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Signa Vitae

A Journal In Intensive Care And Emergency Medicine

Month: March 2018 (Page 1 of 4)

Major differences between conventional and compression-only cardiopulmonary resuscitation

Dear Editor,

I read the article by Skulec et al. “Rescuer fatigue does not correlate to energy expenditure during simulated basic life support,” with great interest. (1) Although conventional cardiopulmonary resuscitation (CCPR) has been considered a standard CPR method since 1960, compression-only CPR (COCPR) has emerged as an alternative method to CCPR because of some evidence favoring COCPR. (2,3)

Therefore, numerous studies have attempted to determine whether COCPR could indeed improve the quality of CPR. A systematic review of these studies confirmed several obvious differences. (4)

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New challenges in hemodynamics and intensive care medicine – 2nd International congress and workshops

University Hospital Dubrava, Zagreb, Croatia, March 8th – 9th 2018

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Intensive care management of patients with left ventricular assist device


Mechanical circulatory support devices, especially left ventricular assist devices (LVADs) represent an important treatment modality for patients with end-stage heart failure (HF). In a 1-year period (from January to December 2017) in our intensive care unit (ICU) we had a total of 8 patients with LVAD implantation. LVADs are devices with unique physiology which restore tissue circulation by increasing blood supply, nevertheless, they can be challenging to manage and are associated with significant complications.

Keywords: Critical Care, Heart-Assist Devices, Heart Failure, Hemodynamics, Hemodynamic Monitoring, Cardiac surgery, Postoperative Complications

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Haemodynamic monitors in laparoscopy


Laparoscopic procedures are often performed on high risk surgical patients that could benefit from close haemodynamic monitoring and goal directed fluid therapy. Pneumoperitoneum has been shown to influence haemodynamic variables and alter arterial pressure waveform upon which many minimally invasive haemodynamic monitors rely. There are a few individual studies verifying various less invasive haemodynamic devices. With the possible exception of oesophageal Doppler, their measurements under pneumoperitoneum conditions are less reliable. Besides modifying reliability of monitors, pneumoperitoneum possibly also exerts independent influence on haemodynamic variables, such as lowering predictive value of pulse pressure variation for fluid responsiveness.

KEYWORDS: pneumoperitoneum, laparoscopy, haemodynamic monitoring

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Electrical impedance tomography as ventilation monitoring in ICU patients


Electrical impedance tomography (EIT), as a monitoring tool of regional lung ventilation, is radiation-free imaging with high temporal resolution. The most important purpose of EIT is to visualize the distribution of tidal volume in different lung regions especially between dependent (dorsal in supine patients) and non-dependent (ventral in supine patients) regions.
Many clinical studies evaluated the applicability of PulmoVista® 500 (Dräger Medical GmbH, Lübeck, Germany) and similar EIT devices in estimating optimal PEEP after recruitment maneuvers (RM) in lung healthy patients and acute respiratory distress syndrome (ARDS), ventilation distribution in cystic fibrosis, COPB, pneumonia and respiratory diseases syndrome in infants.

Keywords: Electrical impedance tomography – EIT, regional ventilation, lung monitoring

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