TY - JOUR AU - Gyöngyösi, Zoltán AU - Belán, Ivett AU - Nagy, Edit AU - Fülesdi, Zsófia AU - Farkas, Orsolya AU - Végh, Tamás AU - Hoksbergen, Arjan Willem AU - Fülesdi, Béla TI - Incomplete circle of Willis as a risk factor for intraoperative ischemic events during carotid endarterectomies performed under regional anesthesia – A prospective case-series JF - TRANSLATIONAL NEUROSCIENCE J2 - TRANSL NEUROSCI VL - 14 PY - 2023 IS - 1 SP - 8 SN - 2081-3856 DO - 10.1515/tnsci-2022-0293 UR - https://m2.mtmt.hu/api/publication/34083583 ID - 34083583 LA - English DB - MTMT ER - TY - JOUR AU - Gyöngyösi, Zoltán AU - Farkas, Orsolya AU - Papp, Lóránd AU - Bodnár, Fruzsina AU - Végh, Tamás AU - Fülesdi, Béla TI - The value of transcranial Doppler monitoring of cerebral blood flow changes during carotid endarterectomy performed under regional anesthesia – A case series JF - TRANSLATIONAL NEUROSCIENCE J2 - TRANSL NEUROSCI VL - 13 PY - 2022 IS - 1 SP - 476 EP - 482 PG - 7 SN - 2081-3856 DO - 10.1515/tnsci-2022-0257 UR - https://m2.mtmt.hu/api/publication/33535642 ID - 33535642 N1 - Department of Anesthesiology and Intensive Care, University of Debrecen, Nagyerdei krt. 98, Debrecen, H-4030, Hungary Department of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Outcomes Research Consortium, Cleveland, OH, United States Export Date: 13 March 2023 Correspondence Address: Fülesdi, B.; Department of Anesthesiology and Intensive Care, Nagyerdei krt. 98, Hungary; email: fulesdi@med.unideb.hu AB - Recent evidence suggests no difference between patient outcomes when carotid endarterectomies (CEAs) are performed under general or regional anesthesia. However, for detecting the need for a shunt, general anesthesia has the drawback of monitoring needs in the intraoperative setting. In the present study, we attempted to perform intraoperative transcranial Doppler (TCD) monitoring for CEAs performed under intermediate plexus block to describe cerebral hemodynamic changes during different phases of the procedure. LA - English DB - MTMT ER - TY - JOUR AU - László, István AU - Végh, Tamás AU - Szántó, Dorottya AU - Véghné Juhász, Marianna Beáta AU - Molnár, Csilla AU - Fülesdi, Béla TI - Preparing the Patient for ICU Transfer: What Is the Anesthesiologist’s Role? JF - CURRENT ANESTHESIOLOGY REPORTS J2 - CURR ANESTHESIOL REP VL - 12 PY - 2022 IS - 4 SP - 461 EP - 466 PG - 6 SN - 1523-3855 DO - 10.1007/s40140-022-00543-z UR - https://m2.mtmt.hu/api/publication/33123777 ID - 33123777 AB - Purpose of Review This review summarizes the anesthesiologist’s role in transferring critically ill surgical patients at different phases of care. Recent Findings Early recognition of patients at high intraoperative and postoperative risk is one of the most important first steps, followed by preoperative and intraoperative stabilization measures depending on the individual needs. It mainly is the anesthesiologist’s responsibility to decide on postoperative ICU admission. The transfer of the critically ill should be planned; the ICU staff has to be informed as early as possible. Locally developed checklists should be used during the preparation of patient transport. Trained, dedicated staff should be made available in every institution. A detailed handover using dedicated institutional flowcharts should ensure patient safety upon arrival to the ICU. Summary Transfer of critically ill patients from the OR to the ICU is an interdisciplinary task with a high probability of eventual incidents. Anesthesiologists should play a key role in all phases of the procedure to improve patient outcomes LA - English DB - MTMT ER - TY - JOUR AU - Balla, Boglárka AU - Fülesdi, Béla AU - Végh, Tamás TI - Korábban SARS-CoV-2-fertőzésen átesett betegek műtéti érzéstelenítése és perioperatív ellátása JF - ORVOSI HETILAP J2 - ORV HETIL VL - 163 PY - 2022 IS - 18 SP - 695 EP - 701 PG - 7 SN - 0030-6002 DO - 10.1556/650.2022.32506 UR - https://m2.mtmt.hu/api/publication/32809581 ID - 32809581 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Senturk, Mert AU - El Tahan, Mohamed R. AU - Shelley, Ben AU - Szegedi, Laszlo L. AU - Piccioni, Federico AU - Licker, Marc-Joseph AU - Karzai, Waheedullah AU - Gil, Manuel Granell AU - Neskovic, Vojislava AU - Vanpeteghem, Caroline AU - Pelosi, Paolo AU - Cohen, Edmond AU - Sorbello, Massimiliano AU - MBChB, Johan Bence AU - Stoica, Radu AU - Mourisse, Jo AU - Brunelli, Alex AU - Jimenez, Maria-Jose AU - Globokar, Mojca Drnovsek AU - Yapici, Davud AU - Morsy, Ahmed Salaheldin AU - Kawagoe, Izumi AU - Végh, Tamás AU - Navarro-Ripoll, Ricard AU - Marczin, Nandor AU - Pálóczi, Balázs AU - Unzueta, Carmen AU - Di Gregorio, Guido AU - Wouters, Patrick AU - Rex, Steffen AU - Mukherjee, Chirojit AU - Paternoster, Gianluca AU - Guarracino, Fabio TI - Thoracic Anesthesia during the COVID-19 Pandemic: 2021 Updated Recommendations by the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC) Thoracic Subspecialty Committee JF - JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA J2 - J CARDIOTHOR VASC AN VL - 35 PY - 2021 IS - 12 SP - 3528 EP - 3546 PG - 19 SN - 1053-0770 DO - 10.1053/j.jvca.2021.07.027 UR - https://m2.mtmt.hu/api/publication/32531606 ID - 32531606 AB - The novel coronavirus pandemic has radically changed the landscape of normal surgical practice. Lifesaving cancer surgery, however, remains a clinical priority, and there is an increasing need to fully define the optimal oncologic management of patients with varying stages of lung cancer, allowing prioritization of which thoracic procedures should be performed in the current era. Healthcare providers and managers should not ignore the risk of a bimodal peak of mortality in patients with lung cancer; an imminent spike due to mortality from acute coronavirus disease 2019 (COVID-19) infection, and a secondary peak reflecting an excess of cancer-related mortality among patients whose treatments were deemed less urgent, delayed, or cancelled.The European Association of Cardiothoracic Anaesthesiology and Intensive Care Thoracic Anesthesia Subspecialty group has considered these challenges and developed an updated set of expert recommendations concerning the infectious period, timing of surgery, vaccination, preoperative screening and evaluation, airway management, and ventilation of thoracic surgical patients during the COVID-19 pandemic. (C) 2021 Elsevier Inc. All rights reserved. LA - English DB - MTMT ER - TY - JOUR AU - Véghné Juhász, Marianna Beáta AU - Páll, Dénes AU - Fülesdi, Béla AU - Molnár, Levente AU - Végh, Tamás AU - Molnár, Csilla TI - The effect of propofol-sufentanil intravenous anesthesia on systemic and cerebral circulation, cerebral autoregulation and CO2 reactivity – a case-series JF - BRAZILIAN JOURNAL OF ANESTHESIOLOGY J2 - BRAZ J ANESTH VL - 71 PY - 2021 IS - 5 SP - 558 EP - 564 PG - 7 SN - 0104-0014 DO - 10.1016/j.bjane.2021.04.002 UR - https://m2.mtmt.hu/api/publication/31991553 ID - 31991553 AB - Background and objectives The aim of our study was to assess systemic and cerebral hemodynamic changes as well as cerebral CO2-reactivity during propofol anesthesia. Methods 27 patients undergoing general anesthesia were enrolled. Anesthesia was maintained using the Target-Controlled Infusion (TCI) method according to the Schnider model, effect site propofol concentration of 4 μg.mL-1. Ventilatory settings (respiratory rate and tidal volume) were adjusted to reach and maintain 40, 35 and 30 mmHg EtCO2 for 5-minutes, respectively. At the end of each period, transcranial Doppler and hemodynamic parameters using applanation tonometry were recorded. Results Systemic mean arterial pressure significantly decreased during anesthetic induction and remained unchanged during the entire study period. Central aortic and peripherial pulse pressure did not change significantly during anesthetic induction and