[Treatment of acute exacerbation of the obstructive pulmonary disease with hospitalization at an intensive care unit]. / Lécba akutní exacerbace chronické obstrukcní plicní nemoci za hospitalizace a na luzku intenzivní péce.

Bronchodilatation is preferably achieved with beta-2-agonists (SABA), salbutamol. Therapy is intensified with anticholinergics (ipratropium bromide monohydrate). A combined preparation may also be used (ipratropium bromide monohydrate and fenoterole hydrobromide). Methylxantines (theophylline) are the second line option. Corticosteroids are administered orally (prednisolone) or intravenously (methylprednisolone or hydrocortisone). Patients who have problems expectorating are administered mucolytics (ambroxol hydrochloride or bromhexine hydrochloride). Some patients are treated with antibiotics. Oxygenotherapy is indicated in patients with hypoxemia. Insufficient treatment effect and progression of respiratory insufficiency warrants application of mechanical or non-invasive ventilation.

[Care for patients on mechanical ventilation from the perspective of an internal medicine physician]. / Péce o nemocné na umelé plicní ventilaci z pohledu lékare internisty.

At times of respiratory insufficiency, mechanical ventilation (MV) provides support for or a substitution ofcertain components of the respiratory system. The aim of ventilation therapy is to achieve appropriate ventilation and oxygenation parameters and to minimize adverse events of MV. The main examples of non-invasive ventilation (NIV) are Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP). The main benefit of NIV is a minimal need for tracheal intubation. To perform invasive mechanical ventilation, it is necessary to secure the airways with intubation or tracheotomy. We aim for the shortest possible duration of mechanical ventilation and intubation; their duration is a risk factor in development of ventilator-associated pneumonia.

[Superior vena cava syndrome (definition, aetiology, physiology, symptoms, diagnosis and treatment)]. / Syndrom horní duté ziliy: definice, etiologie, fyziologie, symptomy, diagnostika a lécba.

Superior vena cava syndrome is a group of symptoms arising from reduced blood flow from the superior vena cava to the right atrium. The causes of superior vena cava syndrome can be malignant or benign. Nearly 95% of cases are, however, the result of malignant diseases. Superior vena cava syndrome is characterised by swelling of the face, neck or upper limbs with visible dilation of the veins in the neck or chest. Frequent symptoms are breathlessness and coughing. The treatment of the syndrome depends on the aetiology of the obstruction, the seriousness and prognosis of the disease. Treatment should begin as early as possible.