The Incidence of Perioperative Hypotension in Patients Undergoing Major Abdominal Surgery with the Use of Arterial Waveform Analysis and the Hypotension Prediction Index Hemodynamic Monitoring-A Retrospective Analysis.

Intraoperative hypotension (IH) is common in patients receiving general anesthesia and can lead to serious complications such as kidney failure, myocardial injury and increased mortality. The Hypotension Prediction Index (HPI) algorithm is a machine learning system that analyzes the arterial pressure waveform and alerts the clinician of an impending hypotension event. The purpose of the study was to compare the frequency of perioperative hypotension in patients undergoing major abdominal surgery with different types of hemodynamic monitoring.

Admission Lactate Concentration, Base Excess, and Alactic Base Excess Predict the 28-Day Inward Mortality in Shock Patients.

Base excess (BE) and lactate concentration may predict mortality in critically ill patients. However, the predictive values of alactic BE (aBE; the sum of BE and lactate), or a combination of BE and lactate are unknown. The study aimed to investigate whether BE, lactate, and aBE measured on admission to ICU may predict the 28-day mortality for patients undergoing any form of shock.

Population Pharmacokinetic Model of Dexmedetomidine in a Heterogeneous Group of Patients.

Dexmedetomidine is a hepatically eliminated drug with sedative, anxiolytic, sympatholytic, and analgesic properties that has been increasingly used for various indications in the form of a short or continuous intravenous infusion. This study aimed to propose a population pharmacokinetic (PK) model of dexmedetomidine in a heterogeneous group of intensive care unit patients, incorporating 29 covariates potentially linked with dexmedetomidine PK. Data were collected from 70 patients aged between 0.

Streptococcus constellatus as an aetiological factor of extensive neck phlegmon complicated by sepsis - case study.

. Streptococcus constellatus are opportunistic microorganisms. When immunocompromised patients with concomitant systemic diseases are infected with S.

Pharmacokinetics of dexmedetomidine during analgosedation in ICU patients.

Dexmedetomidine (DEX) is a fairly new alfa-agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit.

Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients.

Introduction: Because of the high mortality of invasive fungal infections (IFIs), appropriate exposure to antifungals appears to be crucial for therapeutic efficacy and safety.

Materials And Methods: This review summarises published pharmacokinetic data on systemically administered antifungals focusing on co-morbidities, target-site penetration, and combination antifungal therapy.

Conclusions And Discussion: Amphotericin B is eliminated unchanged via urine and faeces.

The pharmacokinetics of propofol in ICU patients undergoing long-term sedation.

The aim of this study was to characterize the pharmacokinetics (PK) of propofol in ICU patients undergoing long-term sedation and to assess the influence of routinely collected covariates on the PK parameters. Propofol concentration-time profiles were collected from 29 patients. Non-linear mixed-effects modelling in NONMEM 7.

An acid-base disorders analysis with the use of the Stewart approach in patients with sepsis treated in an intensive care unit.

Background: Patients with sepsis admitted to the intensive care unit often present with acid-base disorders. As the traditional interpretation might be clinically misleading, an alternative approach described by Stewart may allow one to quantify the individual components of acid-base abnormalities and provide an insight into their pathogenesis. The aim of our study was to compare the traditional and Stewart approaches in the analysis of acid-base disturbance.

Outcome of acute East African trypanosomiasis in a Polish traveller treated with pentamidine.

Background: African trypanosomiasis is a parasitic infection sporadically imported to Europe by tourists or immigrants returning from endemic areas. We present the first and an unusual case of East African trypanosomiasis imported to Poland by a patient returning from a tourist trip to Uganda and Rwanda, which was successfully treated with pentamidine.

Case Presentation: A 61-year-old Polish man was admitted to the Department because of high-grade fever and multi-organ dysfunction after a tourist trip to East Africa.

Acid-base disorder analysis during diabetic ketoacidosis using the Stewart approach--a case report.

This case report presents a 49 year-old female with type 1 diabetes admitted to the intensive care unit with acute respiratory failure and severe diabetic ketoacidosis with an initial measurement of blood glucose level of 1,200 mg L⁻¹, pH 6.78, serum HCO₃ ⁻ 3.2 mmoL L⁻¹ and BE -31.

Theorethical principles of fluid managment according to physicochemical Stewart approach.

Interpreting acid base disturbances according to the physicochemical Stewart approach allows the cause of such abnormalities to be discovered. This method is based on three independent variables: SID (strong ion difference), mainly sodium and chloride; weak acids concentration - Atot, mainly albumins and phosphate; and carbon dioxide tension - pCO₂. These three independent variables are responsible for the change of water dissociation and for the change in H+ concentration and, consequently, the change in serum pH value.

Continuous infusion of antibiotics in critically ill patients.

Antibiotics are the most commonly used drugs in intensive care unit patients and their supply should be based on pharmacokinetic/pharmacodynamic rules. The changes that occur in septic patients who are critically ill may be responsible for subtherapeutic antibiotic concentrations leading to poorer clinical outcomes. Evolving in time the disturbed pathophysiology in severe sepsis (high cardiac output, glomerular hyperfiltration) and therapeutic interventions (e.

Discrete movements of foot epithelium during adhesive locomotion of a land snail.

During the adhesive locomotion of land snails a series of short dark transverse bands, called pedal or foot waves, is visible ifa moving snail's ventral surface is observed through a sheet of glass. Moreover, the mucus secreted from the pedal glands and some pedal epithelial cells forms a thin layer which acts as a glue augmenting adherence, while also acting as a lubricant under the moving parts of the snail's foot. The relationships between velocity and the frequency of pedal waves as well as changes in the volume of small air bubbles under foot waves were analyzed by means of digital recordings made through a glass sheet on which the snails were moving.

