Selective peripheral nerve blocks of the upper extremityReview Article

Nalos D., Naňka O., Beňo L., Zapletal J.

Anest. intenziv. Med. 2024;35(4):236-241 | DOI: 10.36290/aim.2024.058  

The aim of this article is to provide an overview of the possibilities of selective peripheral nerve blocks of the upper extremity suitable for minor surgical procedures and invasive analgesic treatment. The development of ultrasound assistance allows for more precise localization of the course of nerves and offers the possibility of selective blockades with minimal impact on postoperative mobility. To facilitate needle tip navigation, the article emphasizes the relationship of nerve pathways to vascular, muscular, and fascial structures.

Since when is salt acidic? Do we really understand hyperchloremic acidosis?Review Article

Šitina M.

Anest. intenziv. Med. 2024;35(4):229-235 | DOI: 10.36290/aim.2024.028  

The article compares 2 perspectives on acid-base considerations. The formal view, of Stewart, is suitable for exact calculations, but less intuitively understandable, since it does not deal with the question of the internal mechanisms of acid-base processes, but suffices to satisfy formal physical-chemical laws. And the intuitive view, which provides a comprehensible qualitative idea of the direction, toward acidosis or alkalosis, in which acid-base will evolve. The article further explains the nature of dilutional and hyperchloremic acidosis and shows that not NaCl but water in solution is its cause.

Issues of pain assessment in patients with delirium in intensive care - narrative reviewReview Article

Mica P., Čundrle I.

Anest. intenziv. Med. 2024;35(4):223-228 | DOI: 10.36290/aim.2024.044  

Intensive care patients frequently experience delirium and pain. Their occurrence is a contributing factor to the increased morbidity and mortality and organ complications in these patients. For a variety of reasons, the evaluation of pain in delirium patients is challenging. It is advisable to employ validated tools for its evaluation. Initiating targeted therapy and identifying pain and delirium early are the primary responsibilities of the attending staff.

Enoxaparin dosage and incidence of venous thromboembolism in critically ill patients with COVID-19Original Article

Beneš J., Kalina M., Černý V.

Anest. intenziv. Med. 2024;35(4):215-222 | DOI: 10.36290/aim.2024.032  

Objective: COVID-19 is associated with a high risk of thromboembolic disease (VTE) and this risk is further increased in critically ill patients. Elevated D-dimer levels are a predictor of severe COVID-19 disease. Data on the incidence of VTE, mortality of critically ill patients with COVID-19, and its association with the dose of prophylactic anticoagulation in Czechia have not been published. We performed a retrospective analysis of patients with COVID-19 admitted to the intensive care unit. The primary endpoint was new-onset deep vein thrombosis during ICU stay. Secondary objectives were incidence of pulmonary embolism, venous thromboembolism (deep...

The XXX national CSARIM congress abstractsCongress abstracts

redakce

Anest. intenziv. Med. 2024;35(3):199-208  

CSARIM 2024 awardsReports from professional societies

redakce

Anest. intenziv. Med. 2024;35(3):192-198  

CSARIM awards: what is their meaning in the context of the fieldEditorial

prof. MUDr. Vladimír Černý, Ph.D., FCCM, FESAIC, prof. MUDr. Jan Beneš, Ph.D. 

Anest. intenziv. Med. 2024;35(3):139  

Congress EMHG 2024, BrnoReports from professional societies

Klincová M., Štěpánková D., Schröderová I., Tomášková V., Štourač P.

Anest. intenziv. Med. 2024;35(3):190-191 | DOI: 10.36290/aim.2024.037  

The forgotten pioneer of medicine Med. et Chir. Dr. Augustin GöttingerShort Communication

Vetešník J.

Anest. intenziv. Med. 2024;35(3):188-189 | DOI: 10.36290/aim.2024.035  

Choosing the optimal vascular access in perioperative and intensive careShort Communication

Astapenko D., Kletečka J., Řehák D., Nosková P.

Anest. intenziv. Med. 2024;35(3):185-187 | DOI: 10.36290/aim.2024.036  

A case of whole­‑body rigidity in a patient after orthopedic surgeryCase Report

Tlapáková K., Černá Pařízková R., Astapenko D.

Anest. intenziv. Med. 2024;35(3):182-184 | DOI: 10.36290/aim.2024.031  

In our case report, we present a case of swiftly manifesting malignant neuroleptic syndrome in a patient after orthopedic surgery who was treated for a new onset of delirium with a combination of antipsychotic drugs. Thanks to early diagnosis and treatment the patient didn't suffer any organ dysfunction and could have been discharged from our intensive care unit in two days back to the standard unit. The goal of this case report is to highlight this rare yet still life-threatening condition to our colleagues to help them take care of patients with such diagnoses in the future.

The importance of perfusion and preservation solutions in perioperative medicineReview Article

Navrátil P., Břízová P., Astapenko D.