maintenance, whereas augmentation index as marker of arterial stiffness significantly decreased during the anesthetic induction and remained stable at the time points when target CO2 levels were reached. Both cerebral autoregulation and cerebral CO2-reactivity was maintained during propofol anesthesia. Conclusions Propofol at clinically administered doses using the Total Intravenous Anesthesia (TIVA/TCI) technique decreases systemic blood pressure, but does not affect static cerebral autoregulation, flow-metabolism coupling and cerebrovascular CO2 reactivity. According to our measurements, propofol may exert its systemic hemodynamic effect through venodilation. Trial registration The study was registered at http://www.clinicaltrials.gov, identifier: NCT02203097, registration date: July 29, 2014. LA - English DB - MTMT ER - TY - CHAP AU - Marczin, Nándor AU - Licker, Marc AU - Szegedi, Laszlo L. AU - Piccioni, Federico AU - Granell, Manuell AU - Végh, Tamás AU - Karzai, Waheed AU - Unzueta, Carmen AU - Senturk, Mert AU - Bence, Johan D. AU - Shelley, Benjmin G. AU - Tahan, Mohamed El ED - Kocher, Gregor J. ED - Aresu, Giuseppe ED - Ciuche, Adrian ED - Kırali, Kaan ED - Tsui, Steven ED - Nistor, Claudiu E. TI - General Aspects of Thoracic Anesthesia T2 - Thoracic Surgery PB - Springer Netherlands CY - Cham SN - 9783030406783 PY - 2020 SP - 31 EP - 49 PG - 19 DO - 10.1007/978-3-030-40679-0_2 UR - https://m2.mtmt.hu/api/publication/31624637 ID - 31624637 AB - Thoracic anesthesia, a fascinating subspecialty, provides perioperative medicine for a spectrum of dynamically evolving surgical procedures ranging from classical thoracotomies to minimally invasive and ultra-minimally invasive video or robotically assisted procedures. Its core mission is to provide optimal surgical conditions by deflating the operative lung while providing adequate oxygenation and avoiding injury to the ventilated lung. Thoracic anesthesia also provides preoperative care to achieve best possible health status before surgery and improves postoperative recovery by providing means of pain therapy and enhanced recovery following some of the most painful procedures in patients who are at the highest risk for developing chronic pain. This chapter focuses on major current paradigms of general thoracic anesthesia representing the clinical views and preferences of a substantial core leadership of the EACTA thoracic subcommittee. As such, it is a uniquely European perspective not on the exact procedure specific details but, as the title demands, on the fundamentally basic principles of thoracic anesthesia. While covering the traditional topics of airway management, ventilation and acute pain in sufficient detail, it also expands into newer areas of interest as preoperative optimization through prehabilitation and introducing new methods to prevent chronic pain. While the discussed strategies currently represent our view as a group, we hope to formally test these concepts in the near future by subjecting these recommendations to a formal consensus statement (Thoracic Anaesthesia Consensus Agreement, TOSSCA) through a robust Delphi process involving the full membership of the EACTA Thoracic committee and the wider EACTA membership. LA - English DB - MTMT ER - TY - JOUR AU - Şentürk, Mert AU - Tahan, Mohamed R. El AU - SZEGEDI, Laszlo L. AU - Marczin, Nándor AU - Karzai, Waheedullah AU - Shelley, Ben AU - Piccioni, Federico AU - Gil, Manuel Granell AU - Rex, Steffen AU - Bence, Johan AU - Cohen, Edmond AU - Gregorio, Guido Di AU - Drnvsek-Globoikar, Mojca AU - Jimenez, Maria-José AU - Licker, Marc-Josephjo AU - Mourisse, Jo AU - Mukherjee, Chirojit AU - Navarro-Ripolli, Ricard AU - Neskovic, Vojislava AU - Pálóczi, Balázs AU - Paternoster, Gianluca AU - Pelosi, Paolo AU - Salaheldeen, Ahmed AU - Stoica, Radu AU - Unzueta, Carmen AU - Vanpeteghem, Caroline AU - Végh, Tamás AU - Wouters, Patrick AU - Yapici, Davud