[Glucose-6-phosphate dehydrogenase].

Toxicity of Doxorubicin (Dox) to different experimental organ systems.

Objectives:To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivorsData Sources:PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and Cochrane Controlled Trials Registry (1970–2015)Study S

Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis.

Anxiety symptoms in survivors of critical illness: a systematic review and meta-analysis

Background Survivors of critical illness often experience poor outcomes after hospitalisation, including delayed return to work, which carries substantial economic consequences. Objective To conduct a systematic review and meta-analysis of return to work after critical illness. Methods We searched PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from 1970 to February 2018. Data were extracted, in duplicate, and random-effects meta-regression used to obtain pooled estimates. Results Fifty-two studies evaluated return to work in 10 015 previously employed survivors of critical illness, over a median (IQR) follow-up of 12 (6.25–38.5) months. By 1–3, 12 and 42–60 months’ follow-up, pooled return to work prevalence (95% CI) was 36% (23% to 49%), 60% (50% to 69%) and 68% (51% to 85%), respectively (τ2=0.55, I2=87%, p=0.03). No significant difference was observed based on diagnosis (acute respiratory distress syndrome (ARDS) vs non-ARDS) or region (Europe vs North America vs Australia/New Zealand), but was observed when comparing mode of employment evaluation (in-person vs telephone vs mail). Following return to work, 20%–36% of survivors experienced job loss, 17%–66% occupation change and 5%–84% worsening employment status (eg, fewer work hours). Potential risk factors for delayed return to work include pre-existing comorbidities and post-hospital impairments (eg, mental health). Conclusion Approximately two-thirds, two-fifths and one-third of previously employed intensive care unit survivors are jobless up to 3, 12 and 60 months following hospital discharge. Survivors returning to work often experience job loss, occupation change or worse employment status. Interventions should be designed and evaluated to reduce the burden of this common and important problem for survivors of critical illness. Trial registration number PROSPERO CRD42018093135.

https://thorax.bmj.com/content/thoraxjnl/75/1/17.full.pdf

Return to work after critical illness: a systematic review and meta-analysis

ContextTreatment in an ICU can be stressful and traumatic for patients, and can lead to various physical, psychological and cognitive sequelae.ObjectivesThe aim of the study was to assess the influence of the social, economic and working status of individuals in regard to long-term anxiety and depre

Emotional sequelae among survivors of critical illness: a long-term retrospective study.

Stress prevalence and stressors among anaesthesiology and intensive care unit workers: A multicentre survey study.

Background : Doxorubicin (DOX) is an anticancer drug displaying cardiac and hepatic adverse effects mostly dependent on oxidative stress. Green tea (GT) has been reported to play a protective role in diseases resulting from oxidative stress. Objective : The objective of this study was to evaluate if GT protects against DOX-induced oxidative stress, heart and liver morphological changes, and metabolic disorders. Methods : Male Wistar rats received intraperitoneal injection of DOX (1.0 or 2.0 mg/kg b.w.) for 7 weeks or concomitantly GT extract soluble in drinking water. Results : There were multidirectional effects of GT on blood metabolic parameters changed by DOX. Among all tested biochemical parameters, statistically significant protection of GT against DOX-induced changes was revealed in case of blood fatty acid–binding protein, brain natriuretic peptide, and superoxide dismutase. Conclusion : DOX caused oxidative stress in both organs. It was inhibited by GT in the heart but remained unchanged in the liver. DOX-induced general toxicity and histopathological changes in the heart and in the liver were mitigated by GT at a higher dose of DOX and augmented in rats treated with a lower dose of the drug. Keywords: cardiotoxicity; doxorubicin; green tea; catechins; oxidative stress (Published: 21 December 2015) Citation: Food & Nutrition Research 2015, 59: 29754 - http://dx.doi.org/10.3402/fnr.v59.29754

/pdf/the-differential-effects-of-green-tea-on-dose-dependent-3rr7lf95i2.pdf

The differential effects of green tea on dose-dependent doxorubicin toxicity

BACKGROUND: A pulse oximeter is a standard device for perioperative monitoring. It is well known that the early detection of tissue hypoxia is of great importance. It has been made easier due to a new generation pulse oximetry device from Masimo. This enables measurements of the peripheral perfusion index (PI) in real time. It has been found that volatile anaesthetics such as sevoflurane and desflurane increase the perfusion index. As we know, no data is available about perfusion index during propofol/remifentanil total intravenous anaesthesia. METHODS: ASA I and II class women scheduled for elective gynaecological surgery were eligible for the study. Patients were divided into two groups: group P receiving propofol/remifentanil intravenous anaesthesia and group D receiving desflurane/fentanyl general anaesthesia. PI was noted before anaesthesia, after remifentanil/fentanyl injection, after endotracheal intubation, at the beginning of surgery, during the procedure at ten minute intervals, at the end of the procedure, after awakening, after extubation and before discharge to the ward. RESULTS: Eighty-three patients were enrolled to the study. In both groups, PI increased significantly from the start to the end of surgery. There was a significant correlation between PI and end-tidal desflurane concentration (r = 0.807; P = 0.001). No correlation was found between propofol or remifentanil concentrations and PI. CONCLUSION: Both intravenous propofol/remifentanil and desflurane/fentanyl general anaesthesia increase peripheral perfusion. An increase in end-tidal desflurane concentration raises peripheral perfusion.

New generation pulse oximetry in the assessment of peripheral perfusion during general anaesthesia - a comparison between propofol and desflurane.

BACKGROUND: Independent lung ventilation (ILV) has been recommended for unilateral pulmonary pathology. We describe a case of a multiple trauma patient treated with ILV for unilateral lung injury. CASE REPORT: Following a road accident, an 18 year-old male patient was referred to the university hospital with multiple organ failure, a ruptured liver and spleen, a fractured spine at the Th1–2 level, and left lung contusion. Splenectomy and liver repair had been performed in a regional hospital. On admission, a left sided pneumothorax and haemothorax were diagnosed and an emergency thoracotomy was performed, with partial resection of the left lower lobe. Because of the failure of recruitment of the left upper lobe, the patient was intubated with a double lumen tube and ILV was started using a single ventilator and a prototype flow separator, allowing separation of volume and PEEP settings. The left lung was ventilated with larger volumes and a higher PEEP than the right side, resulting in rapid improvement of gas exchange, reduction of air leak, and a return to conventional ventilation within two days. The patient underwent spinal stabilisation, and was extubated a few days later and transferred to a rehabilitation unit. CONCLUSIONS: ILV with a larger tidal volume and high PEEP may be indicated in unilateral lung injury with a significant air leak from the injured tissue.

Michał Kowalczyk

Papers

Emotional sequelae among survivors of critical illness: a long-term retrospective study.

Stress prevalence and stressors among anaesthesiology and intensive care unit workers: A multicentre survey study.

The differential effects of green tea on dose-dependent doxorubicin toxicity

New generation pulse oximetry in the assessment of peripheral perfusion during general anaesthesia - a comparison between propofol and desflurane.

Independent lung ventilation for treatment of post-traumatic ARDS