Massive bleeeding from upper gastrointestinal tract as a symptom of rupture of splenic artery aneurysm to stomach.

Background: Splenic artery aneurysm is the most common aneurysm of visceral vessels. Their rupture usually leads to massive bleeding, being a direct life threat. Splenic artery aneurysms usually rupture into the free peritoneal cavity, and much less frequently into the lumen of the gastrointestinal tract.

The bi-phased course of electrophysiological response of isolated snail intestine on mechanical stimulation.

The transepithelial potential difference and changes of diameter of isolated snail intestine as index of its motility were studied in immersed bath in control conditions and after gentle stimulation by 60 seconds of washing of the intestinal lumen. Immediate depolarization and 20% augmentation of the lumen were observed during the stimulation. After stimulation, additional transient depolarization of the transepithelial potential difference and gradual diminution of intestine lumen back to control values over a period of 20 minutes occurred.

Echocardiographic evaluation of percutaneous valve repair in patients with mitral regurgitation using the CARILLON system.

Background: Dilated cardiomyopathy is characterised by significant enlargement of cardiac chambers, which can lead to functional mitral regurgitation. Surgery is a widely accepted treatment of secondary mitral regurgitation. Conventional cardiac surgery has a high procedural risk and therefore new techniques for percutaneous repair of mitral valve are being developed.

Glycemic profile and effectiveness and safety of insulin therapy in septic patients: is the blood glucose level sufficient?

Introduction: Hyperglycemia in sepsis is managed by intensive insulin therapy, which can cause hypoglycemia.

Objectives: The aim of the study was to evaluate the glycemic profile as well as safety and effectiveness of a nurse-controlled insulin therapy protocol in patients with severe sepsis and septic shock.

Patients And Methods: The study included 16 septic patients who died (nonsurvivors) and 61 septic patients who survived.

[Does the coexistence of cancer have an influence on the course of sepsis].

Unlabelled: The guidelines for management of sepsis are constantly updated, nevertheless sepsis is still a difficult clinical problem, especially as its treatment often ends in failure. Hospitalized cancer patients diagnosed with sepsis are especially concerned, as sepsis death rate is significant in that group of patients. The aim of the study was to evaluate and compare cancer- and non-cancer patients diagnosed with sepsis.

Toluene diisocyanate caused electrophysiological disturbances in the upper airways wall.

Objectives: Toluene diisocyanate (TDI) due to its widespread use in industry is one of the most common and well-known causes of occupational asthma and Reactive Airways Dysfunction Syndrome (RADS). In this study the impact of TDI on the electrophysiological properties of the airways wall, particularly on the mechanisms of absorption of sodium ions and chloride ions secretion was evaluated.

Materials And Methods: Isolated rabbit tracheal wall (from outbred stock animals) was mounted in an apparatus for electrophysiological experiments by means of Ussing method and was mechanically stimulated by the jet flux of specified fluid directed onto the mucosal surface of the tissue from a peristaltic pump.

Venous catheter microbiological monitoring. Necessity or a habit?

Background: Usefulness and economic aspects of microbiological analysis of central venous catheter (CVC) tips in diagnosis of the catheter-related bloodstream infection (CRBSI).

Material/methods: Retrospective study of an adult intensive care unit in a university hospital. Catheter removal was performed when the clinical state of the patient indicated that the catheter could be the source of infection or inflammation was observed at the puncture site.

Late diagnosed necrotizing fasciitis as a cause of multiorgan dysfunction syndrome: A case report.

Necrotizing fasciitis is a rapidly progressive, life-threatening soft tissue bacterial infection. We present a serious case of a 43-year-old male who suffered from necrotizing fasciitis of the left leg in whom a delayed diagnosis caused multiorgan dysfunction.Early recognition of important symptoms is essential in the management and surgical debridement of necrotizing fasciitis.

[Tracheotomy as a bedside procedure in the Intensive Care Unit: is it safe?].

Background: The authors would like to present the problem of performing bedside tracheotomy in the Intensive Care Unit. The tracheotomy have been done in the highly specific group in poor or fatal general condition, so the complication rate according to the general status of the patients is discussed.

Material: 92 patients were treated with tracheotomy between I 2003-XII 2005 and in this number 13 complications occurred.

Percutaneous valve repair for mitral regurgitation using the Carillon Mitral Contour System. Description of the method and case report.

Mitral regurgitation may result from left ventricular dilatation and cause progression of heart failure. Percutaneous techniques for mitral valve repair are under development. Techniques utilizing a trans-coronary venous approach exploit the anatomical relationship between the mitral annulus and the venous system of the heart.

[Central venous catheter as a reason of bleeding after tracheotomy].

Tracheotomy as an operation may be connected with many complications. One of them is intra- or postoperative bleeding. A lot of reasons of such bleeding is well known, but we describe a case of bleeding caused by central venous catheter which was inserted into external jugular vein, but dislocated into anterior jugular vein and destructed it's wall.

Comparison of the influence of halothane and isoflurane on airway transepithelial potential difference.

Bidirectional transport of Na+ and Cl- ions by the epithelium controls production and composition of airway surface liquid and airway transepithelial potential difference and in these ways supports mucociliary transport. Volatile anesthetics are able to inhibit epithelial ion transport processes when applied at high concentration and have been suggested to elicit depression of airway clearance and both these effects could be involved in postoperative pulmonary complications. The goal of these studies was to reveal possible influence of halothane and isoflurane at lower concentrations on electrogenic ion transport in airway epithelium.