The 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova, 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine, 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care September 27-29, 2018, Chisinau, the Republic of Moldova http://repository.usmf.md:80/handle/20.500.12710/17902 2026-04-11T03:59:58Z 2026-04-11T03:59:58Z http://repository.usmf.md:80/handle/20.500.12710/16551 2021-09-24T11:09:22Z 2018-01-01T00:00:00Z

Title: The Moldovan Medical Journal. September 2018, Vol. 61: AIC Congress Issue Abstract: The Moldovan Medical Journal is an international scientific double-blind peer reviewed periodical edition, 6 per year, of the Scientific Medical Association of the Republic of Moldova designed for specialists in the areas of medicine, dentistry, pharmacy, social medicine and public health. From its debut the journal has striven to support the interests of Moldovan medicine concerning the new concepts of its development. The Editorial Board warmly welcomes both the readers of and the authors for the journal, all those who are enthusiastic in searching new and more effective ways of solving numerous medicine problems. We hope that those who want to make their contribution to the science of medicine will find our journal helpful and encouraging. Description: Joint Meeting of 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care September 27-29, 2018, Chisinau, the Republic of Moldova. Fondatori: Ministerul Sănătăţii al Republicii Moldova, Universitatea de Stat de Medicină şi Farmacie “Nicolae Testemiţanu”

2018-01-01T00:00:00Z Voinschi, Romaniţa Mihailişin, Nicolae Severin, Ghenadie Chesov, Ion http://repository.usmf.md:80/handle/20.500.12710/9926 2021-09-24T11:08:01Z 2018-01-01T00:00:00Z

Title: Rezistenţa culturilor bacteriene în secţia de terapie intensivă Authors: Voinschi, Romaniţa; Mihailişin, Nicolae; Severin, Ghenadie; Chesov, Ion Abstract: Introducere: Rezistenţa bacteriilor la antibiotice reprezintă o problemă majoră în sistemul medical. Antibioticoterapia excesivă reduce biodiversitatea bacteriană, favorizând colonizarea gazdei umane cu germeni rezistenţi la diverse antimicrobiene. Material şi metode: Analiza retrospectivă a examinărilor bacteriologice în perioada 1 ianuarie 2016 – 31 decembrie 2017 în Spitalul Clinic Municipal nr. 1, Chişinău, probe prelevate din Secţia de terapie intensivă. Pentru definirea multidrog-rezistenţei au fost utilizate criteriile European Centre for Disease 2012. Rezultate: Au fost cercetate 530 de rezultate microbiologice, în 497 de cazuri au fost depistate tulpini bacteriene. Au fost analizate tulpinile muldidrog-rezistente. Tulpinile de P. aeruginosa au prezentat nivele de rezistenţă la: Piperacillin –tazobactam (2016 – 13%; 2017 – 100%); Levofloxacin (2016 – 53%; 2017 – 55%); Tobramicin (2016 – 33%; 2017 – 59%); Meropenem (2016 – 100%; 2017 – 69%). Tulpinile de S. aureus au prezentat nivele de rezistenţă la: Doxycycline (2016 – 0%; 2017 – 100%); Erytromicin (2016 – 39%; 2017 – 50%); Clindamycin (2016 – 31%; 2017 – 43%). Tulpinile de Enterococcus spp. au prezentat nivele de rezistenţă la: Meropenem (2016 – 100%; 2017 – 100%); Gentamicin (2016 – 80%; 2017 – 75%); Doxycycline (2016 – 67%; 2017 – 62%). Tulpinile de Enterobacteriaceae au prezentat nivele de rezistenţă la: Cefuroxime (2016 – 100%; 2017 – 100%); Cefepime (2016 – 67%; 2017 – 90%); Gentamicin (2016 – 45%; 2017 – 62%); Meropenem (2016 – 100%; 2017 – 73%). Concluzii: Tulpinile izolate au înregistrat nivele înalte de rezistenţă la aminoglicozide, cefalosporine şi tetracicline. Analiza patternurilor de MDR la cele 3 tulpini izolate au demonstrat nivele înalte de rezistenţă pentru toate 3 tulpinile. Nu au fost identificate tulpini cu rezistenţă extinsă (XDR) şi pan-rezistenţă (PDR) conform criteriilor European Centre for Disease.; Background: Antibiotic resistance is recognized as a major problem of the medical system. Excessive antibiotic therapy reduces bacterial biodiversity by favoring colonization of the human organism with germs resistant to various antimicrobials. Material and methods: Retrospective analysis of bacteriological examinations during January 1, 2016 – December 31, 2017, collected in the ICU, Municipal Clinical Hospital Nr. 1, Chisinau. The criteria for the European Center for Disease 2012 were used to define multidrug resistance. Results: 530 analyses were investigated and were obtained 497 cases of bacterial strains. The following MDR strains were identified: a) P. aeruginosa strains showed resistance levels to: Piperacillin-tazobactam (2016 – 13%, 2017 – 100%); Levofloxacin (2016 – 53%, 2017 – 55%); Tobramycin (2016 – 33%, 2017 – 59%); Meropenem (2016 – 100%, 2017 – 69%). b) S. aureus strains showed resistance levels to: Doxycycline (2016 – 0%, 2017 – 100%); Erythromycin (2016 – 39%, 2017 – 50%); Clindamycin (2016 – 31%, 2017 – 43%). c) Enterococcus spp. showed resistance levels to: Meropenem (2016 – 100%, 2017 – 100%); Gentamicin (2016 – 80%, 2017 – 75%); Doxycycline (2016 – 67%, 2017 – 62%). d) Enterobacteriacae showed levels of resistance to: Cefuroxime (2016 – 100%, 2017 – 100%); Cefepime (2016 – 67%, 2017 – 90%); Gentamicin (2016 – 45%, 2017 – 62%); Meropenem (2016 – 100%, 2017 – 73%). Conclusions: 1) Isolated strains recorded high levels of resistance to aminoglycosides, cephalosporins and tetracyclines. 2) Analysis of MDR patterns in the isolates showed high resistance levels for all strains. 3) Strains with extended resistance (XDR) and pan-resistance (RDP) were not identified according to the criteria of the European Center for Disease. Description: Catedra de anesteziologie și reanimatologie nr. 1, Universitatea de Stat de Medicină și Farmacie “Nicolae Testemițanu” Chișinău, Republica Moldova, The 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova, 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine, 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care, September 27-29, 2018, Chisinau, the Republic of Moldova

