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. Influence of prehospital volume replacement on outcome in polytraumatized children. Crit Care 2012; 16(5): R201. http://dx.doi.org/10.1186/cc11809 21. Younes RN, Aun F, Accioly CQ et al. Hypertonic solutions in the treatment of hypovolemic shock: A prospective, randomized study in patients admitted to the emergency room. Surgery 1992; 111: 380-5. 22. Bulger EM, May S, Kerby JD et al. Out-of-hospital hypertonic resuscitation after traumatic hypovolemic shock: A randomized, placebo controlled trial. Ann Surg 2011; 253: 431-41. http://dx.doi.org/10.1097/SLA.0b013e3181fcdb
References 1. Atwood C, Eisenberg MS, Herlitz J, Rea TD. Incidence of EMS-treated out-of-hospital cardiac arrest in Europe. Resuscitation 2005; 67:75-80. 2. Nurnberger A, Sterz F, Malzer R, et al. Out of hospital cardiac arrest in Vienna: Incidence and outcome. Resustitation 2013; 84:42-47. 3. Adrie C, Adib-Conquy M, Laurent I et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation 2002;106:562-8. 4. Nolan JP, Soar J, Cariou A, Cronberg T, Moulaert V, et al. European Resuscitation Council and European Society
complete splanchnic emptying followed soon after by splanchnic ischemia and complete mobilization of blood reserves prior to complete collapse of peripheral resistance [ 7 ]. A few conclusions: First, it appears that hemorrhage (at least under controlled laboratory conditions) progresses in a regular fashion as the result of changes in regional blood flows and blood volumes. Second, one might therefore infer that measuring blood volumes within regional different body segments can be used to monitor the progress of hemorrhage and/or resuscitation. Recently electrical
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1 Introduction In emergency situations, physicians sometimes have to make difficult decisions on whether or not to initiate emergency life-sustaining therapy. Usually the principle of the best interest of the patient is taken into account ( 1 ). In certain emergency situations, physicians can get guidance from family members and relatives ( 2 , 3 ). Janiver et al. performed a study among Canadian physicians and students in law, medicine, anthropology and bioethics on do-not resuscitate decision-making based on hypothetical clinical patients’ case vignettes that
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Aim: To present a chronological overview of the most important events and actors that have marked the history of anaesthesiology and intensive treatment in R. Macedonia since its beginnings in the 1950s.
Method: Retrospective study based on archive materials, published literature and jubilee publications, as well as the memories of individuals who have worked in the field of anaesthesiology in the past period.
Results: Between the two World Wars the first anaesthesia procedures were handled by surgeons. After World War II, the development of anaesthesia in R. Macedonia could be divided into two periods: before 1965 and after 1965. Before 1965 anaesthesia was mainly given by technicians trained on courses, and after this year anaesthesiology was taken over by anaesthesiologists who had specialized at the Faculty of Medicine in Skopje. In 1985 the number of anaesthesiologists was 100, and today it exceeds 250. The most important figures in the history of Macedonian anaesthesiology are: Dr. Risto Ivanovski, who worked from 1954-78, and Prof. Dr. Vladimir Andonov, who worked as an anaesthesiologist from 1965-99. Both of them are doyens who contributed a lot to the development of the anaesthesiology service and education of anaesthesiologists in R. Macedonia. Intensive treatment had started in 1955, but in real terms it has been performed since 1966, when artificial ventilators were introduced. The modern Intensive Care Department was opened at the Surgical Clinic in 1995 and it was followed in other hospitals in the state. The Department of Anaesthesiology has existed since 1975, and it has made a huge contribution to the education of professionals who apply modern principles in emergency medicine and intensive care.
Conclusion: From modest beginnings in the 1950s, anaesthesiology today in R. Macedonia has developed well organized activity that successfully follow the trends of modern medicine in the field of anesthesiology, resuscitation, intensive care and pain treatment.
survival of in-hospital compared to out-of-hospital refractory cardiac arrest patients treated with extracorporeal membrane oxygenation: an Italian tertiary care centre experience. Resuscitation. 2012;83:579-83. doi: 10.1016/j.resuscitation.2011.10.013. 6. Dworschak M. Is extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest superior compared with conventional resuscitation? Crit Care Med. 2013;41:1365-6. doi: 10.1097/CCM.0b013e31828044c0. 7. Le Guen M, Nicolas-Robin A, Carreira S, et al. Extracorporeal life support following out
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