Anaesthesia, Pain & Intensive Care最新文献

{"title":"Ultrasound guided erector spinae plane catheter for thoracotomy: a case report","authors":"A. Usman, A. Khan, M. Ijaz","doi":"10.35975/apic.v25i6.1707","DOIUrl":"https://doi.org/10.35975/apic.v25i6.1707","url":null,"abstract":"Major thoracic surgery results in severe postoperative pain. Epidural analgesia is considered the gold standard for pain management after thoracic surgery. However, epidural blocks are contraindicated in certain clinical conditions. Pain management in such patients poses a unique challenge to the anesthesiologists. Erector spinae plane block (ESPB) is a less invasive and relatively new technique, which has shown promising results. This case report describes the use of ESPB as an alternate analgesic technique. A 65-year-old man underwent thoracotomy and left upper lobe resection. Intraoperative and postoperative pain was managed with intermittent boluses of bupivacaine through the erector spinae plane catheter. Effective analgesia was achieved with minimal morphine consumption in postoperative period. Although central neuraxial blocks are considered to be gold standard for major thoracic surgery but where applicable, alternatives can be opted for better patient outcomes. \u0000Key words: Analgesia; Erector spinae plane block; Thoracotomy; Pain control; Neuraxial analgesia \u0000Citation: Usman A, Khan AW, Ijaz MK. Ultrasound guided erector spinae plane catheter for thoracotomy: a case report. Anaesth. pain intensive care 2021;25(6):812–815; \u0000DOI: 10.35975/apic.v25i6.1707 \u0000Received: August 16, 2021, Reviewed: October 28, 2021, Accepted: October 31, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45288194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incoherency between the clinical condition and the chest X-ray result in COVID-19 patients: a case series","authors":"S. Permana, D. Aditianingsih, Muhammad Husni Thamrin, A. -, P. -","doi":"10.35975/apic.v25i6.1710","DOIUrl":"https://doi.org/10.35975/apic.v25i6.1710","url":null,"abstract":"Despite the routine dependence upon chest X–ray (CXR) to monitor COVID-10 patients’ condition, we found that CXR and the clinical condition of some patients were incoherent, especially regarding the need of oxygen supplementation. In our patients, the incoherency was found in three patients, although, the PCR test result was still positive. In the first patient, we noted from the CXR that the pulmonary infiltrate was getting worse, but the oxygen demand was getting less and the PaO2/FiO2 was getting better on Day 4. For the second patient it happened on Day 4 and 5. In our third patient, it happened on the Day 6 and 11. All of the patients were cured and discharged home safely. \u0000Our finding indicates that we have to rely more on the clinical condition and subjective complaints of the patients, rather than CXR results to evaluate the therapy because there may be an incoherency between the two. \u0000Key word: COVID-19; Timeline; Incoherency; Clinical condition \u0000Citation: Permana SA, Aditianingsih D, Thamrin MH, Arifin, Purwoko. Incoherency between the clinical condition and chest X-ray result in COVID-19 patients: a case series. Anaesth. pain intensive care 2021;25(6):798–803 ; \u0000DOI: 10.35975/apic.v25i6.1710 \u0000Received: September 11, 2021, Reviewed: September 22, 2021, Accepted: September 24, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42854503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypopigmentation and subcutaneous fat atrophy associated with corticosteroid injection: a case report","authors":"Fata Prihatsari, H. Hidayati, D. Damayanti, Trianggoro Budisulistyo","doi":"10.35975/apic.v25i6.1708","DOIUrl":"https://doi.org/10.35975/apic.v25i6.1708","url":null,"abstract":"Corticosteroid injections have been shown to be an effective treatment modality in many of the musculoskeletal and rheumatologic conditions. Yet, the potential adverse effects of corticosteroid injections have not been given much attention. One of the potential adverse effects that should be considered by clinicians is skin hypopigmentation and subcutaneous fat atrophy. Although it is a rare side effect, it may have cosmetically unpleasant effect. The aim of this case report is to highlight the importance of providing adequate information to the patients regarding these dermal adverse effects of corticosteroid injections. We report the case of a 31-year-old female who suffered from skin hypopigmentation and subcutaneous fat atrophy after triamcinolone injection given for de Quervain’s tenosynovitis. \u0000Key words: de Quervain’s tenosynovitis; Fat atrophy; Hypopigmentation; Corticosteroid injections; Adverse effects; Pain \u0000Citation: Prihatsari F, Hidayati HB, Damayanti D, Budisulistyo T. Hypopigmentation and subcutaneous fat atrophy associated with corticosteroid injection: a case report. Anaesth. pain intensive care 2021;25(6):807–811; \u0000DOI: 10.35975/apic.v25i6.1708","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42135740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Febrile seizure secondary to opioid and benzodiazepine withdrawal in post-operative airway pediatric surgery: a case report","authors":"Muhamad Rafiqi Hehsan, Wan Fadzlina Wan Muhd Shukeri","doi":"10.35975/apic.v25i6.1709","DOIUrl":"https://doi.org/10.35975/apic.v25i6.1709","url":null,"abstract":"The sedoanalgesic drugs frequently have to be administered to relieve pain and anxiety of patients in intensive care units (ICU). An ideal agent would be rapidly metabolized, and facilitate desirable level of sedation without compromising hemodynamic and respiratory function. This makes opioids and benzodiazepines to be the most commonly prescribed drugs in intensive care. However, weaning off from these drugs may be associated with withdrawal effects. We present a case report of febrile seizure following airway pediatric surgery and opiate and benzodiazepine discontinuation. The weaning off process from these drugs should be meticulously done especially in pediatric age group to avoid subsequent complications. \u0000Key words: Febrile seizure; Opioids; Benzodiazepine; Withdrawal; Post-operative; Airways \u0000Abbreviations: PICU - Pediatric intensive care unit; IWS - Iatrogenic withdrawal syndrome \u0000Citation: Hehsan MR, Shukeri WFWM. Febrile seizure secondary to opioid and benzodiazepine withdrawal in post-operative airway pediatric surgery: a case report. Anaesth. pain intensive care 2021;25(6):804–806: \u0000DOI: 10.35975/apic.v25i6.1709 \u0000Received: September 10, 2021, Reviewed: September 18, 2021, Accepted: October 25, 2021","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41378076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of recovery time with target controlled infusion of propofol with sevoflurane anesthesia using bispectral index monitoring in vitrectomy surgery","authors":"A. Tantri, R. B. Sukmono, Linda Stefanie Atmadja","doi":"10.35975/apic.v25i6.1689","DOIUrl":"https://doi.org/10.35975/apic.v25i6.1689","url":null,"abstract":"Background: Rapid recovery after anesthesia is critical and is associated with the anesthetic agents used. The bispectral index (BIS) monitoring to guide anesthetic agents' doses may play a significant role in the recovery time. This study compared recovery time after Target Controlled Infusion (TCI) of propofol with sevoflurane anesthesia by using BIS monitoring during vitrectomy surgery.  \u0000Methodology: This was a prospective observational, randomized study on 40 patients aged 18–65 y, physical status ASA I–II, body mass index (BMI) 18–30 kg/m2, who underwent vitrectomy surgery. Subjects were randomly assigned into two groups, Group P – the TCI propofol group, and Group S – the sevoflurane group. Subjects in the Group P received TCI propofol (Schnider), and subjects in the Group S received sevoflurane for anesthesia maintenance, with a targeted BIS score of 40–60. Inj. fentanyl 1 µg/kg was administered if there was an increase in blood pressure, heart rate and/or BIS that could not be overcome by increasing the dose of TCI propofol or sevoflurane. Recovery time was calculated from when the maintenance regimen was stopped until the patient was able to obey simple commands. Recovery time, fentanyl consumption, postoperative agitation, nausea and vomiting incidence were noted and analyzed with SPSS v21.0 for Windows. T–Test or Mann–Whitney U test was performed to analyze the data.  \u0000Result: Recovery time in the Group P [11.5 (5–25) min)] was not significantly different from the Group S [9 (4–18) min, p = 0.139]. Total fentanyl consumption was higher in the Group P than in the Group S (1.765 vs. 1.428 µg/kg). The frequency of agitation during recovery was higher in the Group S than in the Group P (30% vs. 20%) \u0000Conclusion: There was no significant difference in recovery time between target controlled infusion of propofol and BIS controlled sevoflurane anesthesia in vitrectomy. Total fentanyl consumption was higher in the Group P than in the sevoflurane group. The impact of these anesthetic regimens on postoperative agitation needs further investigation. \u0000Key words: Intravenous anesthesia; Bispectral index monitoring; BIS;  Propofol; Sevoflurane; Target Controlled Infusion; TCI; Vitrectomy \u0000Citation: Tantri AR, Sukmono RB, Atmadja LS. Comparison of recovery time with target controlled infusion of propofol with sevoflurane