Anest. intenziv. Med. 2024;35(3):176-181 | DOI: 10.36290/aim.2024.029  

Perfusion and preservation solutions are indispensable in the field of cardiothoracic surgery and transplantation. These solutions, developed to protect and maintain organs during surgical interventions, are crucial for preserving their viability and improving surgical outcomes. In the context of cardioplegia, they provide heart protection during cardiothoracic surgeries, enabling controlled cardiac arrest while minimizing myocardial metabolic activity. In transplantation, they maintain organ functionality during storage and transport. Research focuses on developing new solutions and techniques to further improve the organ protection and efficiency...

Perioperative care of patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary endarterectomy - twenty years of experience at an expert Centre in the Czech RepublicReview Article

Kunstýř J., Lindner J., Jansa P., Michálek P.

Anest. intenziv. Med. 2024;35(3):168-175 | DOI: 10.36290/aim.2024.027  

This year marks the 20th anniversary of the launch of the chronic thromboembolic pulmonary hypertension (CTEPH) surgical treatment programme, which involves three departments of the Cardiac Centre of the General University Hospital in Prague. Diagnosis and decision-making on the type of treatment, including indication for surgical treatment, is carried out at the Centre. Other non-surgical treatments and long-term dispensary care are also available to patients. Over 500 patients with CTEPH have been operated on during the program's lifetime. Our Centre also concentrates on patients with other types of severe pulmonary hypertension who are indicated...

Perioperative management in patients treated with gliflozinsReview Article

Šitina M., Šrámek V.

Anest. intenziv. Med. 2024;35(3):162-167 | DOI: 10.36290/aim.2024.021  

Patients treated with gliflozins, mostly with type 2 diabetes mellitus, may develop ketoacidosis with normal to moderately eleva­ted glycemia (euglycemic ketoacidosis) in the perioperative period. Therefore, gliflozins should be discontinued 3-4 days before elective surgery and only restarted when oral intake is reliably restored and the condition is clinically stable. In the case of minor surgery without the need for fasting, omitting gliflozins only the day before surgery and on the day of surgery may be considered. If gliflozins have not been discontinued, acid-base balance and, optimally, ketone bodies should be checked regularly until reliable...

Spinal morphine up­‑to­‑dateReview Article

Buršík D., Romanová T., Vodička V., Jor O., Máca J.

Anest. intenziv. Med. 2024;35(3):155-161 | DOI: 10.36290/aim.2024.030  

Over many decades, spinal (intrathecal) opioid administration has become a proven method of analgesia for the perioperative period. However, in clinical practice, it is confronted with concerns about potential complications, the need for increased postoperative monitoring, and the unavailability of a relevant commercial product on the Czech market. Pathophysiological interpretation of adverse effects and their potential prevention is evolving as research continues. The implementation of spinal opioids in clinical practice is likewise changing. When used appropriately, it is a safe method to improve the postoperative course of the full spectrum of surgical...

Analysis of risk factors and the effect of specific treatments on the clinical outcome of patients hospitalized for COVID-19 at a university hospital in the Czech RepublicOriginal Article

Černá Pařízková R., Astapenko D., Balík M., Blažek M., Dostál P., Dušek L., Fajfr M., Jarkovský J., Jurišínová I., Svobodová E., Szanyi J., Šmahel P., Černý V.

Anest. intenziv. Med. 2024;35(3):142-154 | DOI: 10.36290/aim.2024.034  

Objective: The study aimed to evaluate the clinical outcome of patients hospitalized for COVID-19 in two university hospitals in 2021-2022, define risk factors, and evaluate the effect of specific treatment procedures. Design: A multicentric retrospective study. Setting: Intensive care units. Material and methods: The study included all adult patients hospitalized for COVID-19. The demographic data, comorbidities, degree of vaccination, ventilatory support, and pharmacotherapy were recorded. The study aimed to determine the impacts of selected risk factors, pharmacotherapy, and vaccination against SARS-CoV-2 on the clinical outcome. Results: A total...

Role recenzentů - nenahraditelná, ale bohužel neviditelná…Editorial

prof. MUDr. Vladimír Černý, Ph.D., FCCM, FESAIC, doc. MUDr. Jiří Málek, CSc.

Anest. intenziv. Med. 2024;35(2):85-86  

Bronchoskopie jednorázovými endoskopyReports from professional societies

Votruba J., Otáhal M., Balík M.

Anest. intenziv. Med. 2024;35(2):133-135 | DOI: 10.36290/aim.2024.024  

Komentář k článku: Použití plné krve u pacientů se život ohrožujícím krvácením v důsledku traumatu: souhrn a konsenzus jednání mezioborového paneluCorrespondence

Lejdarová H.

Anest. intenziv. Med. 2024;35(2):132  

Komentář k článku: Použití plné krve u pacientů se život ohrožujícím krvácením v důsledku traumatu: souhrn a konsenzus jednání mezioborového paneluCorrespondence

Blatný J.

Anest. intenziv. Med. 2024;35(2):131  

Použití plné krve u pacientů se život ohrožujícím krvácením v důsledku traumatu: souhrn a konsenzus jednání mezioborového paneluShort Communication

Bláha J., Bohoněk M., Černý V., Klugar M., Kočí J., Loužil J., Řeháček V., Truhlář A., Zýková I.

