May noninvasive mechanical ventilation and/ or continuous positive airway pressure increase the bronchoalveolar lavage salvage in patients with pulmonary diseases? Randomized clinical trial - Study protocol.

Purpose: Bronchoalveolar lavage (BAL) procedure is a useful tool in the diagnosis of patients with interstitial lung disease (ILD) and is helpful in clinical research of chronic obstructive pulmonary disease (COPD) patients. Still little is known about predictors of poor BAL salvage. The trial aims to find the most efficient way to improve BAL recovery.

The use of non-invasive respiratory assistance to facilitate bronchofiberoscopy performance in patients with hypoxemic (type one) respiratory failure - Study protocol.

Purpose: Bronchofiberoscopy (FOB) is a procedure routinely performed for: lung cancer, obstruction, interstitial diseases, foreign bodies' removal, airway clearance, and hemoptysis. It causes acute airway narrowing leading to respiratory and cardiovascular stress. Due to increasing number of ill patients with respiratory failure (RF), conventional oxygen therapy (COT) is frequently insufficient to assure accurate oxygenation and prevent RF in patients requiring FOB.

Autopsy Histopathologic Lung Findings in Patients Treated With Extracorporeal Membrane Oxygenation.

Context.—: Extracorporeal membrane oxygenation (ECMO) is increasingly used in the treatment of respiratory and cardiac failure, but data describing lung histopathology in ECMO recipients are limited.

Objective.

Value, time and outcomes of elevated lactate levels in adult patients on extracorporeal membrane oxygenation.

Introduction: Lactate levels have been recognized as a reliable tool for monitoring critically ill patients requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) or venovenous extracorporeal membrane oxygenation (VV ECMO) but the reasons behind the overproduction of lactate are different and the influance for survival remains controversial. We analyzed the lactate values and lactate clearance in adult patients in these two forms of extracorporeal support.

Methods: Patient demographics, ECMO duration, 30-day mortality, lactate values and lactate clearance at 24, 48 and 72 h from ECMO initiation of patients supported with VV and VA ECMO at Silesian Centre for Heart Deasese, between January 2011 and April 2020 were retrospectively analyzed.

Pulmonary function, exercise capacity and dyspnea in patients 7 ​years after Nuss surgery.

Purpose: Pectus excavatum is a frequent thoracic malformation increasingly treated with minimally invasive methods (MIRPE), which are performed for cardio-respiratory problems and in some centers also for esthetic considerations. Theoretically, MIRPE may increase thoracic elastic recoil, work of breathing and cause emphysema. The aim of the present study was to determine whether teenagers who underwent MIRPE may expect normal thoracic cage development, cardio-respiratory function, exercise capacity and asymptomatic functioning.

Post-tracheostomy complications: respiratory failure caused by authologic foreign body-case report.

Tracheostomy is performed frequently as a palliative treatment in patients with end-stage respiratory failure (RF). However, in patients requiring prolonged mechanical ventilation it may be difficult to recognize and can often lead to life-threatening RF. We present two cases of acute-on-chronic respiratory failure (ACRF) occurring in patients who had undergone tracheostomy [one with percutaneous dilatational tracheostomy (PDT) and the second with surgical tracheostomy (ST)].

Novel Antibacterial Modification of Polycarbonate for Increment Prototyping in Medicine.

In the era of modern medicine, the number of invasive treatments increases. Artificial devices used in medicine are associated with an increased risk of secondary infections. Bacterial biofilm development observed on the implanted surface is challenging to treat, primarily due to low antibiotics penetration.

Epidemiology and clinical characteristics of patients discharged from the ICU in a vegetative or minimally conscious state.

Purpose: A significant percentage of patients are discharged from intensive care units (ICU) with disorders of counciousness (DoC). The aim of this retrospective, case-control study was to compare patients discharged from the ICU in a vegetative state (VS) or minimally conscious state (MCS) and the rest of ICU survivors, and to identify independent predictors of DoC among ICU survivors.

Methods: Data from 14,368 adult ICU survivors identified in a Silesian Registry of Intensive Care Units (active in the Silesian Region of Poland between October 2010 and December 2019) were analyzed.

Risk factors of complications during noninvasive mechanical ventilation -assisted flexible bronchoscopy.

Purpose: Flexible bronchoscopy (FB) causes airway narrowing and may cause respiratory failure (RF). Noninvasive mechanical ventilation (NIV) is used to treat RF. Until recently, little was known about noninvasive mechanical ventilation assisted flexible bronchoscopy (NIV-FB) risk and complications.

The clinical value of the routine analysis of cardiac implantable electronic devices after the patient's death in a tertiary cardiovascular center.

Introduction: The postmortem interrogation of cardiac implantable electronic devices (CIEDs) has not been regularly practiced yet. We presumed that it can provide data not only on the mechanism of the patient's death but also on possible device malfunctions contributing to its occurrence.

