Myasthenia Gravis (MG) is an autoimmune disorder affecting the neuromuscular junction function and causing muscle weakness that gets worse during the day and after physical activity. The most common medication prescribed for MG treatment is pyridostigmine. Continue reading
Anaphylaxis is a severe, potential life threatening allergic reaction, which is characterized by rapid onset and varied clinical manifestations involving in most of the cases the respiratory and cardiovascular systems and sometimes skin and mucosa. Twentysix patients (16♀ & 10♂) with a mean age of 59.7± 8.6yrs were included in this study. Continue reading
The work of breathing (WOB) is the amount of energy, which is consumed by the respiratory muscles, in order to perform one complete respiratory cycle. In several medical conditions, WOB might rise to a critical level which could necessitate initiation of mechanical ventilation (MV) or complicate weaning of the patient from MV. Continue reading
Four patients (♂/♀: 1/3), aged 51, 52, 50 and 58 years old, who underwent general surgery procedures, suffered acute major blood loss intraoperatively. For the management of acute hemorrhage, 4ml/kg NaCl 7.5% were administered in each patient at the fastest possible rate through the existing intravenous line. Both standard monitoring and Oesophageal Doppler Monitoring (ODM) were applied and heart rate (HR), mean arterial pressure (BPmean), stroke volume (SV), peak velocity (PV), mean acceleration (MA) and corrected flow time (FTc) were recorded at six different phases, before blood loss (Phase 1), before and after completion of NaCl 7.5% administration (Phases 2 & 3), 10min and 20min after NaCl 7.5% administration (Phases 4 and 5) and at the end of the surgical procedure (Phase 6). Continue reading
Anesthesia for thoracic surgery presents specific challenges since anesthesiologists have to manage patients with several comorbidities, apply One Lung Ventilation (OLV) to facilitate surgery and at the same time they should try to maintain adequate safe oxygen levels. Hypoxemia is a common consequence of OLV. The aim of the present retrospective study was to investigate the impact of intraoperative hypoxia on the early outcome of patients. Continue reading
Increased Intraabdominal Pressure (IAP) is common in critical care patients and has detrimental effects on organs and systems. Several mechanisms and causes are involved in its pathogenesis. The aim of the present study was to investigate and record IAP effects alone and in combination with sepsis on respiratory mechanics. Continue reading
Η περιεγχειρητική χορήγηση υγρών αποτελεί τον ακρογωνιαίο λίθο στη διαχείριση των χειρουργικών ασθενών, αλλά και σημείο έντονων επιστημονικών αντιπαραθέσεων και διχογνωμιών για το είδος και την ποσότητα των χορηγούμενων διαλυμάτων3,4
. Οι χειρουργικοί ασθενείς κατά την περιεγχειρητική περίοδο, χρειάζονται υγρά, και μερικές φορές απαιτούνται μεγάλες ποσότητες για τη διατήρηση του ενδαγγειακού όγκου και της αιμοδυναμικής σταθερότητας. Ο περιορισμός στη χορήγηση υγρών αλλά και η υπερχορήγηση μπορεί να δημιουργήσουν προβλήματα ικανά να επηρεάσουν την έκβαση5,6
. Continue reading
Several prevention and treatment strategies have been applied in order to prevent hypoxemia after open heart surgery with comparable good results.
The aim of this study is to compare the effectiveness of two different alveolar recruitment maneuvers [RM] for the management of oxygenation impairment in cardiac surgical patients.
A total number of sixty patients were included in this study. All patients underwent cardiac surgical procedures with extracorporeal circulation and developed oxygenation impairment after withdrawal of extracirculation support and sternal closure.
Patients were randomly assigned into two Groups A and B according to the applied RM. In Group A three hyperinflations of the lungs were applied at an airway pressure of 40cmH2
O for 10 sec, whereas in Group B Pressure Control Ventilation was applied for 2min with the inspiratory pressure set at 40cmH2
O. After application of any of the two RM, PEEP was increased from 5 to 10 cmH2
O in all patients. Anesthesia induction and maintenance and mechanical ventilation settings were similar in both study Groups. Continue reading
Pericardial decompression syndrome (PDS) is a rare but eventually fatal syndrome, which occurs after pericardial drainage. In this report we describe a patient who suffered from cardiovascular collapse and pulmonary edema after pericardial drainage. A male patient aged 42yrs complained of progressive dyspnea over the past 2 months and presented with clinical signs of pericardial tamponade. The patient underwent a surgical subxiphoid pericardial drainage under general anesthesia and mechanical ventilation. After pericardial drainage of 2.2lt, the patient was transferred to the Intensive Care Unit, where he was extubated2 hours later. Immediately after extubation, he showed clinical signs of cardiovascular collapse and pulmonary edema. The patient was reintubated immediately and placed on mechanical ventilation. He was extubated after 12hrs. His postoperative course was uneventful and he was discharged from the hospital after a few days. Continue reading