Degloving lower leg injury - the importance of additional treatment: negative pressure and hyperbaric oxygen therapy.

Degloving injury poses a severe therapeutic challenge concerning both trauma and plastic surgery. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. Treatment is often long-lasting and brings unsatisfying results due to the extent of damage, risk of infection and massive blood loss.

Bacterial infections in Intensive Care Unit patients analyzed on the example of the Lodz Medical University Hospital No 1 in the period 2002-2015.

Introduction: In the present study, nosocomial infections, increased resistance to carbapenem among clinical isolates of Pseudomonas aeruginosa and Acinetobacter spp. are analyzed on the example of the intensive care unit (ICU) at the Lodz Medical University Hospital No I in a long period of time (2002-2015).

Methods: In the period from 2002 to 2015, 19870 bacteriological cultures were made from 4289 patients hospitalized at the ICU.

Assessment of Ventilation Distribution during Laparoscopic Bariatric Surgery: An Electrical Impedance Tomography Study.

. The aim of the study was to assess changes of regional ventilation distribution at the level of the 3rd intercostal space in the lungs of morbidly obese patients as a result of general anaesthesia and laparoscopic surgery as well as the relation of these changes to lung mechanics. We also wanted to determine if positive end-expiratory pressure of 10 cm HO prevents the expected atelectasis in the morbidly obese patients during general anaesthesia.

Dexmedetomidine for attenuating haemodynamic response to intubation stimuli in morbidly obese patients anaesthetised using low-opioid technique: comparison with fentanyl-based general anaesthesia.

Background: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanylbased or low-opioid using dexmedetomidine.

Assessment of regional ventilation in acute respiratory distress syndrome by electrical impedance tomography.

Mechanical ventilation in acute respiratory distress syndrome (ARDS) incurs a risk of ventilator-associated lung injury (VALI) from inhomogeneous conditions and different properties of dependent and non-dependent lung regions at risk of atelectasis and overdistension, respectively. Electrical impedance tomography (EIT) offers regional ventilation assessment to optimise treatment with mechanical ventilation. This article provides an overview of scientific literature on the application of impedance tomography in acute respiratory distress syndrome.

Results of the severe sepsis registry in intensive care units in Poland from 2003-2009.

Background: Severe sepsis remains the most common cause of death in intensive care units (ICUs) according to many epidemiological studies. There are no data in Poland on the extent of severe sepsis cases treated in ICUs. The aim of the study was to analyse the course and outcome of severe sepsis patients treated in Polish ICUs.

Intraoperative monitoring of cerebral NIRS oximetry leads to better postoperative cognitive performance: a pilot study.

Objectives: The aim of this study is the assessment of the regional cerebral oximetry - NIRS (near infrared spectroscopy) as an intraoperative monitoring system to protect the patient against the incidents of brain desaturations. We hypothesize that patients monitored with NIRS present a smaller range of postoperative cognitive dysfunctions (POCD) in comparison with those without NIRS monitoring during lumbar spine surgery in a prone position.

Settings: This study was performed at the Clinical Department of Neurosurgery and Oncology of the Central Nervous System, Medical University of Lodz, Poland.

The doripenem serum concentrations in intensive care patients suffering from acute kidney injury, sepsis, and multi organ dysfunction syndrome undergoing continuous renal replacement therapy slow low-efficiency dialysis.

Doripenem is a novel wide-spectrum antibiotic, and a derivate of carbapenems. It is an ideal antibiotic for treatment of serious nosocomial infections and severe sepsis for its exceptionally high efficiency and broad antibacterial spectrum of action. Doripenem is eliminated mainly by the kidneys.

[Fungal infections in patients of an intensive care unit analyzed on the example of the Lodz Medical University Hospital No 1 in the period of 2002-2012].

Introduction: The objective of this study was to analyze the fungal infections in patients of an intensive care unit (ICU) in a long period (2002-2012) on the example of the Lodz Medical University Hospital No 1. This analysis was focused on the study of the effect of antimicrobial therapy on the level of these infections.

Methods: A total of 291 strains of fungi were isolated from blood, tips of central intravenous catheters, lower respiratory tract, urine, wounds, pressure sores, and cerebrospinal fluid of 3177 patients.

[Patient satisfaction with anaesthesia and pre-anaesthetic information].

Background: Patient satisfaction with perioperative care plays an important role in the assessment of quality of care. Written evaluation forms are commonly used all over the world for this purpose. The aim of this study was to assess the quality of perioperative care, with special attention being directed to anaesthesia-associated side effects.

The role of the immuno-inflammatory response in patients after cardiac arrest.

Introduction: The aim of the research was to assess whether concentrations of inflammatory markers in blood of patients after cardiac arrest (CA) are related to their clinical state and survival.

