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

2016b

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Dear colleagues,

From 2004, the presence of the Greek e-Journal of Perioperative Medicine among the National Scientific Journals has been gradually increased. On behalf of the editorial board of the Greek e-journal of the Perioperative Medicine, we would like to thank you for your support in order to reform and modernize our journal.

We would like to inform you that the Greek e-journal of the Perioperative Medicine is accepted in several indexing databases like DRJI – Directory of Research Journal  Indexing, Research Bible, GIF.org, Journal Index.net, INNOSPACE, Unifactor.org, MJL-Medical journals Links, ICMJE- International Committee of Medical Journal Editors, CiteFactor.org, ISI-International Scientific Indexing, EZB – Universitätbibliothek Regensburg, OAJI – Open Access Journal Indexing, PBN-Polska Bibliografia Naukowa, ESJI- Eurasian Scientific Journal Index, ISRUS (EyeSource) – International society of Universal Research in Sciences, JIF – Global Society for Scientific Research and DOAJ – Directory of Open Access Journals.

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After the implementation of Common Assessment Framework (CAF) – a useful quality tool – in the ICU of General Hospital of Trikala from 2012 up to 2015, we integrated the first cycle of self assessment and we present our results and conclusions of the past 3-year-period (2012- 2013 -2014). We analyzed CAF, FS- ICU 24, TISS-28 and Burn out syndrome questionnaires and medical indicators as Standardized mortality rate (SMR), Length of Stay (LOS), Standardized Resource Use (SRU), SMR/SRU, Therapeutic intervention scoring system (TISS-28), TISS-28/days of hospitalization, Nurse/Patient ratio, cost indicators and mortality. Analyzing the CAF questionnaire the score was 2.5-3.5, counting the indicator TISS-28 we found an average value higher than 50, concerning the burn-out syndrome questionnaire it was found that 58.82% of the respondent employees working in the ICU had mild symptoms of the syndrome. We analyzed the true Level of ICU (TISS-28/days of hospitalization) with the Level of ICU (nurse /patient ratio) and we found that they were not alike. We found an increase of mortality rate and LOS (length of stay) during the period of 2011 –2015 but a gradual reduction of the SMR/SRU indicator (the whole period ≤ 1) and a decline of the average cost/ patient and the average cost/ day of hospitalization.

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The interaction between increased Intra Abdominal Pressure (IAP) and Intrathoracic Pressure under different Positive End Expiratory Pressure (PEEP) levels is intriguing, since these two conditions coexist frequently in several clinical settings. The aim of our study was to investigate the interaction between different PEEP levels and increased IAP during laparoscopic cholecystectomy. In fifty two patients, who underwent scheduled laparoscopic cholecystectomy, cardiovascular parameters were determined by an Oesophageal Doppler Monitor device during two different time periods, before and after pneumoperitoneum, and under five conditions: (i) PEEP 0 cmH2O (ii) PEEP 5cm H2O (iii) PEEP 10cm H2O (iv) PEEP 15cm H2O and (v) in the absence of PEEP or ventilation. Cardiac output and stroke volume showed a statistically significant decrease compared to the baseline value after the application of different PEEP levels, when there was no pneumoperitoneum (p<0.05). However, both parameters increased, when PEEP and pneumoperitoneum were applied together (p<0.001). Corrected flow time, peak flow velocity in the descending thoracic aorta and mean acceleration showed similar alterations but not at all PEEP levels. Finally, αt the no PEEP or ventilation phase, the negative effects of increased IAP on the cardiocirculatory function were predominant. According to these results, application of PEEP seems to counterbalance the negative hemodynamic effects of increased IAP. Moreover, it could also be concluded that ‘ideal’ PEEP level might be the one that borders the IAP level, since the best cardiac output and stroke volume values were reported at that point.

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We report a rare case of a young woman with anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis, who developed psychiatric symptoms, dyskinesias, hypoventilation, hypersalivation and seizures. Serial analysis of antibodies to NR1/NR2B heteromers of the NMDAR was positive on the patient's serum and cerebrospinal fluid (CSF). Removal of an ovarian teratoma after intravenous immunoglobulin and corticosteroid therapy resulted in a prompt neurological response.

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During recent years the application of non invasive ventilation (NIV) has emerged as a central component of respiratory failure management, acute and chronic. Although the use of NIV in acute respiratory failure was initially meant to be given in critical care units, it is nowadays natural to provide it in other settings as well, provided that there are the necessary resources and expertise. NIV represents a viable alternative to endotracheal ventilation and despite most data refer to patients with chronic obstructive pulmonary disease; its indications are continuously expanding to cover more clinical scenarios. Randomized controlled studies are needed in order to provide sound evidence regarding optimal patient-ventilator interface, NIV duration and ventilation parameters in thoracic surgery patients.

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