Suchergebnisse

The tracheoesophageal fistula which occurred during oro-tracheal intubation of a patient in intensive care unit is a true challenge both in diagnostic and in therapeutic approach. The best treatment is prevention, by identifying risk factors but especially is important which the mechanism in the occurrence of tracheoesophageal fistula was. The occurrence of this complication in the evolution of hospitalized patients in ICU is accompanied by significant increase in mortality, contributing to negative prognostic. We have started a large multicentric study in April 2016 regarding all patients who required intubation longer than 7 days. The study will finish at the end of 2020. We are looking for a definite conclusion, in this moment we do not have enough data for a conclusion researches are being conducted in order to develop this technology with medical applications. The technique consists in the significant increase in the electrical conductivity and permeability of the.

Drug-induced sleep endoscopy emerged and developed as an essential alternative diagnosis tool in sleep-disordered
breathing patients. Accurate identification and dynamic characteristics of upper respiratory airway obstruction are paramount
in establishing an adequate therapeutic plan and selecting for particular surgical or non-surgical strategies. This article reviews
the current aspects of intravenous sedation for drug-induced sleep endoscopy (DISE) in adults, emphasizing its implications for
patients with sleep apnea. The ideal sedative agent for DISE should replicate natural sleep patterns while maintaining upper
airway dynamics. The clinical practice exhibits a significant variability in drug selection, with midazolam and propofol often being
preferred. The review presents emerging trends and advancements in DISE, emphasizing its role in optimizing surgical indications,
predicting outcomes, and screening patients for alternative therapeutic strategies for OSA. Future research is needed to
understand better the impact of specific sedative drugs on DISE findings, contributing to the development of standardized
protocols and the evolution of new sedative drugs with improved effects and optimized techniques for delivering sedation.

"Surgical site infections (SSI) greatly concern clinicians, as they are associated with significant morbidity and mortality, prolonged hospitalization, and costs. Antibiotic prophylaxis plays a pivotal role among the procedures that are usually employed for the prevention of surgical-related infections. This narrative review aims to cover some of the particular situations when the clinician might consider individualizing antibiotic prophylaxis for a patient. With the rising incidence of multi-drug resistant bacteria carriage among not only hospitalized or institutionalized patients but also patients from the community, there might be a tendency to use extended-spectrum antibiotics for longer periods for surgical infection prevention. However, the inappropriate use of antibiotics increases the selection pressure, thus favoring the spreading of resistant bacteria. Moreover, specific patient characteristics or pathologies might need to be considered to customize the type, dose, or length of administration of an antibiotic as surgical prophylaxis. Using prosthetic material or prolonged surgeries with large fluid shifts are other situations when individualized antibiotic prophylaxis might be thought of. Keeping in mind that it is of utmost importance that everyone adheres to the current guidelines for surgical antibiotic prophylaxis, customization of local protocols according to well-thought-out strategies might prove beneficial in SSI prevention."