Česká anesteziologická cesta 2025

Horáček M., Beneš J.

Anest. intenziv. Med. 2025;36(4):237-238 | DOI: 10.36290/aim.2025.056

Experiences of HCPs working at ICUs with a virtual reality in postgraduate training - multicentre survey

Prokopová T., Diabelko D., Vafková T., Klabusayová E., Hudec J., Štourač P.

Anest. intenziv. Med. 2025;36(4):241-246 | DOI: 10.36290/aim.2025.039

Objective: The primary goal of this study was to explore the experience of health care professionals (HCPs) working at intensive care units (ICUs) with virtual reality (VR) involvement in postgraduate training. The second goal was to explore the expectations and common concerns associated with the VR-based courses. Design: Observational online cross-sectional survey. Setting: ICUs of various types across hospitals in the Czech Republic. Material and methods: An online questionnaire for HCPs working at ICUs. Methods of descriptive statistics were used for data interpretation. Results: A total...

Comparison of ibuprofen and paracetamol combination with ketorolac and paracetamol in patients undergoing gynecologic surgery:  A review of pain level, coagulation profile, and interleukin-6 levels

Maarif M. K., Musba A. M. T., Datu M. D., Gaus S., Wirawan N. S., Adil A.

Anest. intenziv. Med. 2025;36(4):247-252 | DOI: 10.36290/aim.2025.043

Background: Postoperative pain management in gynecological surgery remains a significant challenge, with many patients experiencing moderate to severe pain despite standard analgesic interventions. The risk of complications, such as bleeding and prolonged recovery, is heightened by the use of certain analgesics, emphasizing the need for optimal pain management strategies. This study compares the efficacy of two multimodal analgesic regimens-ibuprofen-paracetamol and ketorolac-paracetamol-on pain, coagulation, and interleukin-6 (IL-6) levels.  Methods: A double-blind randomized trial was conducted with 40 patients undergoing gynecological surgery....

Hypertonic sodium lactate solution in the resuscitation of septic shock: a narrative review of pathophysiology, preclinical and clinical data

Kříž M., Nalos M., Vintrych P., Müller J., Raděj J., Matějovič M.

Anest. intenziv. Med. 2025;36(4):253-261 | DOI: 10.36290/aim.2025.047

Aim: Excessive fluid accumulation during fluid resuscitation is associated with increased mortality and organ dysfunction. The promise of personalized fluid therapy lies in maximizing its benefits while minimizing the harmful effects of fluid resuscitation. This includes prediction of the hemodynamic response to infusion and careful consideration of its volume and composition in the context of the clinical situation. In light of recent paradigm shifts in lactate metabolism, we therefore discuss current evidence on the concept of low-volume intravenous resuscitation with hypertonic sodium lactate (HSL). Design: A narrative review of the current literature...

Current methods of cardiac output monitoring

Klimovič A., Smékalová O., Kletečka J., Beneš J., Zatloukal J.

Anest. intenziv. Med. 2025;36(4):262-271 | DOI: 10.36290/aim.2025.048

Cardiac output monitoring and other parameters as part of extended hemodynamic monitoring represent an advanced tool for the early detection of circulatory disturbances that cannot be identified through standard vital sign monitoring. Such disturbances may lead to inadequate tissue oxygen delivery and subsequent clinical deterioration. Extended hemodynamic monitoring is indicated in patients who do not respond to initial therapy, and in the perioperative setting, it is recommended for high-risk patients undergoing high-risk surgical procedures. The choice of cardiac output monitoring modality may be challenging due to the wide range of available technologies,...

The specifics of psychiatric patients in the context of anaesthesia

Apjarová T., Bönischová T., Kosinová M., Štourač P.

Anest. intenziv. Med. 2025;36(4):272-279 | DOI: 10.36290/aim.2025.045

The prevalence of psychiatric disorders is rising globally, with one in five individuals now affected. As a result, patients taking psychotropic medications are encountered frequently in clinical practice. This article explores the specific considerations in providing anaesthetic care to psychiatric patients, with a focus on pharmacological interactions between psychotropic and anaesthetic drugs, as well as on the risks associated with their combined use. Additionally, the article discusses strategies to minimize potential complications during the perioperative period.

Risk­‑assesment before lung surgery - what's new? Narrative review article

Bartoš Š., Predáč A., Čundrle I.

Anest. intenziv. Med. 2025;36(4):280-286 | DOI: 10.36290/aim.2025.041

Surgical treatment is the primary therapeutic option for patients with early-stage lung cancer. The most common causes of perioperative morbidity and mortality in these patients are postoperative pulmonary complications. Peak oxygen consumption (VO2) has long been considered the gold standard for predicting these complications. In recent years, several new parameters for risk assessment have been described in peer-reviewed journals, notably ventilatory efficiency (VE/VCO2 slope) and end-tidal CO2. Both parameters have demonstrated excellent predictive ability for postoperative pulmonary complications, even in patients in whom peak VO2 failed. This...

Patient with progressive pulmonary tuberculosis on ECMO

Mica P., Rychlíčková J., Čundrle I., Pokorná A.

Anest. intenziv. Med. 2025;36(4):287-291 | DOI: 10.36290/aim.2025.046

Miliary pulmonary tuberculosis is a rare but severe form of disseminated disease that can lead to acute respiratory distress and multiorgan failure. We present the case of a 46-year-old man whose tuberculosis manifested as severe respiratory failure requiring artificial pulmonary ventilation and subsequent use of extracorporeal membrane oxygenation. The case highlights the diagnostic difficulty, complexity of care and therapeutic challenges with emphasis on individualized pharmacotherapy in an interdisciplinary collaboration.

Translumbar access to the inferior vena cava - rescue option for insertion of a central venous catheter

Michálek P., Brožek T., Kaván J., Forejtová L., Novák M., Malík J.

Anest. intenziv. Med. 2025;36(4):292-295 | DOI: 10.36290/aim.2025.054

Long-term central venous access is currently indicated mainly in patients receiving parenteral nutrition, dialysis, or chemothera­py. Some patients require the catheter to be inserted repeatedly or for a period longer than one year. A translumbar approach with direct insertion of a central venous catheter into the inferior vena cava can be an alternative in cases of confirmed superior vena cava obstruction or significant stenosis. This technique is relatively difficult; it requires fluoroscopy or computed tomography guidance and cooperation of an interventional radiologist. This review article describes indications, technique of insertion, and complications...

Letter to the Editor: Transient BIS elevations during caloric testing in brain death: artifactual or physiological?

Ceylan Delice M., Kavrut Ozturk N.

Anest. intenziv. Med. 2025;36(4):296-297 | DOI: 10.36290/aim.2025.049

Ocenění ČSARIM 2025

Redakce

Anest. intenziv. Med. 2025;36(4):298-301

Abstrakty posterů z kongresu ČSARIM 2025

Redakce

Anest. intenziv. Med. 2025;36(4):302-313

Highlights from literature

Horáček M., Klučka J., Skříšovská T.

Anest. intenziv. Med. 2025;36(4):314-321