Error message
User error : Failed to connect to memcache server: druportbe01:11211 in dmemcache_object() (line 415 of /production/drupal/dim_prod/drupal/d7cl4/prod/unich/releases/7/web/sites/all/modules/contrib/memcache/dmemcache.inc ).
ANESTHESIOLOGY AND INTESIVE THERAPY Integrated educational activity
Course Sheet Academic Year of enrolment:
Hours of classroom activity:
Prerequisites:
As required by the academic regulations
Basic knowledge of physiology
Objectives
Contents ANESTHESIOLOGY AND INTENSIVE CARE
The contest
Clinical perfusion scientists (clinical perfusionists) are members of the multi-disciplinary cardiac surgical team. They have a clearly defined and uniquely specialised role. They are responsible for all aspects of patient care associated with the use of CPB during cardiac surgery. The safe conduct of CPB requires the clinical perfusionist to measure and control haematological, biochemical and other physiological parameters such as blood temperature, blood gases, pressures and flows in the circuit, during the period of bypass.
Within the context of the cardiac surgical team, the clinical perfusionist is responsible for this specialist task, working very closely with other members of the team, including the cardiothoracic surgeon, cardiothoracic anaesthetists and cardiac theatre nurse to ensure safe and successful patient outcomes.
During surgery, medicines and additional fluids are given to the patient through the CPB machine. The clinical perfusionist is also responsible for the safe termination of CPB following the instruction of the surgeon to terminate.
Clinical perfusionists also work in intensive care, the emergency department, non-cardiac theatres and the cardiac catheter laboratory, providing mechanical circulatory support and other specialist services for patients with heart disease and for other procedures, such as liver surgery and cancer chemotherapy.
CARDIOVASCULAR ANESTHESIOLOGY
Anesthesia in the cardiac patient. The cardiogenic shock inotropic and vasoconstrictive drugs; Fluid therapy in the operating room. Organ damage: kidney, main central nervous system. Cardiac output monitoring PAC, PiCCO, EV-1000. Advanced coagulation monitoring.
Extended Syllabus ANESTHESIOLOGY AND INTENSIVE CARE
• Risk in the SO and principles of clinical safety for the SO team
• Safety Manual in Surgery - Ministry and WHO
• Hospital infections and prevention strategies
• Sepsis: new guidelines - early identification and strategies recommended by the World Sepsis Campaign
• Microhemodynamics: dCO2 vs Lactates *
• EGDT in Shock: pathophysiology, ScvO2, SvO2, O2Er and Lactates *
• Gelli law and health care responsibility profiles
• Good Clinical Practices and examples: AGENAS - CIO Bundle - SIAARTI Perioperative Normothermia
• In-hospital emergency and care intensity
• Post resuscitation care and therapeutic hypothermia
• Indications for admission to intensive care and limitation of care
• Organ and tissue donation: role of the medical-nursing resuscitation and operating room team
CARDIOVASCULAR ANESTHESIOLOGY
Various types of shocks found in clinical practice and specifically cardiogenic shock and its pharmacological treatment and through the use of forms of mechanical assistance. Hemodynamic monitoring for the management of pass-range syndrome. New management of TEG and ROTEM coagulation.
Recommended Bibliography Material provided by the course teachers (slides, lecture notes)
J. A. Kaplan - Cardiac anesthesia - Ed. Delfino Editore, 1986
Teaching Methods Frontal lessons;
Theoretical-practical sessions;
Training in hospital
Evaluation methods Verification of learning:
Collegial evaluation with the other teachers of the Integrated Course
The students' learning test will take place through an oral exam and the final assessment will be expressed in thirtieths. The topics covered by the exam will reflect those covered during teaching and present in the program, developed in a way that leads students to reflect on the issues of the discipline. A correct use of medical terminology and a clear and concise presentation that allow to understand the logical connections between different issues is necessary to pass the exam.
Contacts/More Information