AU - Guarracino, Fabio TI - Thoracic Anesthesia of Patients with Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the EACTA Thoracic Subspecialty Committee JF - JOURNAL OF CARDIOTHORACIC AND VASCULAR ANESTHESIA J2 - J CARDIOTHOR VASC AN VL - 34 PY - 2020 IS - 9 SP - 2315 EP - 2327 PG - 13 SN - 1053-0770 DO - 10.1053/j.jvca.2020.03.059 UR - https://m2.mtmt.hu/api/publication/31279850 ID - 31279850 AB - The novel coronavirus has caused a pandemic around the world. Management of patients with suspected or confirmed coronavirus infection who have to undergo thoracic surgery will be a challenge for the anesthesiologists. infection who have to undergo thoracic surgery will be a challenge for the anesthesiologists. The thoracic subspecialty committee of European Association of Cardiothoracic Anaesthesiology (EACTA) has conducted a survey of opinion in order to create recommendations for the anesthetic approach to these challenging patients. It should be emphasized that both the management of the infected patient with COVID-19 and the self-protection of the anesthesia team constitute a complicated challenge. The text focuses therefore on both important topics. LA - English DB - MTMT ER - TY - JOUR AU - Berhés, Mariann AU - Fábián, Ákos István AU - László, István AU - Végh, Tamás AU - Molnár, Csilla AU - Fülesdi, Béla AU - Koszta, György TI - Emelt szintű szervtámogató és életfenntartó kezelések kritikus állapotú COVID–19-fertőzött betegeken JF - ORVOSI HETILAP J2 - ORV HETIL VL - 161 PY - 2020 IS - 17 SP - 704 EP - 709 PG - 6 SN - 0030-6002 DO - 10.1556/650.2020.31813 UR - https://m2.mtmt.hu/api/publication/31275347 ID - 31275347 AB - A COVID–19-fertőzéses, kritikus állapotba került betegek körében a cardiorespiratoricus rendszer összeomlása a következő mechanizmusok útján történhet: (1) citokinvihar, haemophagocytosis – szeptikus sokk, (2) uralhatatlan hypoxaemia, (3) specifikus szervelégtelenségek, illetve többszervi elégtelenség részjelenségeként. Ebben az összefoglalóban a fenti állapotok ellátásának és megelőzésének jelenleg rendelkezésre álló terápiás opcióit tekintjük át. A szeptikus sokk kezelésére az utóbbi években egyre gyakrabban és biztató sikerességgel kerül alkalmazásra a citokinek eltávolítása CytoSorb-haemoperfusióval. A konvencionális, mechanikus lélegeztetéssel már nem kezelhető hypoxaemia esetén szóba jön az inhalált nitrogén-oxid (iNO), az inhalációs formában bejuttatott epoprosztenol és a venovenosus extracorporalis membránoxigenizáció (VV-ECMO). A többnyire késői fázisban fellépő szervelégtelenségek gyakori komponense az akut veseelégtelenség, amely a rendelkezésre álló folyamatos vesepótló kezelések valamelyikének indítását igényli. Orv Hetil. 2020; 161(17): 704–709. LA - Hungarian DB - MTMT ER - TY - JOUR AU - László, István AU - Molnár, Csilla AU - Koszta, György AU - Végh, Tamás AU - Fábián, Ákos István AU - Berhés, Mariann AU - Véghné Juhász, Marianna Beáta AU - Fülesdi, Béla TI - A COVID-19-betegek kórházon belüli újraélesztésének speciális szempontjai JF - ORVOSI HETILAP J2 - ORV HETIL VL - 161 PY - 2020 IS - 17 SP - 710 EP - 712 PG - 3 SN - 0030-6002 DO - 10.1556/650.2020.31816 UR - https://m2.mtmt.hu/api/publication/31275345 ID - 31275345 AB - A koronavírus-pandémia számos kihívással szembesíti az egészségügyi ellátószemélyzetet. A vírus cseppfertőzéssel terjed, és magas a virulenciája, ezért minden olyan beavatkozás, mely légúti aeroszolképződéssel jár, potenciálisan veszélyezteti az ellátásban részt vevők egészségét. A koronavírus-fertőzés mortalitása akár 10% feletti lehet, ezért a COVID–19-betegek körében gyakori a reanimáció. A reanimáció során fokozott a légúti aeroszolképződés valószínűsége, így magas az ellátószemélyzet fertőződésének a veszélye. Cikkünk célja, hogy gyakorlatorientált áttekintést adjon a koronavírussal fertőzött betegek újraélesztésének specialitásairól. Orv Hetil. 2020; 161(17): 710–712. LA - Hungarian DB - MTMT ER -