Occupational reintegration after severe burn injury: a questionnaire study.

Background: As a consequence of improved survival rates after burn injury occupational reintegration of burn survivors has gained increasing significance. We aimed to develop a precise patient questionnaire as a tool to evaluate factors contributing to occupational reintegration.

Material And Methods: A questionnaire comprising 20 questions specifically evaluating occupational reintegration was developed under psychological supervision.

Update on hyperbaric oxygen therapy in burn treatment.

Hyperbaric oxygen therapy (HBOT) has been shown to improve tissue hypoxia, neovascularization and ischemia reperfusion injury and reduce pathologic inflammation in various clinical settings and was proposed to be a game changer in treatment of burns. Improved and faster wound healing as well as a reduction of morbidity and mortality after thermal and concomitant carbon monoxide poisoning are expected. In defiance of the observed benefits for burn wounds and carbon monoxide poisoning in animal models and few randomized controlled trials there is an ongoing controversy regarding its use, indications and cost effectiveness.

Sepsis caused by multidrug-resistant klebsiella pneumoniae infection in a 23-year-old burn patient: case report and literature review.

Septic complications are a major problem in burn care. Infections caused by multidrug-resistant (MDR) Klebsiella pneumoniae strains represent a growing threat. In particular, Romania has seen rapidly increasing rates of MDR Klebsiella pneumoniae isolates in recent years.

Are we bound to our scores? a 74-year-old patient with an abbreviated burn severity index of 14.

We report a case of a 74-year-old female patient who was involved in a car accident. The patient suffered deep dermal and full thickness burns and the probability of survival calculated with the Abbreviated Burn Severity Index (ABSI) was extremely low. The patient showed sufficient cardiorespiratory and renal function for the entire treatment period.

Incidence of risk factors for bloodstream infections in patients with major burns receiving intensive care: A retrospective single-center cohort study.

Objectives: The objective was primarily to identify risk factors for bloodstream infections (BSI) caused by different pathogens.

Methods: A retrospective single-center cohort study was performed on 472 burn patients with an abbreviated burn severity index (ABSI)≥3, a total burn surface area (TBSA)≥10%, and an ICU stay of at least 24h. Risk factors for different BSI pathogens were analyzed by competing risks regression model of Fine and Gray.

Determination of gas flow through airway exchange catheters: measured and calculated values and dependence on pressure and entrainment.

Serious complications have been described during oxygenation of patients with airway exchange catheters, due to catheter malpositioning, accidentally applied high airway pressures or high delivered volumes. In this in-vitro study, we analysed gas flow through various airway exchange catheters and described its dependence on driving pressure and entrainment. We applied driving pressures between 0.

Predisposing factors for candidemia in patients with major burns.

Background: Despite advances in surgery and critical care, candidemia remains a significant cause of morbidity and mortality in patients with extensive burns.

Methods: A retrospective single-center cohort study was performed on 174 patients admitted to the Burn Intensive Care Unit of the General Hospital of Vienna (2007-2013). An AIC based model selection procedure for logistic regression models was utilized to identify factors associated with the presence of candidemia.

Non-occlusive mesenteric ischaemia: the prevalent cause of gastrointestinal infarction in patients with severe burn injuries.

Background: Gastrointestinal complications occur frequently in intensive care patients with severe burns. Intestinal infarction and its deleterious consequences result in high mortality despite rapid surgical intervention. Our objective was to evaluate the aetiology of gastrointestinal infarction in intensive care patients with severe burns.

Development of demographics and outcome of very old critically ill patients admitted to intensive care units.

Purpose: To evaluate the development of demographics and outcome of very old (>80 years) critically ill patients admitted to intensive care units.

Setting: All consecutive patients admitted to 41 Austrian intensive care units (ICUs) over an 11-year period.

Methods: We performed a retrospective cohort study of prospectively collected data.

The Veres adapter: clinical experience with a new device for jet ventilation via a laryngeal mask airway during flexible bronchoscopy.

Background: A new device was developed to deliver high-frequency jet ventilation via a laryngeal mask airway (LMA). We investigated its use during flexible fiberoptic bronchoscopy in anesthetized patients.

Methods: Thirty adults were studied during interventional bronchoscopy.

Intrinsic positive end-expiratory pressure at various frequencies of supraglottic jet ventilation in a model of dynamic upper airway obstruction.

Background: Supraglottic jet ventilation (JV(S)) with injectors above airway stenoses may result in inadvertent high lung pressures. We designed this study to investigate intrinsic positive end-expiratory pressure (PEEP(i)) during jet ventilation via a distant injector in a model of dynamic upper airway obstruction.

Methods: Respiratory pressure-time curves were recorded during JV(S) in a tracheal lung model using a pig's trachea and an embolectomy catheter's air-filled balloon to simulate 60 and 80% airway obstruction.

Airway stenosis-related increase of pulmonary pressure during high-frequency jet ventilation depends on injector's position.

Background: High-frequency jet ventilation (HFJV) can lead to high-airway pressures under certain conditions. In this laboratory study, we evaluated the influence of the injector's position relative to a fixed airway obstruction on peak pressures in a tracheal-lung model.

Methods: We administered HFJV via a metal jet injector at varying distances from connectors simulating laryngotracheal airway stenosis.

The effects of aminophylline on bispectral index during inhalational and total intravenous anaesthesia.

Aminophylline is usually used during anaesthesia to treat bronchospasm but recent findings suggest that it can also be used to shorten recovery time after general anaesthesia. However, it is unclear whether aminophylline shows similar properties during a steady-state phase of deep surgical anaesthesia. We therefore wanted to test the hypothesis that the administration of aminophylline leads to an increase in bispectral index as a surrogate parameter suggesting a lighter plane of anaesthesia.

Superimposed high-frequency jet ventilation (SHFJV) for endoscopic laryngotracheal surgery in more than 1500 patients.

Background: Superimposed high-frequency jet ventilation (SHFJV), which does not require any tracheal tubes or catheters, was developed specifically for use in laryngotracheal surgery. SHFJV uses two jet streams with different frequencies simultaneously and is applied in the supraglottic space using a jet laryngoscope and jet ventilator.

Methods: Between 1990 and 2004, SHFJV was studied in 1515 consecutive patients (including 158 children requiring laryngotracheal surgery) prospectively.

Spinal versus general anesthesia for orthopedic surgery: anesthesia drug and supply costs.

Total hip or knee replacement surgeries are common orthopedic interventions that can be performed with spinal anesthesia (SA) or general anesthesia (GA). No study has investigated the economic aspects associated with the two anesthetic techniques for this common surgery. We randomized 40 patients to receive either SA or GA and analyzed the drug and supply costs for anesthesia und recovery.

[Perioperative pain management at the department of orthopaedic surgery of the Vienna Medical School].

Surgical treatment in the skeleton region and its adjacent tissue causes severe pain, demonstrated by the high demand of anaesthetics in the early postoperative phase. In order to offer adequate and individually adapted pain management, the orthopaedic department is working closely with the departments of anaesthesiology and intensive care medicine of the Vienna Medical University at the Vienna's General Hospital. The aim of this cooperation is to start postoperative rehabilitation early, to increase postoperative quality of life and to reduce the length of hospital stay.

Alveolar recruitment of atelectasis under combined high-frequency jet ventilation: a computed tomography study.

Objective: To quantify the effect of superimposed high-frequency jet ventilation on lung recruitment in adult patients with acute lung injury.

Design And Setting: Prospective clinical study in the intensive care unit of a university teaching hospital.

Patients: Eight adults suffering from acute lung injury with a mean lung injury score of 2.