Survival and predictive factors of clinical outcome in patients with severe acquired brain injury.

Background: Despite the many tools available to modern medicine, predicting the neurological and functional status of patients after severe brain injury remains difficult.

Aim: This analysis evaluates the outcomes of patients with the most severe degree of cerebral function impairment.

Design: Retrospective cohort study.

Cranial Electrode Belt Position Improves Diagnostic Possibilities of Electrical Impedance Tomography during Laparoscopic Surgery with Capnoperitoneum.

Laparoscopic surgery with capnoperitoneum brings many advantages to patients, but also emphasizes the negative impact of anesthesia and mechanical ventilation on the lungs. Even though many studies use electrical impedance tomography (EIT) for lung monitoring during these surgeries, it is not clear what the best position of the electrode belt on the patient's thorax is, considering the cranial shift of the diaphragm. We monitored 16 patients undergoing a laparoscopic surgery with capnoperitoneum using EIT with two independent electrode belts at different tomographic levels: in the standard position of the 4th-6th intercostal space, as recommended by the manufacturer, and in a more cranial position at the level of the axilla.

Multilocular infection caused by hypervirulent Klebsiella pneumoniae.

Hypervirulent strains of Klebsiella pneumoniae (hvKP) can cause atypical multilocular infections in otherwise healthy patients. Diagnosis of infection caused by hvKP is based mainly on clinical findings and laboratory results, including detection of virulence genes. It typically manifests as hepatic abscess with metastatic spread.

Temporary phrenic nerve stimulated patients: What is the role of ultrasound examination?

Background: Prolonged mechanical ventilation caused by ventilator-induced diaphragm dysfunction (VIDD) is a serious problem in critically ill patients. Identification of patients who will have difficulty weaning from ventilation along with attempts to reduce total time on mechanical ventilation is some of the aims of intensive care medicine.

Observations: This article briefly summarizes current options for temporary phrenic nerve stimulation therapy in an effort to keep the diaphragm active as direct prevention and treatment of ventilator-associated diaphragmatic dysfunction in patients on mechanical ventilation.

The Role of Ultrasound Examination in the Differential Diagnosis of Cardiac Arrest in Prehospital Care: A Case Report.

The survival rate of patients with out-of-hospital cardiac arrest has improved in recent years; however, it remains low. One approach to improving outcomes in these cases is to implement point-of-care ultrasound as an integral part of advanced cardiac life support management. Due to its growing popularity among emergency physicians, several protocols for this examination have been developed; however, there are little data on its use in the prehospital setting.

Where Did the Midline Catheter Disappear?

Intravascular catheter break off is a rare complication during insertion or nursing care. We report the intravascular break off of a midline catheter after wound dressing change and its migration into the pulmonary artery. The broken piece of catheter was removed percutaneously using a snare kit.

Evaluation of the insertion parameters and complications of the i-gel Plus airway device for maintaining patent airway during planned procedures under general anaesthesia: a protocol for a prospective multicentre cohort study.

Introduction: Supraglottic airway devices represent a less invasive method of airway management than tracheal intubation during general anaesthesia. Their continued development is focused mainly on improvements in the insertion success rate and minimalisation of perioperative and postoperative complications. The i-gel Plus is a novel, anatomically preshaped supraglottic airway device which achieves a perilaryngeal seal due to a non-inflatable cuff made of a soft thermoplastic elastomer.

Phrenic nerve stimulation prevents diaphragm atrophy in patients with respiratory failure on mechanical ventilation.

Background: Diaphragm atrophy and dysfunction is a major problem among critically ill patients on mechanical ventilation. Ventilator-induced diaphragmatic dysfunction is thought to play a major role, resulting in a failure of weaning. Stimulation of the phrenic nerves and resulting diaphragm contraction could potentially prevent or treat this atrophy.

Effects of pleural effusion drainage in the mechanically ventilated patient as monitored by electrical impedance tomography and end-expiratory lung volume: A pilot study.

Purpose: In patients with pleural effusion (PLE) monitored by Electrical Impedance Tomography (EIT) an increase in end-expiratory lung impedance (EELI) is observed following evacuation of the PLE. We aimed at differentiating the effect of fluid removal from lung reaeration and describe the change in ventilation distribution.

Materials And Methods: Mechanically ventilated patients were monitored by EIT during PLE evacuation.

Initial Assessment of the Percutaneous Electrical Phrenic Nerve Stimulation System in Patients on Mechanical Ventilation.

Objectives: Maintaining diaphragm work using electrical stimulation during mechanical ventilation has been proposed to attenuate ventilator-induced diaphragm dysfunction. This study assessed the safety and feasibility of temporary percutaneous electrical phrenic nerve stimulation on user-specified inspiratory breaths while on mechanical ventilation.

Design: Two-center, nonblinded, nonrandomized study.

The use of cryopreserved platelets in the treatment of polytraumatic patients and patients with massive bleeding.

Background: The short shelf-life of fresh platelets limits their efficient inventory management and availability during a massive transfusion protocol. Risk of insufficient availability can be mitigated by building an inventory of cryopreserved platelets (CPs).

Methods: A comparative study of fresh apheresis platelets (FAPs) and CPs was performed.

Subdural empyema case report of a rare disease with a high mortality.

