Treatment of Esophago-Airway Fistula after Esophageal Resection.

(1) Background: Esophago-airway fistula after esophageal resection is a rare, life-threatening complication associated with a high postoperative mortality rate. Managing this condition is challenging, and the prognosis for patients is uncertain. The results and our own approach to treatment are presented.

Hand hygiene improvement of individual healthcare workers: results of the multicentre PROHIBIT study.

Background: Traditionally, hand hygiene (HH) interventions do not identify the observed healthcare workers (HWCs) and therefore, reflect HH compliance only at population level. Intensive care units (ICUs) in seven European hospitals participating in the "Prevention of Hospital Infections by Intervention and Training" (PROHIBIT) study provided individual HH compliance levels. We analysed these to understand the determinants and dynamics of individual change in relation to the overall intervention effect.

Classical Microbiological Diagnostics of Bacteremia: Are the Negative Results Really Negative? What is the Laboratory Result Telling Us About the "Gold Standard"?

Standard blood cultures require at least 24-120 h to be reported as preliminary positive. The objective of this study was to compare the reliability of Gram staining and fluorescent in-situ hybridization (FISH) for detecting bacteria in otherwise negative blood culture bottles. Ninety-six sets were taken from patients with a diagnosis of sepsis.

Frailty is associated with an increased mortality among patients ≥ 80 years old treated in Polish ICUs.

Background: 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.

Methods: This is a report from the Polish sample of the VIP1 multicentre cohort study (NCT03134807).

A comparison of the ultrasound measurement of the inferior vena cava obtained with cardiac and convex transducers.

Background: Ultrasound measurement of the inferior vena cava diameter and its respiratory variability are amongst the predictors of fluid volume status. The primary purpose of the present study was to compare the consistency of inferior vena cava diameter measurements and the collapsibility index, obtained with convex and cardiac transducers. A secondary aim was to assess the agreement of the patient's allocation to one of the two groups: "fluid responder" or "fluid non-responder", based on inferior vena cava collapsibility index calculation made with two different probes.

Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections.

Purpose: To test the effectiveness of a central venous catheter (CVC) insertion strategy and a hand hygiene (HH) improvement strategy to prevent central venous catheter-related bloodstream infections (CRBSI) in European intensive care units (ICUs), measuring both process and outcome indicators.

Methods: Adult ICUs from 14 hospitals in 11 European countries participated in this stepped-wedge cluster randomised controlled multicentre intervention study. After a 6 month baseline, three hospitals were randomised to one of three interventions every quarter: (1) CVC insertion strategy (CVCi); (2) HH promotion strategy (HHi); and (3) both interventions combined (COMBi).

Severe Hypothermia Management in Mountain Rescue: A Survey Study.

Unlabelled: Podsiadło, Paweł, Tomasz Darocha, Sylweriusz Kosiński, Kinga Sałapa, Mirosław Ziętkiewicz, Tomasz Sanak, Rachel Turner, and Hermann Brugger. Severe hypothermia management in mountain rescue: A survey study. High Alt Med Biol 18:411-416, 2017.

Difficulties in funding of VA-ECMO therapy for patients with severe accidental hypothermia.

Background: Severe accidental hypothermia is defined as a core temperature below 28 Celsius degrees. Within the last years, the issue of accidental hypothermia and accompanying cardiac arrest has been broadly discussed and European Resuscitation Council (ERC) Guidelines underline the importance of Extracorporeal Rewarming (ECR) in treatment of severely hypothermic victims. The study aimed to evaluate the actual costs of ECR with VA-ECMO and of further management in the Intensive Care Unit of patients admitted to the Severe Accidental Hypothermia Centre in Cracow, Poland.

Measuring core temperature using the proprietary application and thermo-smartphone adapter.

Fast and accurate measurement of core body temperature is crucial for accidental hypothermia treatment. We have developed a novel light and small adapter to the headset jack of a mobile phone based on Android. It has been applied to measure temperature and set up automatic notifications (e.

Tension pneumothorax as a severe complication of endobronchial ultrasound-guided transbronchial fine needle aspiration of mediastinal lymph nodes.

This article presents a case report of a patient suffering from bullous emphysema and chronic obstructive pulmonary disease, who was diagnosed with tension pneumothorax after undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Tension pneumothorax is a severe but rare complication of EBUS-TBNA. It can result from lung injury caused by the biopsy needle or, in patients suffering from bullous emphysema, from spontaneous rupture of an emphysematous bulla resulting from increased pressure in the chest cavity during cough caused by bronchofiberoscope insertion.

Beta-thromboglobulin as a marker of perioperative myocardial infarction in patients undergoing coronary artery bypass grafting following aspirin discontinuation.

Perioperative myocardial infarction (PMI) following coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. The aim of this study was to assess platelet activation and oxidative stress in the setting of PMI in patients undergoing CABG. We studied 108 consecutive patients who stopped taking low-dose aspirin 7-10 days prior to elective isolated on- or off-pump CABG.

Intraoperative awareness--recommendations of the Committee on Quality and Safety in Anaesthesia, Polish Society of Anaesthesiology and Intensive Therapy.

Modern general anaesthesia is complex and reversible.It involves a temporary loss of consciousness, analgesia,a decrease in muscle tension or complete muscle relaxation,suppressed reactions of the autonomic nervous system,and the provision of amnesia of events after its completion.

Factors influencing the occurence of nosocomial bloodstream infections observed in thoracic and cardiosurgical postoperative care units.

Background: The aim of this study was to analyse the epidemiology and aetiology of laboratoryconfirmed bloodstream infections (LC-BSI) and central line-associated bloodstream infections (CLABSI) after pulmonary and coronary surgery, in postoperative intensive care units in 2009.

Methods: Sources of infections were identified by the hospital Infection Control Team in cooperation with ITU personnel using the CDC definitions.

Results: A total of 37 LC-BSI and 21 CLA-BSI cases in 3.

[Fibrinolysis activation after cardiac surgery--role of thromboelastography in the diagnosis and treatment].

Use of cardiopulmonary bypass in cardiac surgery strongly influences haemostatic system, activating fibrinolysis as well. The widespread use of antiplatelet and fibrinolytic drugs creates haemostatic disturbances in the perioperative period. Thromboelastography seems to be a useful tool in the assessment of this complex process, particularly in the early postoperative period.

[Surgical revascularization in patients with acute coronary syndromes: early outcome].

Objective: Between January 1 2001 and June 30 2002, 2204 CABG procedures were performed in our institution. 110 patients underwent urgency CABG within six hours of ACS. We analyzed their short-term results.