Apneic oxygenation is an adjunct „ventilation‟ technique that involves insufflation of oxygen at varying flows through a catheter that is inserted through the endotra-cheal tube and is positioned above the carina. Apneic oxygenation improves gas exchange efficiency and preserves the arterial oxygenation at an acceptable level.
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A lot of techniques have been tested for their potential to salvage myocardial tissue during an episode of acute ischaemia. Techniques that are applied before the onset of acute ischaemia, i.e. preconditioning techniques, have proved to be really protective, but scheduled ischaemia or at least high probability for the timing of it’s occurrence, is a pre-requisite for their application. This disadvantage led to experimentation on techniques that can be applied immediately after the onset of acute ischaemia or at least on the time of reperfusion.
Continue readingEarly tracheal extubation has been safely performed after large operative procedures, questioning the need for routine postoperative ventilation. Because immediate postoperative tracheal extubation of liver transplanted patients has not been previously reported in Greece, we announce the first case report.
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A majority of current pharmacokinetic and pharmacodynamic data are generated from studies in healthy volunteers and stable patients with single organ dysfunction. However, critically ill patients differ from other patients because of the complex and unstable nature of their illness. Critical illness results in multiple changes that alter drug disposition in the body. As organs fail, so the pharmacokinetic processes of absorption, distribution, and elimination are affected.
Continue readingThe ability of the cerebral vascular bed to undergo constriction or dilation in response to various stimuli is termed vascular reactivity or cerebral autoregulation. When the stimulus is the change in cerebral perfusion pressure (CPP) the vascular response is termed cerebrovascular pressure reactivity. When the stimulus is the change in PaCO2 the vascular response is termed carbon dioxide reactivity. The transcranial Doppler (TCD) provides information about changes in flow velocities secondary to changes in CPP or PaCO2.
Continue readingThe reduction of homologous blood transfusions remains an important goal. The actual blood loss and the positive fluid balance during cardiac operations involving CPB result in a fall in the haematocrit and represent major risk factors for blood transfusions. Methods and techniques which lead to a decrease of haemodilution are important when aiming at fewer transfusions in such operations.
Continue readingThe management of patients, who had previously undergone percutaneous coronary interventions (PCI) with or without coronary artery stenting and who are presenting for noncardiac surgery has become a major topic of interest and concern for anesthesiologists worldwide. This review will update recent reports, as well as recommendations for the perioperative care of these patients.
Continue readingInevitably, ethical dilemmas and end-of-life decisions are issues that need to be faced in the common practice of intensive care units. In this review these dilemmas are approached through the medical ethical issues of patient autonomy, beneficence, non-maleficence and justice. Patient autonomy is further analyzed as opposed to medical paternalism with reference to historical, political, social and legal particularities.
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The aim of our study was to compare video laryngoscopy and direct laryngoscopy views, and the resultant intubation conditions as well, provided by video or conventional laryngoscope respectively, in patients receiving general anaesthesia for elective surgery. One hundred patients, with no expected difficult airway, were randomly allocated to undergo tracheal intubation with the Macintosh video laryngoscope or a conventional Macintosh laryngoscope.
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