anesthesia using bispectral index monitoring in vitrectomy surgery. Anaesth. pain intensive care 2021;25(6):707–712: \u0000DOI: 10.35975/apic.v25i6.1689","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44707946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INFLUENCE OF IRRATIONAL PRESCRIPTION OF ANTIBACTERIAL THERAPY ON THE PROGNOSIS OF TREATMENT AND SURVIVAL IN PATIENTS WITH COVID-19","authors":"A. Kotliar, S. Dubrov, S. Sereda, M. Denisyuk, G. Ponyatovska","doi":"10.25284/2519-2078.4(97).2021.248405","DOIUrl":"https://doi.org/10.25284/2519-2078.4(97).2021.248405","url":null,"abstract":"IIntroduction. The COVID-19 pandemic became a major challenge for healthcare systems around the world. The development and improvement of basic treatments for coronavirus patients is important to improve public health and improve quality of life after recovery.\u0000The aim of the study: to determine the frequency and structure of prescribing antibacterial drugs in the prehospital and hospital stages, used in patients with COVID-19. Assess the relationship between irrational use of antibacterial drugs with the length of hospital stay of patients with coronavirus disease, the risk of transfer to the intensive care unit (ICU) and mortality.\u0000Materials and methods: Statistical, retrospective analysis of 400 case histories of patients with COVID-19 who were treated at the Municipal Non-Profit Enterprise «Kyiv City Clinical Hospital №17» (KNP «KMKL#17») for the period from September 2020 to November 2021 with severe coronavirus disease.\u0000Results: 400 medical charts were selected for the study, which were divided into two groups according to the purpose of antibacterial therapy. Of the group of patients who received pre-hospital antibacterial therapy (200 people), indications for its appointment had only 7 % of patients. Among the group receiving antibacterial drugs there is a prolongation of the length of stay in the hospital, the risk of transfer to ICU increases. There is also higher risk of mortality in patients of group 1 (14,5 %), compared with group 2 (8 %), whose antibacterial drugs were not prescribed at the prehospital stage.\u0000Conclusion: as a result of the study it was found that patients who were unreasonably prescribed antibacterial therapy prolongs the period of general hospitalization by 2.3 ± 0.8 days, increasing the need for transfer of patients due to deterioration to ICU by an average of 13 %, increase in the incidence of antibiotic-associated diarrhea by 7-8 %, and there is a tendency to increase mortality from COVID-19. Antibacterial drugs should be used only on the basis of indications in the case of proven bacterial co-infection (superinfection) or reasonable suspicion of it in patients with respiratory disease caused by SARS-CoV-2 and in no case should be prophylactic.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74937137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"РЕТРОСПЕКТИВНЫЙ АНАЛИЗ ПРИЧИН ЛЕТАЛЬНОСТИ У БОЛЬНЫХ С ТЯЖЕЛЫМ ТЕЧЕНИЕМ COVID-19","authors":"S. Sereda, S. Dubrov, M. Denysiuk, O. Kotliar, S. Cherniaiev, Y. Zaikin, T. Baranovska, O. Havrylenko, V. Borisova, G. Ponyatovska","doi":"10.25284/2519-2078.4(97).2021.248401","DOIUrl":"https://doi.org/10.25284/2519-2078.4(97).2021.248401","url":null,"abstract":"In Ukraine, more than 3.5 million cases of COVID-19 have been registered during the pandemic, and the death toll is almost 90,000. Ukraine is a leader in Europe in the growth of new cases of COVID-19 and mortality from this disease. The search for effective treatment regimens and new approaches to the management of patients with coronavirus disease in order to reduce the severity of coronavirus disease, reduce mortality, the number of complications and improve the rehabilitation period is very important nowadays.\u0000The aim of the work. To determine the main causes of mortality in patients with severe COVID-19 by analyzing the frequency and structure of complications in deceased patients.\u0000Materials and methods. The study conducted a retrospective analysis of 122 medical charts of deceased patients with COVID-19 who were hospitalized in a communal non-profit enterprise “Kyiv city clinical hospital №17” for the period from September 2020 to November 2021.\u0000Results and discussion. The overall mortality among patients with COVID-19 was 9.3%, in the intensive care unit (ICU) – 48.4%. The most common causes of death in patients with COVID-19 were: respiratory failure (RF) – 100% of cases, pulmonary embolism (PE) and acute heart failure (AHF) - about 60%. The average length of stay of patients in inpatient treatment was 11.67 ± 8.05 days, and in the intensive care unit – 7.94 ± 6.24 days. The mean age of patients hospitalized in the ICU was 63.5 ± 12.9 years and the mean age of patients who died was 71.2 ± 10.29 years.