[The role of specialist advisory boards in the development of anesthesiology and intensive care in Poland]. / Rola nadzoru specjalistycznego w rozwoju anestezjologii i intensywnej terapii w Polsce.

Specialists Advisory Board for the first time was funded of July 20th 1950, followed by the establishing country and share specialists. Advisory Board since the beginning is responsible for increasing medical knowledge and prophylactic. First country specialist was elected Mieczyslaw Justyna MD, PhD, in 1951. This period characterized different opinions between surgeons and anesthesiologists about the future development of specialty. In 1953 the new system of specialization was introduced. The full-qualified specialist was recognized after 36 months of clinical work. In 1961 the new system of organization of anaesthetics departments was introduced for the whole country. This system still exists in practice. In 1963 the lower stage of specialists (share) was introduced. In 1972 anaesthesiology was established as a specialty consists of following tasks: anaesthesia, intensive therapy, pain treatment and resuscitation. Intensive therapy is responsible for maintaining the vital function, diagnosis and treatment of cause of life emergency state. Intensive therapy, and intensive care were recognizing separately.

[Role of the anesthesiologist in perioperative medicine]. / Rola anestezjologa w medycynie okolooperacyjnej.

Perioperative medicine is a new approaches for quicker and better preparation all patients for surgery and postoperative treatment. Perioperative medicine should fulfilled following problems: a) Preoperative assessment, b) Postoperative pain treatment, c) Postoperative intensive therapy. Anaesthesiologists are interested in above problems, except prolonged preoperative treatment, which is normally provided by other specialists. Perioperative medicine needs a new approach for training new type of anaesthesiologists well prepared for new type of responsibility.

Microcomputer-assisted monitoring system for measuring and processing cardiorespiratory variables: preliminary results of clinical trials.

A microcomputer-assisted monitoring system was developed for the continuous measuring and processing of cardiorespiratory variables, including: systemic and pulmonary arterial pressures, CVP, minute ventilation, inspired and expired O2 and CO2 concentrations, temperature, and heart rate. The primary data were converted to digital form, processed, displayed on a CRT monitor, and also stored for later evaluation. This system automatically calculated and displayed on-line and in real-time both primary measurements and derived cardiorespiratory variables, including: oxygen consumption, CO2 production, left and right ventricular stroke work, pulmonary venous admixture, and systemic and pulmonary vascular resistances. Printouts of the variables and trend graphs could be obtained for any desired time period. During its development, we tested this monitoring system in 30 critically ill patients, finding that the real-time calculation of cardiorespiratory variables was a great advantage during monitoring and treatment.

Rashkind's operation in treatment of complete transposition of the great vessels in the newborn and infants.

The study is a result of many years investigations of a large pediatric team consisting of physicians from various specialities on the methods of management in cases of transposition of greater arterial vessels. Trials of surgical treatment requiring thoracotomy in the newborn with severe cardiorespiratory failure gave no good results. In recent years 65 operations of atrioseptostomy without thoracotomy were carried out during cardiac catheterization. In nearly half the cases improvement of the general condition was obtained with survival for several months or even over one year, but close supervision was required and the children were being prepared for more radical cardiosurgical operations.

[Balloon atrioseptostomy (B.A.S.) in the management of neonates and infants with transposition of great vessels (author's transl)]. / Doswiadczenia wlasne w stosowaniu zabiegu Rashkinda w leczeniu calkowitego przelozenia wielkich pni tetniczych

From June 1969 to April 1973, B.A.S. was carried out in 2-day to 6-month-old 65 infants at the Institute of Paediatrics of the Academy of Medicine in Warsaw. There were 16 infants up to one week old, 39 infants--up to one month, and 10 infants more than one month old. There were 43 boys and 22 girls among them. Cardiac catheterization and B.A.S. were carried out in most children up to 24 hours following hospitalization under local anaesthesia and premedication with robenzperidol and dolantin. In 11 of the 65 infants after B.A.S. the saturation with oxygen in the right atrium under-went no significant changes; in 54 cases it increased by 10 to 49 per cent. Of the 65 infants in whom B.A.S. was performed, 37 are alive, 28 had died. In 20 children under constant outpatient cardiological follow up the observation period has amounted from 6 months to 3 years. Their motoric development and growth is retarded, there is moderate cyanosis, but no symptoms of congestive failure were found. All these children are administered digitalis in chronic maintenance doses. Respiratory infections occured frequently in these patients. As mentioned above, 28 infants died at the age of 2 days to 6 months. Post mortem examination revealed that the B.A.S. was unsufficient in 14 cases. However, 14 infants died in spite of the satisfactority performed atrioseptostomy. Pulmonary oedema or haemorrhagic-and-inflammatory changes in the lungs as well as generalized thrombosis were the most frequent causes of death. On the basis of their own experience the authors elaborated indications and instructions for B.A.S. in neonates and infants with congenital heart diseases. These directives are based on the Team Work of cardiologists, anaesthesiologists, cardiac surgeons and paediatric radiologists. Because ever greater numbers of neonates are being sent to the Institute of Paediatric of the Academy of Medicine from all over Poland, the authors organized continuous cardiological emergency service to carry out B.A.S. procedures as soon as possible, without delay.