[Terminology concerning intravenous ports]. / Próba usystematyzowania terminologii dotyczacej portów dozylnych.

Ports are more and more often applied with patients requiring the permanent intravenous access, not only in the cancer treatment. Very devices, as well as procedures associated with applying them are determined in the heterogeneous way. Therefore during the last conference "Intravenous Port--implantation, care, complications" an attempt to systematize the applied terminology was made.

The analysis of surgical blood order protocol.

BACKGROUND: Surgical procedures frequently require blood transfusion. Blood and its components are frequently ordered and cross-matched excessively, without proper analysis of the real needs. The purpose of this retrospective study was to analyse the actual intraoperative requirement vs the ordering of blood, and the transfusion practices of the University Hospital. METHODS: We analysed the records of all patients scheduled for surgery in July 2007, allocating them to four groups: high, medium, low and minimal risk of blood loss and transfusion. The following calculations were made: cross-match to transfusion RBC ratio (C/T); the number of patients transfused compared to those cross-matched (transfusion probability - %T); and the number of units transfused relative to the number of cross-matched patients (transfusion index - TI). The values justifying blood ordering were: C/T ratio <3.0, %T >30% and TI>0.5. RESULTS: In all four study groups the limit values were not reached. The C/T ratios were 6.61 (high risk group), 13.7 (medium risk group) and 35.5 (low and minimal risk groups). The overall C/T ratio was 9. The %T values were 18.8%, 8.69% and 2.94%, respectively. The TI values were 0.27, 0.42 and 0.15. CONCLUSIONS: We conclude that preoperative blood ordering is far from being related to real needs, and suggest therefore, that hospital blood ordering policy should be reassessed.

Assessment of the depth of anaesthesia during inhalational and intravenous induction of general anaesthesia.

BACKGROUND: Tracheal intubation is one of the strongest stimuli during general anaesthesia and may result in an insufficient depth of anaesthesia. The aim of the study was to compare the clinical evaluation of the depth of anaesthesia with an evaluation using entropy during inhalational and intravenous induction of general anaesthesia. METHODS: This study involved 60 patients undergoing elective surgery under general anaesthesia. Patients were divided into two groups, group E (etomidate induction) and group S (sevoflurane induction). The systolic arterial pressure (SAP), heart rate (HR), response entropy (RE), and state entropy (SE) were determined at the following seven measurement points: before anaesthesia induction, at the loss of consciousness (LOC) point, before tracheal intubation, immediately after intubation, and 2 min., 4 min. and 6 min. after tracheal intubation. An increase in HR and/or SAP of more than 20% and/or the occurrence of lacrimation and/or perspiration in response to tracheal intubation was considered a marker of inadequate anaesthesia in the clinical evaluation. The depth of anaesthesia was considered insufficient according to entropy monitoring if the RE and SE were above 60. RESULTS: In clinical evaluation, insufficient anaesthesia in response to tracheal intubation was observed in all the patients in group E and in more than half of the patients in group S. At the same time, the majority of patients in both groups had entropy values that did not exceed the recommended value as an appropriate level of anaesthesia. CONCLUSIONS: We found a discrepancy in the evaluation of the depth of anaesthesia based on clinical criteria compared with evaluations based on entropy values during both intravenous and inhalational induction of general anaesthesia.