\u0000Prognostically significant criteria for lethal consequences were the presence of comorbidity: cardiovascular diseases- 92.3%, endocrine system diseases – 28.4%, nervous system diseases – 23.07%, kidney diseases – 9.6%, cancer – 9,6%, autoimmune conditions – 7.69%, varicose veins – 5.7%, respiratory system diseases – 5.7%.\u0000In patients with fatal outcome lymphopenia (84.6%) was observed in patients on admission to the ICU.\u0000Vasopressor and inotropic support was performed in 50 % of patients with COVID-19. In 25 % of those who died during long-term treatment and long-term respiratory support, there was the development of multiple organ failure, which in most cases was the point of no return.\u0000Conclusions. The most common causes of death were: respiratory failure, thrombosis, acute cardiovascular failure, sepsis and multiple organ failure. The main nature of the complications is common, but the cohort may be affected by different factors and the percentage of complications may differ in other hospitals.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76711847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PRIMARY HYPERPARATHYROIDISM: OPTIMIZATION OF ANAESTHESIA","authors":"S. Tarasenko, S. Dubrov, V. Palamarchuk, M. Gorobeiko, V. Voitenko, O. Yefimova, O. Nechay, P. O. Lishchynsky, V. Smolyar, O. Tovkay, V. L. Rudenko","doi":"10.25284/2519-2078.4(97).2021.248397","DOIUrl":"https://doi.org/10.25284/2519-2078.4(97).2021.248397","url":null,"abstract":"Background and Aims. The majority of cases of primary hyperparathyreosis (PHPT) due to solitary adenoma and require the target surgery. Research of new anesthesia/analgesia methods, which afford to have an opioid-sparing effect, is going. Methods. 127 patients with PHPT were divided into 3 groups: the group STI-BCSPB (n=26) was used combined general anesthesia (GA) with sevoflurane (SEV), the tracheal intubation (TI) with the myorelaxant introduction and bilateral cervical superficial plexus blockade (BCSPB); the group STI (n=82) was used SEV anaesthesia with IT and no BCSPB; the group PLM-BCSPB (n=19) was provided propofol (P) GA with protection air-ways by laryngeal mask (LM) and BCSPB. In both groups (STI-BCSPB and PLM-BCSPB) were used co-analgesics, such as dexamethasone (DXM) 8 mg IV, 2% lidocaine (L) 1,0-1,5 mg/kg IV, metamizole (M) or paracetamol (P) 1 g IV, dexketoprofen (DKTP) 50 mg IV as pre-emptive analgesia 30 min before surgery. Ketamine 25 mg IV was used for induction anaesthesia in these groups. In STI group only opioid with P were used for induction of GA. Duration of surgery (DoS), anaesthesia (DoA), opioid consumption, time from the operation ending until the eyes opening (EyOp), desaturation was measured. All data M±m\u0000Results. DoS for STI-BCSPB, STI and PLM-BCSPB was respectively 38.7±2.7, 37.8±1.3 and 35.6±1.7 min (NS), DoA was respectively 63.8±3.1, 59.4±1.4 m and 53,8±2.7 min (p= 0.028 STI vs PLM-BCSPB, p= 0.024 STI-BCSPB vs PLM-BCSPB, the difference is significant (DS). EyOp was 15.4±1.1, 15.6±1.2 and 11.6±0.9 min respectively for STI-BCSPB, STI and PLM-BCSPB (p=0.022 STI vs PLM-BCSPB (DS) and p=0.025 STI-BCSPB vs PLM-BCSPB (DS). Desaturation (SpO2 below 92%) due to residual sedation and the effect of muscles relaxants was observed in 39 (47.6%) and 11 (42,3%) patients in STI and STI-BCSPB during the first 30 min postop compared to 2 cases (10.5%) in PLM-BCSPB (both STI groups were DS vs PLM-BCSPB, chi-square test). The dose of intra-op fentanyl was 334.3±17.1, 256.5±16.9 197.3±15.3 mcg in STI, STI-BCSPB and PLM-BCSPB respectively, (DS for PLM-BCSPB vs other groups, DS between STI groups).\u0000Conclusions. Combine methods GA with BCSPB have some benefits over mono GA. Co-analgesics afford to achieve an opioidsparing effect. Under ectomy of single parathyroid adenoma, the use of propofol and BSCPB with the laryngeal mask without muscles relaxants seems more preferable compared to sevoflurane anesthesia with BBSCP and tracheal intubation due to the shorter anesthesia duration, time to eye-opening after surgery, lower desaturation frequency.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80821166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TO CHARACTERISTICS OF THE ETIOLOGICAL STRUCTURE AND ANTIBIOTIC SENSITIVITY PATHOGENSOF INFECTIOUS RESPIRATORY ORGANS IN NEWBORN AFTER ARTIFICIAL PULMONARY VENTILATION","authors":"B. Levchenko, D. V. Dmitriev, K. Bertsun, N. A. Bagnyuk, O. Nazarchuk","doi":"10.25284/2519-2078.4(97).2021.248394","DOIUrl":"https://doi.org/10.25284/2519-2078.4(97).2021.248394","url":null,"abstract":"Objective. The study of the etiological structure, properties of pathogens of the Vinnytsia National Medical University named after E. Pirogova, respiratory process in newborns who have underwent artificial mechanical lung ventilation (MLV) and their resistance to antibacterial agents is especially relevant in modern conditions, expands the search for new approaches to pathogens, improves treatment and reduces mortality from this pathology.