Shock represents an acute, life-threatening condition characterized by inadequate tissue perfusion and oxygenation, ultimately leading to multi-organ failure. Timely and targeted restoration of intravascular volume through fluid resuscitation remains a cornerstone of initial management. However, the traditional strategy of aggressive fluid administration has come under scrutiny in recent years, due to the risks associated with fluid overload and its related complications. Continue reading
Ten to twenty percent of the patients hospitalized in an Intensive Care Unit (ICU) will require tracheostomy, either due to long term hospitalization or due to other medical conditions. The procedure itself, as well as the afterward care; carry a lot of potential complications for the patients, some of which may be preventable, if certain precautions are being taken. The decision for the type of the procedure, percutaneous tracheostomy or surgical tracheostomy along with the appropriate tracheostomy tube type is based on the individual characteristics of the patient, ie anatomical characteristics, clinical stability and expertise available. Continue reading
Nalbuphine is a synthetic mixed agonist -antagonist opioid that has long been used for perioperative care. Yet, its use in critical and emergency medicine settings was still relatively low till recently. The current article provides an update of literature regarding nalbuphine in those two specific areas. Continue reading
Η αυξημένη πρόσληψη νατρίου έχει συσχετιστεί με αυξημένα επίπεδα αρτηριακής πίεσης και αυξημένο κίνδυνο εμφάνισης καρδιαγγειακής νόσου. Επίσης, η αναλογία νατρίου/καλίου μπορεί να αποτελέσει ανεξάρτητο παράγοντα πρόβλεψης καρδιαγγειακών συμβάντων, ενώ η ενσωμάτωση τροφών ή συμπληρωμάτων διατροφής πλούσιων σε διττανθρακικά μπορεί να προσφέρει σημαντικά οφέλη στην υγεία. Continue reading
Surgery, as a field itself, is a high stress and high pressure workplace environment. The difficulty that surgeons face, in maintaining their work-life balance along with the increasing litigation instances, has made this profession a less rewarding one. Continue reading
Aortic aneurysms occur mainly due to atherosclerotic disease, and their conventional surgical repair is reserved for patients with anatomy unfavorable to endovascular repair. In this context, one of the challenges for the anesthesiologist is perioperative anesthetic-analgesic control. Continue reading
Orthotopic liver transplantation (OLT) has become a relatively safe procedure over the last decades, with reported 5-year survival rate of over 80%. Increasing numbers of patients will be transplated at a younger age and they will seek obstetric anaesthesia services, as their fertility is restored after succesful transplantation. In 1978, the first succesful pregnancy was reported. Continue reading
Medical nutrition therapy shall be considered for all patients staying in the intensive care unit (ICU), mainly for more than 48 hours. It is well-known that over- and underfeeding are associated with worse outcome, so optimization of nutrition support is one of the most important goals of clinicians. Continue reading
Procedural sedation and analgesia (PSA) is often necessary in order to deal with anxiety, pain and stress that may accompany patients at the hospital during invasive, unpleasant and/or painful procedures. The literature has not presented firm conclusions regarding ideal sedative agents in terms of efficacy and safety in PSA or even present firm data regarding superiority of specific drugs over others which are considered the “gold-standard” in sedation (i.e. propofol). Continue reading
Neuraxial analgesia and anaesthesia in an obstetric patient is associated with the risk of accidental dural puncture and subsequent development of a post dural puncture headache (PDPH). The management of accidental dural puncture requires consists of prevention of PDPH, patient’s information, early diagnosis, treatment, and monitoring until remission of PDPH. Continue reading
