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Over the past three months, the world has faced an unprecedented health hazard. The World Health Organization has announced a pandemic infection with an unknown species of coronavirus called SARS-CoV-2. Spreading mainly through the droplet route, the virus causes mild symptoms in the majority of cases, the most common being: fever (80%), dry cough (56%), fatigue (22%) and muscle pain (7%); less common symptoms include a sore throat, a runny nose, diarrhea, hemoptysis and chills. A life-threatening complication of SARS-CoV-2 infection is an acute respiratory distress syndrome (ARDS), which occurs more often in older adults, those with immune disorders and co-morbidities. Severe forms of the infection, being an indication for treatment in the intensive care unit, comprise acute lung inflammation, ARDS, sepsis and septic shock. The article presents basic information about etiology, pathogenesis and diagnostics (with particular emphasis on the importance of tomocomputer imaging), clinical picture, treatment and prevention of the infection. It goes on to emphasize the specific risks of providing anesthesiology and intensive care services. Due to the fact that effective causal treatment is not yet available and the number of infections and deaths increases day by day, infection prevention and strict adherence to recommendations of infection control organizations remain the basis for fighting the virus.

According to the Occupational Safety and Health Administration of the Department of Labor of the United States, the exposure risk for anaesthesiologists working with COVID-19 patients can be classified as high or very high. This is mostly due to fact that the anaesthesiologists work in close contact with patients’ airways, and the aerosol-generating nature of some procedures they perform. Fortunately, despite the occupational hazard, the incidence of COVID-19 among anaesthesiologists and intensivists remains relatively low. Current evidence suggests that the majority of SARS-CoV-2 infections in this group were either contracted outside of the work environment or can be attributed to personal protective equipment (PPE) malfunction. This article focuses on different aspects of anaesthesiologists’ safety, risks connected with different clinical scenarios and procedures, issues related to testing and screening, as well as modifiable and non-modifiable risk factors for severe illness or from COVID-19. This analysis is accompanied by a review of guidelines dedicated to mitigating said risks. Educating the personnel, introducing appropriate procedures, and proper utilisation of PPE are essential to the safety of all parties involved in hospital care, particularly those with significant exposure risk.

Dysphagia is a common problem among ICU patients. The frequency of dysphagia increases with age and sometimes symptoms can be difficult to recognise. But the consequences of dysphagia can be very serious, including aspiration and subsequently aspiration pneumonia. Therefore, knowing mechanisms and symptoms causing dysphagia is very important and should be well recognised. Proper diagnosis allows one to prevent further complications. However, both the diagnosis and treatment can be very complicated, especially among the patients who do not cooperate. In many cases, the implementation of an appropriate nutrition strategy and proper rehabilitation can alleviate the symptoms of dysphagia and avoid the most severe complications.

Dysphagia is a common problem among ICU patients. The frequency of dysphagia increases with age and sometimes symptoms can be difficult to recognise. But the con-sequences of dysphagia can be very serious, including aspiration and subsequently aspiration pneumonia. Therefore, knowing mechanisms and symptoms causing dysphagia is very important and should be well recognised. Proper diagnosis allows one to prevent further complications. However, both the diagnosis and treatment can be very complicated, especially among the patients who do not cooperate. In many cases, the implementation of an appropriate nutrition strategy and proper rehabilitation can alleviate the symptoms of dysphagia and avoid the most severe complications.

BACKGROUND: Abdominal aortic clamping during aneurysm repair may cause a decrease in splanchnic blood flow and deterioration of gut barrier integrity. Epidural blocks have beneficial effects on vital organs during abdominal surgery, but sparse data are available on the influence on gut permeability during open aortic surgery. The aim of this study was to verify the hypothesis that epidural blocks may have beneficial effects on intestine permeability changes. METHODS: Seventy individuals undergoing elective open abdominal aortic aneurysm repair were randomly assigned to receive either balanced anaesthesia (continuous epidural and general anaesthesia, group E&G) or only general anaesthesia (group G). For group E&G, an epidural catheter was inserted into the epidural space before the induction of general anaesthesia. Ropivacaine was used for intraoperative and postoperative blocks. For both groups general anaesthesia was maintained with sevoflurane. For group G, analgesia was provided with remifentanil. The assessments of gut function were based on measurements of the absorption and percentages of urinary excretion of four sugars (m 3-O-methyl-D-glucose, D-xylose, L-rhamnose and lactulose) and the lactulose/rhamnose (L/R) ratio. RESULTS: No intergroup differences were observed for sugar recovery or L/R ratio. Significant decreases in 3-O-methyl-D-glucose, D-xylose, and L-rhamnose recoveries were revealed in both examined groups when comparing the results obtained at 12 and 24 hours following the administration of anaesthesia. The rate of blood pressure decrease was significantly higher in group E&G. CONCLUSIONS: Aortic clamping during open abdominal aortic repair led to unfavorable changes in intestinal permeability. Epidural block did not attenuate this deterioration.

Background and Objectives Side effects of spinal anesthesia include arterial hypotension and bradycardia. Both of them may be induced by sympathetic nerve blockade as well as by the Bezold-Jarisch reflex, which may be mediated by peripheral serotonin receptors (5-HT3 type). The aim of this study was to verify the hypothesis that blockade of type 3 serotonin receptors by intravenous ondansetron administration might reduce hypotension and bradycardia induced by spinal anesthesia. Methods Seventy-one patients participated in the study; 36 in the ondansetron group (receiving 8 mg intravenous ondansetron), and 35 in the placebo group (receiving isotonic NaCl solution). Measurements of heart rate and arterial blood pressure were taken every 5 minutes after spinal anesthesia was performed with 4 mL 0.5% hyperbaric bupivacaine solution. Results Decreases in mean, systolic, and diastolic arterial pressure as well as in heart rate, compared with baseline values were observed in both groups. Minimal systolic and mean blood pressure values obtained over a 20-minute observation period were significantly higher in the ondansetron group. There were no significant differences in diastolic blood pressure and heart rate values between the groups. Conclusions Ondansetron given intravenously attenuates the fall of systolic and mean blood pressure, but does not have an influence on diastolic blood pressure or heart rate.