[Latest results of intensive care of sepsis, septic shock and multiple organ injuries].

Author is first discussing sepsis and its new categories (SIRS, MODS), its pathogenesis and symptoms. One axis of the events is the release of inflammatory and anti-inflammatory cytokines from the monocytes and macrophages, due to the precipitating injury. The other one is the activation of the polymorphonuclear leucocytes and the endothelial cells and their interaction.

[New advances and debated questions in intensive care in the 90-s].

Author is first dealing with the debate about supranormal oxygen delivery and with the Consensus Conference, closing the debate. Author is emphasizing the significance of the regional tissue-oxygenisation, which can be measured--in the splanchnic region--indirectly by tonometry, suitable for prognostic index too. The continuous blood gas analysis became already a fact and for the estimation of the cerebral circulation are also developed new methods: the measurement of the ajvDO2 and the near infrared spectroscopy.

[Advances in anesthesiology in the 90's].

Author looks over the novelties in anaesthesiology in the 90-ies; (1) effort to relief not only the postoperative, but in general, every kind of pain; (2) publication of evidence based guidelines; (3) standpoints according to perioperative risk factors; (4) conception of preemptive analgesia; (5) usage of modern brain imaging techniques in anaesthesiology also; (6) researches about the sites, where general anaesthetics exert their effect; (7) new volatile anaesthetics (desflurane, sevoflurane); (8) researches, targeting the use of xenon; (9) new i.v. anaesthetics-analgesics (propofol, remifentanil, S(+)-ketamine, eltanolone) and their administration (TCI); (10) potential interactions between NO and anaesthetic agents; (11) new neuromuscular blocking drugs (mivacurium, rocuronium, cis-atracurium) and the new possibilities of neuromuscular monitoring; (12) question of difficult intubation (McCoy and bullard laringoscopes, laryngeal mask); (13) synthesis of the new elements for the challenges of the surgical practice: the anaesthesiological solution of laparoscopic surgery, one-day surgery, minimally invasive heart-surgery; (14) TIVA (recognition of awareness during operation); (15) closed circuit anaesthesia; (16) reduction of expenses; (17) application of computer and data management techniques; (18) organizational steps in order to achieve an integrated standard throughout the country.

[Submental introduction of tracheal tube in endotracheal anesthesia. (Modified tracheal intubation method for cases of simultaneous maxillofacial injuries and osteotomies)].

This article reports the modification of laterosubmental tracheal intubation in single-step surgery of panfacial fractures or osteotomies. In the modified method--after the submental transversal midline skin incision--the tube is guided through a submental tunnel to the oral floor, just behind to caruncula sublingualis.