No abstract

No abstract

I n t r o d u c t i o n : ���tic ��oc� i� d�� n�d �� � �i���t�r��t�nin� or��n ��i�ur� c�u� ���tic ��oc� i� d��n�d �� � �i���t�r��t�nin� or��n ��i�ur� c�u� sed by an abnormal response of the body to infection. Urinary tract infections (UTI�) con�titut� �bout 10%-20% o� ��� community��cquir�d in��ction� �nd �bo� ut 40%-50% o� �o��it����cquir�d in��ction�. In ��ti�nt� wit� im��ir�d immunity they may lead to sepsis. Strains of Klebsiella pneumoniae are often multidrug resi� stant, and therapeutic chances are limited where they occur. A i m : T�� �im o� t�i� ����r i� to di�cu�� t�� mo�t r�c�nt �uid��in�� in di��no�The aim of this paper is to discuss the most recent guidelines in diagno� sing and treating sepsis, referring to a clinical case report. C a s e s t u d y : T�� �tudy �r���nt� � c��� o� ���tic ��oc� in � 44�y��r�o�d ��m��� ��ti�nt in � community��cquir�d UTI c�u��d by K. pneumoniae �xt�nd�d����c� trum ��ct�m���� (E�BL + ). R e s u l t s a n d d i s c u s s i o n : The course of septic shock proved fatal. As the stay in the intensive care unit (ICU) was short, this precluded implementing full diagnostic procedures and identifying the source of infection. A post mortem examination was performed to establish the cause of death and aetiology of the infection.C o n c l u s i o n s : K. pneumoniae ESBL + has become a growing epidemiological problem in Poland and all over the world. This pathogen increasingly often leads to community��cquir�d in��ction� �nd it� mu�tidru� r��i�t�nc� m���� t�� ��� plied therapies ineffective. Diabetes, one of the modern lifestyle diseases, impairs resistance and accelerates rapidly progressing septic shock with multiple organ failure. Late diagnosis of sepsis, because of considerable metabolic and cellular changes, brings about tragic results. Despite implementing new diagnostic me� thods and therapies, the mortality rate in sepsis still remains very high.

Introduction A disease of a loved one constitutes a serious disturbance in the functioning of many families. Meeting expectations of patients’ families is seen as an element conditioning the level of satisfaction from the care provided in hospital. Aim The aim of this study was to investigate the expectations of families of people hospitalized in the Intensive Care Units (ICUs). Material and methods The study was carried out in ICUs in the Warmińsko-Mazurskie Voivodeship. The study was performed by diagnostic survey using the questionnaire technique. In total 104 people were surveyed. Results and Discussion The highest ranking expectation of the patient’s loved ones was that of trust towards the staff diagnosing and treating the patient as well as the staff nursing them. Then there came: the feeling of ensuring the best care possible for the patient, obtaining information about the patient’s health, education on the way the unit functions, staying at the patient’s bedisde in the ICU. Lower in the ranking were the importance of having access to the family zone amenities, the opportunity of sharing their problems with others or receiving psychological and pastoral care. Conclusions The most important need of visitors to the ICU is to obtain assurance that the patient is provided the best care possible. As the second most important need, the respondents mentioned the need to be close to the patient and easiness of obtaining information about their health condition provided by the doctor.

Introduction: The introduction of sugammadex has created new opportunities for a quick reversal of relaxation caused by steroid relaxants. Aim: The objective of this study was to compare relaxation of striated muscles in laryngeal microsurgery depending on the applied agent: mivacurium or rocuronium. Material and methods: 65 low-risk surgery patients were randomly divided into two groups: MIV (n = 32) and ESM (n = 33) before the scheduled larynx microsurgery. The MIV group used mivacurium to relax the muscles, the ESM group used rocuronium.The following parameters were monitored: pulse rate, arterial blood pressure, arterial blood saturation, ventilation parameters according to the conventional standards and the depth and rate of neuromuscullar blockade (NMB) reversal. The demand for anesthetics and analgesics used during the anesthesia and the frequency of complication occurrence were evaluated. Results and discussion: There were no differences under intubation conditions. The conditions of the operation assessed by its operator were better in the ESM group. The time of the operation was similar in the two groups. The acting time of sugammadex in the ESM group was on average 1 minute. The ESM group reached train-of-four ratio (TOFR) of 0.9 (90% recovery of NMB) far more quickly than the MIV group. There was no statistical difference in side effects. Conclusions: It seems to be reasonable to replace mivacurium with rocuronium and reverse its action by means of sugammadex in patients with a positive family history of allergy and anaesthetized for short-term operations or operations of unpredictable duration.