pulmonary blood pressures and cardiac output. It should be given carefully in patients with coronary disease.
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Anestezjol Intens Ter · Jan 2008
[Selected factors affecting long-term outcomes of in-hospital resuscitation].
Results of resuscitation attempts and subsequent survival rates can now be analysed, based on the Utstein templates. Few such reports have been published so far in Poland. ⋯ The most pronounced difference between the results of in-hospital and pre-hospital CPR was the primary cardiac rhythm associated with the cardiac arrest. Defibrillation-susceptible rhythm was observed in only 15% of cases, and was associated with immediate survival and hospital discharge, but not with 12-month survival. The time to administration of the first dose of adrenaline was a sole factor associated with 12 month survival.
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The Hospitals in Europe Link for Infection Control through Surveillance (HELICS) network has been implemented in 15 countries of the EU. The network has been responsible for standardization of definitions, collection of data, and therapeutic procedures. The aim of study was to assess the usefulness of ICU-HELICS programme for surveillance of infections in ITU. ⋯ In the present study overall incidence of nosocomial infections within ITU was not found to be different from that in 1995. The incidence of device-associated nosocomial infections was higher than the mean value for developing countries, but lower than in Finland. The incidence of VAP was higher than in USA and in the majority of European countries with the exception of Holland, Spain, and Finland. In conclusion, we found the HELICS networkto be very helpful, allowing for observation and analysis of nosocomial infections and comparison with other centres.
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Anestezjol Intens Ter · Jan 2008
Case Reports[Arctic Sun System for hypothermia treatment after near-drowning].
Hypothermia is frequently observed in near-downing victims, and rewarming is difficult to control. We describe the use of an automatic heating system (Arctic Sun Temperature Management System). The device consists of hydrogel coated pads that adhere to the patient's abdomen, back and thighs, and react to patient temperature by automatically adjusting the circulating pad water temperature to achieve a preset patient target temperature. Temperature is measured by a bladder temperature probe. The process of warming can be adjusted to allow the body temperature to increase at a rate from 0.5 to 1.0 degree C h(-1). ⋯ The Arctic Sun System has been developed for accurate control of body temperature in patients requiring moderate hypothermia during the post-resuscitation phase, in stroke and/or cranial trauma patients. It can be also used for management of accidental hypothermia.