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The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year. It summarizes the influence of the COVID-19 pandemic on anesthesiological praxis in obstetrics. It also presents new developments in systemic and neuraxial obstetric analgesia, Caesarean Section anesthesia, and emergencies in the peripartum period.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
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From the Evidence-based medicine (EBM) point-of-view, the year 2022 due to the slowly subsiding world SARS-CoV-2 pan-demic, brought the whole complex of articles, publications, and guidelines once again. The aim of the article Year 2022 in pediatric anesthesia and intensive care is to highlight the important publications that should not be missed due to their impact on daily clinical practice.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.
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Study goal: Palliative care is an essential part of a complex approach to patients in the intensive care unit (ICU). This study aimed to describe palliative care practice in ICU in the Czech Republic. Study type: a cross-sectional, questionnaire study Material and methods: The inclusion criteria for study participation were nurses or physicians taking care of patients in the ICU for patients with Coronavirus Disease 2019 (COVID-19). The participants could participate by filling out the electronic survey with 40 questions. The questionnaire was evaluated by descriptive statistical analysis. Results: 313 questionnaires were analyzed. Participants reported up to 15 different terms for end-of-life care, the most often being palliative care (75.1%, n=235). The supportive care, especially sedatives, was most frequently adjusted according to the patient's needs. On the other hand, as a standard approach, the parenteral (35.8%, n=112) and enteral (17.3%, n=54) nutrition were most often withdrawn. Regarding organ support, renal replacement therapy (69.7%, n=218) and vasopressors (60.4%, n=189) were often withdrawn. The most rarely withdrawn organ support was artificial ventilation (24.6%, n=77), endotracheal intubation (11.5%,n=36), and tracheostomy cannula (2.9%, n=9). The majority of respondents would appreciate further education in palliative care. Conclusion: Palliative care is an essential theme not only in the COVID-19 pandemic. The palliative care terminology and practice used in the Czech Republic are heterogeneous. There is a space for further research and education in palliative care.
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Study objective: Administration of systemic corticosteroids in patients with severe COVID-19 (Coronavirus Disease 2019) has been recommended by World Health Organization (WHO) according to the RECOVERY trial results. However, there is still ongoing debate regarding the evidence supporting the dose, timing, route of administration and type of corticosteroid. This survey aimed to describe the current clinical practice of administration of systemic corticosteroids for patients with COVID-19 within Intensive Care Units (ICU) in Czech Republic. Study design: cross-sectional survey Material and methods: Electronic survey containing 15 questions was sent to the members of Czech Society of Anaesthesiol-ogy, Resuscitation and Intensive Care, Czech Society of Intensive care and Czech Pneumological and Phthisiological Society members. The results were analysed by descriptive statistic methods. Results: The survey fulfilled 233 respondents and 231 answers were eligible for analysis. The most prevalent group was attending physician with completed training in anaesthesiology and intensive care medicine (AIM) (32 %, n = 74). The most prevalent indication for initiation of corticosteroid treatment was oxygen therapy (face mask or nasal cannula) (59,3 %, n = 137) and high-flow nasal oxygen therapy (HFNC) (21,6 %, n = 50). The most preferred corticosteroid was dexamethasone (75,8 %, n = 175) at dose of 8 mg intravenously (i. v.) (48,6 %, n = 85), or dose of 6 mg i. v. (32,0 %, n = 56) followed by methylprednis-olone (25,5 %, n= 59) at dose of 80 mg i. v. (35,6 %, n = 21), and 40 mg i. v. (13,6 %, n = 8), respectively. The preferred duration of therapy was 10 days (dexamethasone 60,6 %, n = 106, methylprednisolone 20,3 %, n = 12). Conclusion: Administration of corticosteroid was dominantly initiated in patients with severe COVID-19 receiving supplemental oxygen. The corticosteroid of first choice was intravenous dexamethasone at dose of 8 mg and 6 mg for 10 days, respectively.
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The ongoing SARS-CoV-2 pandemic had significant impact on publication activities in the field of paediatric anaesthesiology and intensive care also in year 2021. The partial lossening of the restrictions had been associated with the elective surgery renewal and modification of intensive care patient's characteristics (post-operative care, injuries, etc.). Despite the available vaccination, COVID-19 remains signifficant topic, fortunately not the single one. The aim of the article Year 2021 in paediatric anaesthesia and intensive care is to highlight the important publications that should not be missed due to their impact on daily clinical practice.
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The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year. It summarizes the influence of COVID-19 pandemia on anaesthesiological praxis in obstetrics. It also presents new developments in systemic and neuroaxial obstetric analgesia, Caesarean Section anaesthesia and emergencies in peripartum period.
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The clinical course of the SARS-CoV-2 virus infection (COVID-19 disease) in paediatric patients is predominantly mild. However, in a small percentage of paediatric patients, the COVID-19 could lead to the development of with the Paediatric Inflammatory Multisystem Syndrome (PIMS) presenting as high fever, gastrointestinal symptoms, neurological symptomatology and even as multiorgan dysfunction. These three cases represent the first published report of critically ill paediatric patients with PIMS in the Czech Republic.
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The article highlights and discusses several current topics that have been published in the field of anaesthesiology in obstetrics in the Czech Republic and abroad last year. It summarizes the influence of COVID-19 pandemic on anaesthesiological praxis in obstetrics. It also presents new developments in systemic and neuroaxial obstetric analgesia, Caesarean Section anaesthesia and emergencies in peripartum period.
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The global SARS-CoV-2 pandemic significantly influenced also the field of paediatric anaesthesia. Although the COVID-19 disease remains worldwide a significant health, economic and social problem, there are also several other aspects of paediatric anaesthesia, which require our attention. In paediatric anaesthesia, the conflicting areas are premedication, rapid sequence induction, airway management, anaesthesia depth monitoring and reduction of complication incidence. When considering COVID-19, the main aim is to reduce the possible transmission of the disease to the health care professionals and to standardise the airway management. The aim of this review is to summarise the key publications in the field of paediatric anaesthesia with the impact on the daily paediatric anaesthesiology practice.