EAEIBE
Εταιρεία Αναισθησιολογίας και Εντατικής Ιατρικής Βορείου Ελλάδας (ΕΑΕΙΒΕ)
HSA
Ελληνική Αναισθησιολογική Εταιρεία

Trend towards noninvasive, easy to use monitor was always a challenge. Numerous indices have been used to monitor the progress of patients on positive pressure ventilation. The present study compares different indices in a mixed larger intensive care unit (ICU) population. In a prospective observational study Arterial blood gases (ABG) analyses were obtained from 225 patients under mechanical ventilation in a polyvalent adult ICU. Values of ideal body weight (IBW), Body mass index (BMI), PAO2, PaO2/FiO2 ratio (PFr), SpO2/FiO2 ratio (SFr), SpO2/PEEP ratio (SPr), SpO2/PaCO­2 ratio (SPCr), Oxygenation index (OI) and Ventillatory ratio (VR) were calculated; and further correlation analysis was conducted. In Pressure control ventilation mode a relative strong relation between PFr and SFr and OI was found; yet further regression analysis implies that no direct replacement of PFr with SFr can be made without limitations, in clinical setting. In Volume control ventilation mode moderate relation was found between SFr and PFr. In the present study a moderate relation was found between SFr and PFr. The results agree with previous published studies; the differences among them lie in the different design of each one of them. The authors believe that- given the fact that one still considers using broadly PFr as index of oxygenation- SFr can be used safely as a surrogate for PFr only for certain disease states. Larger series are needed in order to define those patients groups and these pathophysiological conditions.

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Transfusion related acute lung injury (TRALI), first described as a clinical entity in 1983, is characterized by acute non cardiogenic pulmonary oedema with hypoxia occurring within few hours of receiving blood products. It accounts for 1:5000 of all known transfusion reactions and is one of the leading causes of transfusion related death, approximately 5%. TRALI is thought to be underrecognised and under-reported. Suspected cases should be reported to the blood bank so any other products from the particular donor may be quarantined.

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Technological advances in medicine and the development of intensive care units have faded the frontiers between life and death. Brain death is a diagnosis and there are prerequisite criteria, a differential diagnosis and a decision making process to consider which must be unambiguous, straight forward, understandable and infallible.

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