\u0000The purpose of the study - to determine the etiological structure, sensitivity to antibiotics of the leading pathogens of the infectious process of the respiratory system in newborns who were on mechanical ventilation.\u0000Materials and methods. In total, the species composition of the leading microorganisms that colonized the airways of 180 newborns treated in the Neonatal Intensive Care Unit (VAITN) of Vinnytsia Regional Children’s Clinical Hospital (VRCCH) was studied in 2020. A total of 285 isolates of microorganisms were isolated. 62 patients who underwent mechanical ventilation were involved in a prospective microbiological study, 86 clinical strains of microorganisms were isolated. The susceptibility of microorganisms to 30 antibacterial agents was determined according to the generally accepted method (order of the Ministry of Health of Ukraine №167; recommendations). Research results. The etiological significance of opportunistic pathogens (Enterobacter cloacae - 29%, Staphylococcus aureus - 24.4%, Pseudomonas aeruginosa - 18.6%, Candida albicans) was proved in patients who were on mechanical ventilation in VAITN VRCCH in 2020 for pneumonia. Clinical strains of S. aureus are sensitive to vancomycin, oxacillin and clindamycin.\u0000 Conclusions. Pathogens of the respiratory process in newborns who have been on mechanical ventilation, are resistant to a number of antibiotic drugs (cefepime, gentamicin amikacin, piperacillin).","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77773579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SEVERE COVID-19 IN PATIENT AT EARLY POSTOPERATIVE PERIOD AFTER WHIPPLE’S OPERATION WITH MARGINAL PORTAL VEIN RESECTION","authors":"V. Kopchak, A. Mazur, L. Pererva, О. Khomenko, L. Maksymenko, R. Zatsarynnyy, P. Azadov","doi":"10.25284/2519-2078.4(97).2021.248407","DOIUrl":"https://doi.org/10.25284/2519-2078.4(97).2021.248407","url":null,"abstract":"Introduction. Pancreatoduodenectomy (PDR or Whipple’s operation) remains the only effective radical method of surgery for tumors of the pancreatic head, distal common bile duct and Vater’s papilla. The most frequent complications of the early postoperative period are: gastrostasis, pancreatic fistula, postoperative bleeding and pulmonary complications. According to World Health Organization (WHO) and reviews, severe COVID-19 usually occurs in older age patients, and in patients with oncological diseases.\u0000Case description. Patient V., 64 years old, due to a tumor of the head of the pancreas with invasion of the distal common bile duct and the development of obstructive jaundice, underwent PDR. Histopathologically, ductal adenocarcinoma of the pancreatic head, G-2, was confirmed. The PDR operation was performed within healthy tissues, which was confirmed by histopathology.\u0000On the second day after surgery, patient was admitted to ICU because of respiratory failure, the SARS-CoV-2 antigen test was positive, we suggest that the patient was in the latent period of COVID-19 disease during the surgery. Patient received hormone therapy, anticoagulants in therapeutic doses, O2-therapy. On the 5th day, because of severe ARDS, the patient was intubated, on the 7th day - convalescent plasma transfused (1 dose). On the 9th day, a tracheostomy was applied for airways care and early activation. Respiratory support was provided twelve days. Patient received early activation, exercises, as well as early enteral nutrition. After ICU discharge, patient’s condition was complicated by the gastro-intestinal bleeding, blood transfusion and embolization of the dorsal pancreatic artery were performed. On the day 66th after surgery patient was discharged home in satisfactory condition.\u0000Conclusion. General care and early activation of the patient within early tracheostomy, convalescent plasma usage and the well-coordinated work of the surgical and anesthesiological teams allows timely identification and elimination of early postoperative complications after Whipple’s operation with marginal resection of the portal vein.","PeriodicalId":7735,"journal":{"name":"Anaesthesia, Pain & Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2021-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91211401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}