Objectives: The study aimed to determine the usefulness of the explantation and interrogation of CIEDs after the patient's death in routine clinical practice, when combined with autopsy findings and clinical follow‑up starting from the time after device implantation.

Extracorporeal membrane oxygenation (ECMO) - in the treatment of severe, life-threatening respiratory failure.

Extracorporeal membrane oxygenation (ECMO) is a technique involving oxygenation of blood and elimination of carbon dioxide in patients with life-threatening, but potentially reversible conditions. Thanks to the modification of extracorporeal circulation used during cardiac surgeries, this technique can be used in intensive care units. Venovenous ECMO is used as a respiratory support, while venoarterial ECMO as a cardiac and/or respiratory support.

Should we admit more patients not requiring invasive ventilation to reduce excess mortality in Polish intensive care units? Data from the Silesian ICU Registry.

Introduction: Mortality in Polish intensive care units (ICU) is excessively high. Only a few patients do not require intubation and invasive ventilation throughout the whole ICU treatment period. We aimed to define this population, as pre-emptive admissions of such patients may increase the population which benefits from ICU admission and reduce excessive mortality in Polish ICUs.

The importance of fluid balance in critically ill patients: a retrospective observational study.

Background: Fluid therapy in critically ill patients remains one of the most demanding and difficult aspects of care. This is particularly important in patients admitted to the intensive care unit (ICU) due to cardiovascular disorders.

Aims: The aim of this study was to investigate whether a cumulative fluid balance (FB) affects mortality in critically ill patients hospitalized at the ICU.

Young Adults Among Patients Admitted to Polish Intensive Care Units in the Silesian ICU Registry.

BACKGROUND Patients under 30 years of age constitute a unique population in the Intensive Care Unit (ICU). The aim of this study was to obtain information on young adults admitted to Polish ICUs and to identify independent predictors of favorable outcome in this population. MATERIAL AND METHODS Data from 20 651 adult patients from the Silesian Registry of Intensive Care Units conducted in the Silesian Region of Poland since October 2010 were analyzed.

Surveillance of Antibiotic Prescribing in Intensive Care Units in Poland.

Antibiotic use and microbial resistance in health care-associated infections are increasing globally and causing health care problems. Intensive Care Units (ICUs) represent the heaviest antibiotic burden within hospitals, and sepsis is the second noncardiac cause of mortality in ICUs. Optimizing appropriate antibiotic treatment in the management of the critically ill in ICUs became a major challenge for intensivists.

Evaluation of thoracic epidural analgesia in patients undergoing coronary artery bypass surgery - a prospective randomized trial.

Introduction: Most recent studies tend to confirm the beneficial effect of thoracic epidural analgesia (TEA) in cardiac surgery.

Aim: To assess whether intensive care unit TEA has an influence on the perioperative course following low-risk coronary artery surgery.

Material And Methods: This prospective, randomized trial was performed in patients scheduled for low-risk coronary artery surgery.

Use of ECDC PPS HAI&AU data to evaluate adherence to national guidelines for antimicrobial treatment of community-­acquired pneumonia.

INTRODUCTION    Point prevalence surveys are widely described as a useful tool for evaluating antimicrobial policy and adherence to guidelines. OBJECTIVES    We aimed to investigate if data from the European Centre for Disease Prevention and Control (ECDC) point prevalence survey of healthcare‑associated infections and antimicrobial use (PPS HAI&AU) canbe used to evaluate adherence to national guidelines for the treatment of community‑acquired pneumonia (CAP) and to analyze the quality of treatment regimens. PATIENTS AND METHODS    Data for 72 698 patients were collected in Poland between the years 2012 and 2015 according to the ECDC Protocol v.

Healthcare associated bloodstream infections in Polish hospitals: prevalence, epidemiology and microbiology-summary data from the ECDC Point Prevalence Survey of Healthcare Associated Infections 2012-2015.

Aggregated data from the Polish Point Prevalence Survey of Healthcare Associated Infections and Antimicrobial Use (PPS HAI&AU) collected between 2012 and 2015 were used to describe the epidemiology of healthcare associated bloodstream infections (BSI) in Polish hospitals, in order to assess the rationale for introducing a BSI surveillance programme in our country and analyse selected risk factors. Data were collected according to the ECDC PPS HAI&AU protocol. Within four years, records for 71,039 patients were collected in 36 (2012), 32 (2013), 112 (2014), and 158 (2015) hospitals; representativeness was evaluated as good in 2012-2013, and excellent from 2014.

Emergency HeartWare Ventricular Assist Device (HVAD) exchange due to pump thrombosis using minimally invasive technique.

Left ventricular assist device (LVAD) thrombosis remains a dreadful complication of mechanical circulatory support, with an incidence of 8-12% depending on the pump type and patient's comorbidities. Fibrinolysis may be considered early in pump thrombosis, but when contraindicated a pump exchange remains the only alternative. This short report documents an emergency LVAD exchange in a 55-year-old man who underwent LVAD (HeartWare Inc) implantation in 2013 as a bridge to transplantation.