Anest. intenziv. Med. 2024;35(2):127-130 | DOI: 10.36290/aim.2024.022  

Alois Alzheimer: lékař, na kterého se zapomínáShort Communication

Málek J.

Anest. intenziv. Med. 2024;35(2):125-126 | DOI: 10.36290/aim.2024.017  

Klinická fyziologie respiračního systému a patofyziologie hyperkapnieClinical physiology

Řehák D., Astapenko D., Černý V.

Anest. intenziv. Med. 2024;35(2):122-124 | DOI: 10.36290/aim.2024.026  

Euglycemic ketoacidosis associated with SGLT2 inhibitors and DPP4 inhibitors - discussion of case reportsCase Report

Šitina M., Šrámek V.

Anest. intenziv. Med. 2024;35(2):116-121 | DOI: 10.36290/aim.2024.019  

Euglycemic ketoacidosis is a rare but potentially fatal complication of treatment with SGLT2 inhibitors (gliflozins). However, similar euglycemic ketoacidosis may rarely occur with other antidiabetic drugs or conditions such as pregnancy or alcohol abuse. We describe 3 cases of our patients with euglycemic ketoacidosis associated with gliflozins and 1 case associated with the DPP4 inhibitor sitagliptin and discuss in detail the acid-base disturbances present and the distinction of euglycemic ketoacidosis from classical ketoacidosis in type 1 diabetes.

Management of amniotic fluid embolismReview Article

Pešková K., Štourač P., Seidlová D.

Anest. intenziv. Med. 2024;35(2):104-115 | DOI: 10.36290/aim.2024.023  

Amniotic fluid embolism is characterized by sudden cardiorespiratory collapse during labor or soon after delivery. We present immediate management when a rapid response is critical. The appearance of disseminated intravascular coagulation confirms high suspicion of the diagnosis plausibly. We remind administration of tranexamic acid and fibrinogen. Fibrinogen is preferred over plasma to minimize the risk of volume overload. Avoidance of fluid overload is an important management principle of pulmonary hypertension and right heart failure. Inotropes and pulmonary vasodilators are the mainstays of therapy. Although the therapeutic application of C1 esterase...

Pathogenesis of euglycemic ketoacidosis associated with SGLT2 inhibitorsReview Article

Šitina M., Šrámek V.

Anest. intenziv. Med. 2024;35(2):98-103 | DOI: 10.36290/aim.2024.018  

Euglycemic ketoacidosis associated with SGLT2 inhibitors, also referred to as gliflozins, is a rare but potentially fatal clinical entity characterized by metabolic acidosis with normal or only mildly elevated glycemia, predominantly in patients with type 2 diabetes mellitus. In addition to ketoacidosis, hyperchloremic acidosis may also contribute significantly to metabolic acidosis. Relative hypoglycemia induced by gliflozins and concomitant stress condition lead to decreased insulin level and increased glucagon, cortisol, and catecholamines, which stimulates ketogenesis. At the same time, gliflozins induce complex renal metabolic dysfunction, in...

Management of patients with trauma in the Czech Republic - results of a questionnaire study across 12 trauma centers for adultsOriginal Article

Holubová G., Vymazal T., Beitl E., Dráč P., Edelmann K., Gürlich R., Jícha Z., Kloub M., Kočí J., Krtička M., Menšík P., Pavelka T., Matějka J., Pleva L., Šír M., Šrám J., Durila M.

Anest. intenziv. Med. 2024;35(2):89-97 | DOI: 10.36290/aim.2024.020  

Despite the existence of many guidelines in the management of trauma, trauma is still the leading cause of death in young age groups, and mortality has not decreased in the Czech Republic over the past 10 years. The issues of circulatory stability, indications for the administration of whole blood, routine use of imaging methods, and prioritization of individual care steps are still not clearly defined. We decided to use a questionnaire study to map what the initial care of traumatized patients looks like across our country in 12 trauma centers and to define the circulatory stability of the patient, on which the sequence of individual diagnostic and...

Blahopřání paní doc. MUDr. Jarmile Drábkové, CSc., k životnímu jubileuLaudatio

prof. MUDr. Vladimír Černý, Ph.D., FCCM, FESAIC

Anest. intenziv. Med. 2024;35(1):6  

Předoperační lačnění u dětí - Doporučený postup Evropské společnosti pro anesteziologii a intenzivní péčiNew guidelines

Frykholm P., Disma N., Andersson H., Beck C., Bouvet L., Cercueil E., Elliott E., Hofmann J., Isserman R., Klaucane A., Kuhn F., de Queiroz Siqueira M., Rosen D., Rudolph D., Schmidt A. R., Schmitz A., Stocki D., Sümpelmann R., Stricker P. A., Thomas M., Veyckemans F., Afshari A., Autoři překladu:, Harazim H., Ťoukálková M., Valouchová V., Štourač P.

Anest. intenziv. Med. 2024;35(1):58-80 | DOI: 10.36290/aim.2024.009  

První roky Fondu mobility SMAI ČSARIMReports from professional societies

Bönischová T., Klincová M., Štourač P., Beneš J.

Anest. intenziv. Med. 2024;35(1):56-57