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RISS 인기검색어
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- 저자 : Athanasios Chalkias (검색결과 2 건)
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Chalkias Athanasios,Koutsovasilis Anastasios,Laou Eleni,Papalois Apostolos,Xanthos Theodoros 대한중환자의학회 2020 Acute and Critical Care Vol.35 No.2
Background: Mean systemic filling pressure (Pmsf) is a quantitative measurement of a patient’s volume status and represents the tone of the venous reservoir. The aim of this study was to estimate Pmsf after severe hemorrhagic shock and cardiac arrest in swine anesthetized with propofol-based total intravenous anesthesia, as well as to evaluate Pmsf’s association with vasopressor-free resuscitation. Methods: Ten healthy Landrace/Large-White piglets aged 10–12 weeks with average weight 20±1 kg were used in this study. The protocol was divided into four distinct phases: stabilization, hemorrhagic, cardiac arrest, and resuscitation phases. We measured Pmsf at 5–7.5 seconds after the onset of cardiac arrest and then every 10 seconds until 1 minute postcardiac arrest. During resuscitation, lactated Ringers was infused at a rate that aimed for a mean right atrial pressure of ≤4 mm Hg. No vasopressors were used. Results: The mean volume of blood removed was 860±20 ml (blood loss, ~61%) and the bleeding time was 43.2±2 minutes while all animals developed pulseless electrical activity. Mean Pmsf was 4.09±1.22 mm Hg, and no significant differences in Pmsf were found until 1 minute postcardiac arrest (4.20±0.22 mm Hg at 5–7.5 seconds and 3.72±0.23 mm Hg at 55– 57.5 seconds; P=0.102). All animals achieved return of spontaneous circulation (ROSC), with mean time to ROSC being 6.1±1.7 minutes and mean administered volume being 394±20 ml. Conclusions: For the first time, Pmsf was estimated after severe hemorrhagic shock. In this study, Pmsf remained stable during the first minute post-arrest. All animals achieved ROSC with goal-directed fluid resuscitation and no vasopressors.
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Critical emergency medicine and the resuscitative care unit
Maria Mermiri,Georgios Mavrovounis,Dimitrios Chatzis,Ioannis Mpoutsikos,Aristea Tsaroucha,Maria Dova,Zacharoula Angelopoulou,Dimitrios Ragias,Athanasios Chalkias,Ioannis Pantazopoulos 대한중환자의학회 2021 Acute and Critical Care Vol.36 No.1
Critical emergency medicine is the medical field concerned with management of critically illpatients in the emergency department (ED). Increased ED stay due to intensive care unit (ICU)overcrowding has a negative impact on patient care and outcome. It has been proposed thatimplementation of critical care services in the ED can negate this effect. Two main CriticalEmergency Medicine models have been proposed, the “resource intensivist” and “ED-ICU”models. The resource intensivist model is based on constant presence of an intensivist in thetraditional ED setting, while the ED-ICU model encompasses the notion of a separate EDbasedunit, with monitoring and therapeutic capabilities similar to those of an ICU. Criticalemergency medicine has the potential to improve patient care and outcome; however, establishmentof evidence-based protocols and a multidisciplinary approach in patient managementare of major importance.
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