Browsing by Author "Leibuss, Roberts"

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    Anaesthesia management with deep hypothermia and circulatory arrest during surgery for chronic thromboembolic pulmonary hypertension
    (2014-12-01) Leibuss, Roberts; Kalējs, Mārtiņš; Skride, Andris; Bekkers, Mihails; Ozoliņa, Agnese; Stradiņš, Pēteris; Strīķe, Eva; Lācis, Romans; Rīga Stradiņš University
    Chronic thromboembolic pulmonary hypertension (CTEPH) occurs in 1 to 4% after acute pulmonary embolism. CTEPH can be cured by pulmonary endarterectomy (PEA), which is approved golden standard in chronic condition. There were performed three cases of PEA in Latvian Cardiology Centre during 2013-2014. General anaesthesia under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrests was provided. The core issue is correct patient selection (in terms of central PA obstruction by thrombus) as well as pulmonary circulation recovery capacity. Neuroprotection was provided by deep hypothermia, topical cooling of the head, Trendelenburg position, mild hypocapnia, Hb 9-10 g/L and pharmacological agents. For screening postoperative cognitive function the mini mental state examination (MMSE) was used before and after the surgery. Postoperative pulmonary vascular resistance index decreased by 56.3% (right ventricular systolic pressure decreased from 93.3 ± 25.7 to 44.5 ± 11.2 mmHg). Before the surgery three patients had NYHA functional class III or IV, at the time of discharge - I or II. In one case moderate (MMSE 18) cognitive disorders was observed at discharge from the ICU. No one died neither in the hospital nor within 30 days of discharge. The surgery improved RV function and pulmonary perfusion with no considerable organ failure, except mild cognitive disorders.
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    Pain management in intensive care unit patients after cardiac surgery with sternotomy approach
    (2019) Klēvere, Baiba; Strīķe, Eva; Rutka, Katrīna; Leibuss, Roberts; Rīga Stradiņš University
    Background. Postoperative pain is a common problem among intensive care patients. Pain management includes pain assessment and documentation, patient care, and pharmacological treatment. Materials and methods. The study used a prospective, cross-sectional design. Nineteen intensive care nurses and 72 intensive care patients after cardiac surgery with sternotomy approach were studied. Toronto Pain Management Inventory was used to assess nurses and the 2010 Revised American Pain Society Patient Outcome Questionnaire was used to assess the patients. A research protocol was used to document pharmacological treatment data and Visual Analog Scale (VAS) pain measurements. The pharmacological therapy data was available for 72 patients, but patient satisfaction measurements were acquired from 52 patients. Results. Postoperative pain for intensive care patients after cardiac surgery is mostly mild (68.66%). Pain intensity had a tendency to decrease over time, from a mean VAS score of 4.66 two hours after extubation to a mean VAS score of 3.12 twelve hours after extubation. Mostly opioids (100%) and nonsteroidal anti-inflammatory drugs (NSAIDs, 77.8%) were used for pharmacological treatment, and treatment was adjusted according to pain levels and patient needs. Patient satisfaction regarding pain management in the first 24 hours after surgery was high (94.2%), even though the nurses’ pain knowledge was average(X = 60.6 ± 7.3%).Conclusions. An individualized pain management plan requires pain documentation and ensures high patient satisfaction. Pain levels after cardiac surgery with sternotomy approach are mostly mild and patient satisfaction is high.
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    Transcranial Duplex Ultrasonography Measurements Towards Identification of Blood Vessel Conditions : Artificial Cerebral Blood Flow in Pathologies
    (2022-06) Leibuss, Roberts; Posredņikova, Olga; Pupkeviča, Irina; Meidrops, Kristiāns; Mackevičs, Dāvis; Dekhtyar, Yury; Stradiņš, Pēteris; Strīķe, Eva; Rīga Stradiņš University