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Role of the radiological variables, clinical picture and values of C-reactive protein (CRP) and leukocytes in the brain edema development and eary intrahospital mortality in patients with hemorrhagic cerebrovascular insult
(Macedonian Association of Physiologists and Antropologists, 2020)
Mihajlovska Rendevska, A
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Aleksovski, B
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Aleksovski, V
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Stojanov, D
Introduction: The development of brain edema is one of the key factors that cause early neurological deterioration in patients with hemorrhagic cerebrovascular insult (H-CVI). In this study we analyzed the impact of: radiological variables (initial volume and volume of the 5th day of the intracerebral hematoma (IH), clinical state at admission (scored on appropriate scale), as well as nonspecific inflammatory markers (leukocyte count and C-reactive protein - CRP). on the development of brain edema and early in-hospital mortality, in patients with H-CVI. Material and methods: 26 conservatively treated patients with acute spontaneous intracerebral haemorrhage treated at the University Clinics of Neurosurgery and Neurology in Skopje. Computed tomography (CT) was used to evaluate radiological variables, the Canadian Stroke Scale (CSS) for neurological status scoring, as well as biochemical analysis of blood taken in the first 24 hours, to measure leukocyte counts and CRP level. Results: 8 of 26 patients (30.8%) were with lethal outcome. Initial volume of IH had the strongest effect on the development of perifocal edema, with less impact but statistically significant were: clinical status on admission and age of the patients. The strongest effect on early in-hospital mortality had all radiological variables (hematoma volume at admission and after 5 days, as well as volume of perifocal edema measured after 5 days).
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Does intra-abdominal pressure measurement increase the risk of urinary tract infection in critically ill patients?
(Macedonian Association of Anatomists and Morphologists, 2016)
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Mojsova, M
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Introduction. Intra-abdominal hypertension and abdominal compartment syndrome have been shown to contribute to organ dysfunction and mortality in critically ill patients. The diagnosis relies on intra-abdominal pressure measurement. Aim. To determine whether intra-abdominal pressure monitoring using the Foley catheters and bladder pressure measurements increases the risk of urinary tract infection. Material and methods. Retrospective chart and database review of 130 critically ill patients who underwent intravesical pressure monitoring was done in the Intensive Care Unit at the University Clinic for Anesthesia, Reanimation and Intensive Care, Skopje-Macedonia. For the measurements of intra-abdominal pressure a standard sterile procedure was used. A system was used in which a three-way stopcock was inserted for measuring the intra-abdominal pressure after instillation of 25 mL of saline into the bladder. Analysis and urine cultures of patients that developed fever of > 38.5°C were obtained. Urinary tract infection was defined by microbiological culture documentation of more than 100,000 colony-forming units per high power field of either a specific bacterium or fungus together with significant pyuria. Results. In a total of 130 patients intra-abdominal pressure measurements were made via the bladder. Patients had 520 intravesical pressure measurements performed. In total 4.6% of the patients who required intravesical pressure monitoring developed a urinary tract infection. Conclusion. Intravesical pressure monitoring does not have an influence on the risk of urinary tract infection in critically ill patients.

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