Factors affecting cardiac function in dialysis patients include arterial blood pressure, anemia, intra-vascular volume and the arteriovenous fistula (AVF). We investigated the acute and chronic effects of basilic vein transposition (mean upper arm brachial artery-basilic vein anastomosis) on both the cardiovascular system and the oxygen status.
Sixteen patients with end stage renal failure were enrolled in this study. Patients with heart failure, pericardial effusion or valvular heart disease were not included in the study. Echocardiography (preoperatively and six months after, stages 1 and 2 respectively) and a Swan-Ganz catheter (perioperatively) were used to assess the hemodynamic status during the phases of AVF construction. Flow measurements were made in the parts of the AVF system before, during and after the construction of the AVF.Moreover, at the same time phases blood sampling from the arterial line and the pulmonary artery catheter was performed, in order to assess oxygen and acidbase status.
Continue readingThe incidence of preeclampsia in the western countries is estimated to range from 2% to 6% in healthy, nulliparous women. In developing nations, the incidence of the disease is reported to be 4- 18%,with hypertensive disorders being the second most common obstetric cause of stillbirths and early neonatal deaths in these countries Etiology of the disease is multifactorial, with risk factors like ma-ternal age, oxidative stress, angiotensin T-235 homozygote having a different role in every case. Moreover, the disease its self is a multisystem expression of a complicated pathophysiology. Many attempts to explain the latter have been made with often controversial results. In the present article we explore the hypothesis of intra-abdominal pressure as possible causative factor of preeclampsia and the role ofthe maternal venous compartment and rennin-angiotensin-anldosterin system in this hypothesis. Continue reading
Effective postoperative analgesia in geriatric patients is both challenging and rewarding. Inadequate pain control after surgery is associated with adverse outcomes in the older patient. This review will attempt to describe the difficulty with assessment of pain and variations in pain experience of elder-ly patients. Physiological changes related to aging need to be also carefully considered, because a-ging is individualized and progressive. Pharmacokinetic and pharmacodynamic changes in geriatric patients, the higher incidence of co-morbidities and concurrent use of other drugs, must be carefully adjusted to suit each geriatric patient, concerning postoperative pain management. Medication for postoperative pain will be discussed. Unfortunately, many medications have not been studied well in the older population.Non-pharmacological approaches to postoperative pain management will not be discussed, although this would be an interesting topic for further discussion. Continue reading
- Letter from the Editors
- Epidemiology, Diagnosis and managment of delirium int he Intensive Care Unit: Anarrative review of the literature
- Review of statistical methods reported in oral presentations during seven Greek National Anesthesiology Conferences
- Pediatric risk of Mortality (Prism III-24) performance in a Greek Pediatric Intensive Care Unit
- Ο συνδυασμός Κεταμίνης με Μορφίνη, Ναλμπουφίνη ή Τραμαδόλη για την αντιμετώπιση του μετεγχειρητικού πόνου μετά από επεμβάσεις ριζικής προστατεκτομής
- Improvement of the visualization of larynx and successful intubation with Airtraq® optical laryngoscope. in nine neonates, in fants and children with difficult airway
- Dose titration of sublingual fentanyl, in relation to transdermal fentanyl dosing in cancer patients
- Σύνδρομο Αναστρέψιμης Οπίσθειας εγκεφαλοπάθειας [Posterior Reversible Encephalopathy Syndrome (PRES)] σε άνδρα ηλικίας τριάντα ετών. Παρουσίαση περιστατικού και ανασκόπηση της βιβλιογραφίας
Αγαπητοί συνάδελφοι,
Εκ μέρους της επιτροπής σύνταξης του περιοδικού σας ευχαριστούμε για τη μέχρι σήμερα εμπιστοσύνη και συνεργασία και προσδοκούμε στην περαιτέρω συνεισφορά σας ώστε να συνεχίσει την πορεία του στο χώρο τόσο του ελληνικού όσο και του διεθνούς ιατρικού τύπου.
Το ηλεκτρονικό Ελληνικό Περιοδικό Περιεγχειρητικής Ιατρικής είναι επιστημονικό έντυπο δημοσίευσης ερευνητικού και κλινικού υλικού από όλο το φάσμα της Αναισθησιολογίας, της Επείγουσας και της Εντατικής Ιατρικής, αναγνωρισμένο από το ΥΥΚΑ στα εθνικά περιοδικά (ΦΕΚ 964/20-7-2006) με επίσημο ISSN (1109-6888).
Continue readingDelirium, a serious and common manifestation of brain dysfunction in critically ill patients gained great attention over the last decade. Important risk factors such as use of benzodiazepines, coma, preexisting cognitive impairment, alcoholism and high severity of illness at ICU admission were i-dentified. Screening tools like the CAM-ICU and the ICDSC were extensively validated in many different ICU patient populations and are recommended for routine monitoring in everyday practice. Sedation with novel sedatives such as dexmedetomidine, implementation of non pharma-ceutical, preventive interventions and early mobilization of patients may reduce the incidence of this syndrome. The role of haloperidol and atypical antipsychotics in the prevention and treatment of ICU delirium is still under investigation.
Continue readingThe application of statistical methods in order to extract safer conclusions from samples of medical data has become a key methodology for synthesis and evaluation in any medical research. This study makes a retrospective overview of statistical methods used for oral presentations in the summaries of Greek anesthesia conferences and tries to “capture” the change in the use of statistics in recent years. Nine hundred and twenty five oral presentations from seven Greek anesthesia conferences were included for further analysis.
Continue readingThe purpose of this study was to investigate the performance of the Pediatric Risk of Mortality (PRISM III–24) in a Greek pediatric intensive care unit (PICU). We prospectively followed 300 PICU patients in an observational cohort study. PRISM III-24 performance was assessed in the whole population and in 4 preselected groups (infants, patients with length of PICU stay > 4 days, patients with co-morbidities, ventilated patients) with standard discrimination and calibration me-thods.
Continue readingThe study compares the efficacy of postoperative analgesia after the intravenous administration of opioids (nalbuphine, tramadol or morphine) in combination with ketamine in patients undergoing radical prostatectomy.Eighty eight patients scheduled for radical prostatectomy were randomly assigned in three groups. In Group A (n=31) Morphine was administered {bolus dose (BD) 0.05mg/Kg and continuous infusion (CI) at a dose [mg/24h =18-(agex0.15)]}, in Group B (n=28) Nalbuphine (BD 0.2mg/kg and CI at a rate 0.05mg/kg/h) and in Group C (n=29) Tramadol (BD 1.5mg/Kg and CI at a rate 0.15mg/Kg/h).
Continue readingThe goal of this observesional study was to evaluate the improvement of the visual view of the la-rynx in neonates, infants and children with difficult airway using the Airtraq® Optical Laryngosco-pe, compared with visual views of the first conventional laryngoscopy with Macintosh blade. We studied clinical and/or laryngoscopic manifestations of difficult airway and advanced airway mana-gement of nine consecutive pediatric patients (2 neonates, 5 infants and 2 children) admitted from 1/1/2011 to 31/08/2012 for elective/emergency surgery or diagnostic procedure under general anes-thesia.
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