2018-01-01T00:00:00Z Vaculin, Nicolae http://repository.usmf.md:80/handle/20.500.12710/9924 2021-09-24T11:09:51Z 2018-01-01T00:00:00Z

Title: Managementul anestezic la pacienții cu tumorile zonei chiasmal-selare Authors: Vaculin, Nicolae Abstract: Introducere: Tratamentul pacienților cu tumori ale zonei chiasmal-selare reprezintă o problemă actuală în neurochirurgie și neuroanesteziologie, fiind o provocare pentru medicul anestezist. Acest tip de tumori prezintă o incidență înaltă (18% din numărul total de tumori neurochirurgicale). Conținut: Manifestările clinice și posibilele complicații sunt dictate de localizarea topografică a tumorii, având în vecinătate unele din cele mai importante structuri anatomice (artera carotidă internă, sinusul cavernos, hipotalamusul, ventriculul III). Implicarea lor în procesul patologic sau deteriorarea lor duc, de obicei, la complicații severe intra- și postoperatorii. O altă particularitate este dezechilibrul hormonal dictat de tumorile chiasmal-selare, ce se complică prin perturbări somatice severe dishormonale. Evident, toate acestea necesită o evaluare și o pregătire preoperatorie cu o conduită anestezică specifică ce minimalizează riscul apariției complicațiilor posibile, dictând succesul acestui tip de intervenții neurochirurgicale. Concluzii: Pacienții cu tumori ale zonei chiasmal-selare necesită o abordare complexă și o coordonare între endocrinolog, neurochirurg și anestezist. Manifestările sistemice preoperatorii și bolile sistemice secundare datorate disfuncției pituitare trebuie evaluate și corijate în preoperator. Managementul perioperator anestezic la pacienții cu tumori ale zonei chiasmal-selare necesită o abordare individualizată, în scopul prevenirii și corecției rapide a complicațiilor posibile. Toți pacienții au nevoie de un follow-up pe termen lung, de un endocrinolog experimentat pentru a-și evalua și corija statutul hormonal.; Background: The treatment of patients with tumors of chiasmal-sellar area represents a current issue in neurosurgery and neuroanesthesia; it is a challenge for the anesthesiologist. This type of tumors presents a high incidence (18% from the total number of neurosurgical tumors). Clinical case description: The clinical manifestations and possible complications are dictated by the topographic location of the tumor, having nearby one of the most important anatomical structures (the internal carotid artery, the sinus, the hypothalamus, the 3rd ventricle); their implication in the pathological process or their damage usually leads to severe complications during intraoperative and postoperative period. Another peculiarity is the hormonal imbalance dictated by the chiasmal-sellar tumors, which gets complicated by severe dishormonal somatic disturbances. Obviously, all of these require an evaluation and a preoperative preparation with a special anesthetic conduit, which minimalizes the risk of future complications, dictating the success of this type of neurosurgical interventions. Conclusions: The patients with tumors of the chiasmal-sellar area require a complex approach and coordination between endocrinologist, neurosurgeon and anesthesiologist. The systemic preoperative manifestations and systemic side diseases (comorbidities) due to the pituitary dysfunction have to be appreciated and fixed in the preoperative period. The management of the patients with tumors of the chiasmal-sellar area requires an individualized perioperative anesthetic management with the purpose of rapidly preventing and correcting possible complications. All patients need a follow-up on a long-term basis, made by an experienced endocrinologist in order to evaluate and manage the hormonal status. Description: Departamentul Anesteziologie şi Terapie Intensivă, Spitalul Internațional Medpark, Chișinău, Republica Moldova, The 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova, 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine, 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care, September 27-29, 2018, Chisinau, the Republic of Moldova