Subdural empyema is a rare purulent intracranial infection. Outcome is dependent on the preoperative level of consciousness, therefore an early diagnosis and urgent neurosurgical intervention are necessary. Mortality of subdural empyema remains high, ranging from 6% to 15%.

Epidural hematoma - benign or potentially malignant disease?

Introduction: Epidural hematoma (EDH) is generally considered to be a condition with a good prognosis. However, postoperative results of numerous studies have shown that mortality and morbidity remain relatively high. The aim of our article is to evaluate surgical outcomes in patients undergoing EDH evacuation over the last five years.

Benefits of repeated CT scan in patients with neurosurgical-neurological problems in intensive care retrospective analysis.

Introduction: CT examination of the brain is an integral part of neurointensive care. The examination, however, represents a risk for patients and has side effects. Indications for the procedure should therefore be carefully considered.

[A Case of a patient with AIDS and pneumocystis pneumonia complicated by cytomegalovirus pneumonitis].

We report a case of a 39-year-old male admitted for respiratory failure. On admission, the patient was diagnosed with advanced HIV infection and Pneumocystis jirovecii pneumonia (PJP). The patient's condition improved following specific PJP therapy but then deteriorated.

Ultrasound detection of diaphragm position in the region for lung monitoring by electrical impedance tomography during laparoscopy.

Background And Aims: During laparoscopic surgery, a capnoperitoneum is created to optimize the operating space for surgeons. One effect of this is abdominal pressure which alters the physiological thoraco-abdominal configuration and pushes the diaphragm and lungs cranially. Since the lung image acquired by electrical impedance tomography (EIT) depends on the conditions within the thorax and abdomen, it is crucial to know the diaphragm position to determine the effect of diaphragm shift on EIT thorax image.

A Randomized Comparison of Bougie-Assisted and TracheoQuick Plus Cricothyrotomies on a Live Porcine Model.

Objectives: Cricothyrotomy is a rescue procedure in "cannot intubate, cannot oxygenate" scenarios where other methods of nonsurgical airway management have failed. We compared 2 cuffed cricothyrotomy sets, bougie-assisted cricothyrotomy (BACT) and novel percutaneous TracheoQuick Plus, on a live porcine model in a simulated periarrest situation.

Methods: Thirty-four anesthetized minipigs were randomly allocated into two groups: BACT technique ( = 17) and TracheoQuick Plus ( = 17).

Cardiovascular disease predictors and adipose tissue macrophage polarization: Is there a link?

Background The risk of cardiovascular disease is closely connected to adipose tissue inflammation. The links between cardiovascular risk predictors and pro and anti-inflammatory macrophages in human adipose tissue were analysed to gain an insight into the pathophysiology of cardiovascular disease. Design Subcutaneous and visceral adipose tissues were obtained from 79 subjects, 52 living kidney donors (during nephrectomy) and 27 patients with peripheral artery disease (during arterial tree reconstruction).

[Toxic shock syndrome].

The authors present an up-to-date review of toxic shock syndrome (TSS) - a life-threatening condition where toxins of the Gram-positive bacteria Staphyloccocus aureus and Streptococcus pyogenes play a key role in the pathogenesis. The authors provide insight into the epidemiology and pathogenesis of the disease and point out the relevant patient history data and clinical signs and symptoms that may indicate progression of TSS. Last but not least, the state of the art diagnostic and therapeutic approaches to early and full blown TSS are summarized.

Comparison of five 2nd-generation supraglottic airway devices for airway management performed by novice military operators.

Objectives: Five different second-generation supraglottic airway devices, ProSeal LMA, Supreme LMA, i-gel, SLIPA, and Laryngeal Tube Suction-D, were studied. Operators were inexperienced users with a military background, combat lifesavers, nurses, and physicians.

Methods: This was a prospective, randomized, single-blinded study.

Early Diagnosis of Cutaneous Mucormycosis Due to Lichtheimia corymbifera After a Traffic Accident.

A case report of cutaneous mucormycosis and obstacles to early diagnosis is presented. A 38-year-old male was involved in a car accident that led to amputation of both lower limbs. Subsequently, he developed fungal wound infection of the left lower limb stump.

Effects of hypertonic saline and mannitol on cortical cerebral microcirculation in a rabbit craniotomy model.

Background: Hyperosmolar solutions have been used in neurosurgery to modify brain bulk and prevent neurological deterioration. The aim of this animal study was to compare the short-term effects of equivolemic, equiosmolar solutions of mannitol and hypertonic saline (HTS) on cerebral cortical microcirculation in a rabbit craniotomy model.

Methods: Rabbits (weight, 2.

[The current view of the diagnosis and management of amebiasis in the light of the authors own case reports].

This comprehensive review is focused on a serious protozoan disease, amebiasis. This disease is caused by the human parasite Entamoeba histolytica (E. histolytica), the second leading cause of mortality due to protozoan disease worldwide (the leading cause is malaria).

Fractionated plasmatic separation and adsorption does not alter haemodynamic parameters in experimental acute liver failure.

Objective: Acute liver failure (ALF) is a rare disease with a bad prognosis. Its start is accompanied by haemodynamic instability. The aim of our study was to evaluate the influence of fractionated plasmatic separation and adsorption (FPSA) on body haemodynamics using a large animal experimental model of ALF.