Material And Methods: Forty-six patients, aged 63 ±12 years, 21 of them after out-of-hospital CA and 25 after in-hospital CA, were enrolled in the study. Twenty-five patients survived and were discharged from hospital (CA-S); 21 died during hospitalization (CA-D).

Neuromuscular block reversal with sugammadex in a morbidly obese patient with myasthenia gravis.

Backgraound: Myasthenia gravis is a rare immunological illness that impairs neuromuscular transmission. Myasthenic patients are usually hypersensitive to non-depolarising muscle relaxants, and reversal with neostigmine is rarely effective. We report the successful reversal of rocuroniuminduced neuromuscular block in a morbidly obese myasthenic patient.

[The analysis of patients with body traumas treated in the Military Medical Academy's Second Clinical Hospital of the Medical University of Lodz].

According to recent WHO reports, body traumas are ranked third with respect of frequency of occurrence right after cardiovascular diseases and tumours, and are considered one of the major medical problems. Trauma is a kind of energy (mechanical, thermal or chemical) affecting the human body. After crossing the threshold of tissue endurance, an injury or damage occurs.

[Inflammatory cytokines and long-term prognosis after cardiac arrest].

Background: The long-term survival rate after sudden cardiac arrest remains low despite progress in resuscitation, possibly due to acute ischemia of vital organs and subsequent general inflammatory reaction. We investigated a possible relationship between inflammatory cytokine concentrations and cardiac arrest (CA) survival.

Methods: Fifty one adult acute coronary syndrome patients, 35 males and 16 females, aged 62 +/- 12 years, who survived out-of-hospital CA (45%) and in-hospital CA (55%) were enrolled in the study.

[A comparison of the optical AirTraq and the standard Macintosh laryngoscope for endotracheal intubation in obese patients].

Background: Endotracheal intubation in morbidly obese patients is usually difficult and may lead to traumatic complications.

Methods: We compared the median time needed for endotracheal intubation, between a newly introduced device, the AirTraq optical laryngoscope, and a standard device, the Macintosh blade. The study group comprised adult patients scheduled for elective abdominal surgery, with a BMI >39.

[Influence of antibiotic-therapy on the selection of multi-drug resistant pathogens].

In this paper, relations between the number of nosocomial infections caused by multi-drug resistant pathogens and antibiotic-therapy were investigated. It was found that the number of MRSA infections is directly proportional to the amount of CAZ (ceftazidime) used in the therapy. It was also stated that CAZ, Amc (amoxicillin-clavulan acid) and IPM (imipenem) are strong inductors of ESBL.

[Reversal from non-depolarising neuromuscular blockade in the postoperative period].

Background: Postoperative residual curarisation (PORC) is a serious and underestimated problem and may occur even after relaxation with medium-acting non-depolarising agents.

Methods: One hundred adult patients, scheduled for elective surgical procedures, were enrolled in the study. Atracurium or cis-atracurium was used for relaxation.

[Remifentanil-based anaesthesia in a patient with myasthenia gravis].

Background: Anaesthesia of a patient with myasthenia gravis requires special preoperative management and proper choice of intraoperative agents. The disease should be treated until surgery and some anaesthetics (e.g.

[Nosocomial infection control in intensive therapy].

Background: Nosocomial infections are common among patients treated in ITU settings. The lower airway and genitourinary systems are frequently infected with multiresistant pathogens, and present a serious epidemiological problem. In 2002, at the Lódź Medical University Hospital, strict infection control measures were developed and introduced to minimize the risk of infections in the ITU.

[Analysis of the epidemiological situation and the resistance phenotype of pathogens isolated from patients in the intensive care unite of the Lodz Medical University Hospital No.1 in 2002-2006].

In the period of 2002-2006, total 5152 isolates were obtained from 1330 patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1. A detailed analysis of the epidemiological situation concerned, first of all, MRSA, Ps.

[Sepsis--a new life-threat or better defined old disease entity].

The presence of multiresistant pathogens in a hospital leads very often to a severe sepsis that threatens the patients' life. For this reason, in the interests of the patients in the Intensive Care Unite (ICU) of the Lodz Medical University Hospital No.1, a wide monitoring of the epidemiological situation and the rational antibiotic therapy, taking the resistance mechanisms of pathogens into account, have been started since 2002.

Results of severe sepsis treatment program using recombinant human activated protein C in Poland.

Background: Recombinant human activated protein C (drotrecogin alfa [activated]--DAA) demonstrated in Phase III controlled clinical studies significant reduction of mortality in patients with severe sepsis and high risk of death. The aim of the study was to assess the therapeutic efficacy of DAA in patients included in the National Severe Sepsis Register in Poland.

Material/methods: The analysis included 3233 cases of severe sepsis reported between 04.