2018-01-01T00:00:00Z Tincu, Eugen Damian, Dan Dascalu, Corina http://repository.usmf.md:80/handle/20.500.12710/9922 2021-09-24T11:10:56Z 2018-01-01T00:00:00Z

Title: Point-of-care visual medicine in the management of emergency intensive care patients: case study Authors: Tincu, Eugen; Damian, Dan; Dascalu, Corina Abstract: Introduction: Real-time, bedside (point-of-care) medical image is actually a valuable tool in the diagnosis and management of intensive care patients. In order to illustrate, we present a case with acute chronic respiratory acidosis and hypercapnic coma, when the use of visual medicine shortened the intervention time frame and minimized the complication risks. Case presentation: A male, 64 years old patient, admitted to Internal Medicine with the diagnosis of chronic obstructive bronchopneumopathy exacerbation (respiratory infection) and multiple co-morbidities presents on the 7th day rapid aggravation and has emergency ICU admittance with coma (GCS=8), polypnea (36 breath/min), hypoxemia (SpO2=55%), abundant tracheobronchial secretion retention, arterial hypotension (65/45 mm Hg), tachyarrhythmia (150b/min), acute on chronic respiratory acidosis (pH=7.21, PaCO2=105 mmHg). The emergency management included: video-assisted oro-tracheal intubation (after tube insertion, plugging with abundant secretions) and ventilatory support; vascular access (ultrasound guided central venous and arterial catheterization); fiberoptic-bronchoscopic removal of purulent and bloody abundant secretions; transthoracic echocardiography (severe LV hypokinezia, EF-30%, diffuse subepicardial ischemia). Under complex intensive care treatment (antibiotics, water and electrolyte correction, inotropic support, antiarrhythmic drugs, anticoagulants, mucolytics, antipyretics, enteral nutrition) the condition improves and results in weanning from ventilatory support (the 5th day), from inotropic support (the 7th day) and ICU discharge (the 8th day). Discussion: In critical emergencies, the use of bedside, real-time medical images during diagnostic, monitoring or therapeutic procedures results in several advantages: it shortens the implementation time (tracheal intubation, vascular access), allows rapid evaluation and proper management institution (echocardiography), allows a significant decrease of complication risk (video-assisted laryngoscopy, fiberoptic-bronchoscopy, vascular access). Conclusions: Point-of-care visual medicine – the use of real-time, bedside medical images is an imperative necessity in modern intensive care. Description: Moinesti Emergency Country Hospital Moinesti, Romania, The 5th International Congress of the Society of Anesthesiology and Reanimatology of the Republic of Moldova, 16th Edition of the International Course of Guidelines and Protocols in Anesthesia, Intensive Care and Emergency Medicine, 28th Meeting of the European Society for Computing and Technology in Anesthesia and Intensive Care, September 27-29, 2018, Chisinau, the Republic of Moldova

2018-01-01T00:00:00Z