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Dive into the research topics where Danijela Gulam is active.

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Featured researches published by Danijela Gulam.


Regional anesthesia | 2014

Factors associated with difficult neuraxial blockade.

Tomislav Ružman; Danijela Gulam; Ivana Haršanji Drenjančević; Darija Venžera-Azenić; Nataša Ružman; Jelena Burazin

Spinal and epidural blocks are common practice in anesthesia and are usually used for various surgical or endoscopic procedures. Correct identification and puncture of the epidural or subarachnoid space determine the success or failure of the technique. Multiple attempts and difficult access to the epidural or subarachnoid space is a frequent problem in operating theaters and may be hazardous due to a number of possible acute or long-term complications. In addition, multiple punctures are associated with increased pain and patient discomfort. The aim of this study was to determine the factors associated with a difficult spinal or epidural block, dependent on the patient (age, gender, height, weight, body mass index, and quality of anatomical landmarks), the technique (type of blockade, needle gauge, and patient positioning), and the provider (level of experience). The study was conducted at the Department of Anesthesiology, Resuscitation, and Intensive Care Unit of University Hospital Osijek (Osijek, Croatia) and it included 316 patients who underwent a range of different surgical procedures in neuraxial blocks. There were 219 cases of first puncture success, while the overall success of neuraxial blocks was 97.5%. Five patients (1.6%) were submitted to the alternative technique, ie, general anesthesia. In three patients (0.9%), neuraxial block was partial so they required supplementation of intravenous anesthetics and analgesics. Furthermore, it was found that first puncture success was associated with younger age (P=0.007), lower weight (P=0.032), and body mass index (P=0.020). Spine deformity (P=0.015), poor identification of interspinous space (P=0.005), recumbent patient position during the puncture (P=0.001), and use of a paramedian approach were associated with first puncture failure. Adequate preoperative prediction of difficulties can help to reduce the incidence of multiple attempts, rendering the technique more acceptable and less risky to the patient, and consequently leading to improvement of medical care quality. The attending anesthesiologist should consider an alternative technique (general anesthesia or peripheral nerve block) for a patient if certain difficulties can be predicted.


Journal of Clinical Anesthesia | 2017

Sevoflurane preserves regional cerebral oxygen saturation better than propofol: Randomized controlled trial

Tomislav Ružman; Tatjana Šimurina; Danijela Gulam; Nataša Ružman; Maja Miškulin

STUDY OBJECTIVE To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. DESIGN Randomized, prospective and single-blinded study. SETTING Academic hospital. PATIENTS ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014. MEASUREMENTS Changes of regional cerebral oxygen saturation were measured by near-infrared spectroscopy on the left and right sides of forehead at different time points: before anesthesia induction (Tbas), immediately after induction (Tind), after applaying a pneumoperitoneum (TCo2), 10 minutes after positioning the patient into reverse Trendelenburgs position (TrtCo2), immediately after desufflation of gas (Tpost) and 30 (Trec30) and 60 (Trec60) minutes after emergence from anesthesia. MAIN RESULTS Study population included 124 patients, 62 in each group. There was no significant difference between these groups according to demographic characteristics, surgery and anesthesia times as well as in the basal rcSo2 values. Statistically higher rSco2 values were noted in the VIMA group when compared to the TIVA group in all time points Tind, TCo2, TrtCo2, Tpost, Trec30 and Trec60 and incidence of critical rcSo2 decreases was statistically lower in VIMA group (P<.05). There were no serious perioperative complications. CONCLUSIONS VIMA technique provides significantly (4%-11%) higher rcSO2 values during general anesthesia for laparoscopic cholecystectomy, when compared with TIVA and also provides significantly less number of critical rcSO2 decreases.


Surgical Laparoscopy Endoscopy & Percutaneous Techniques | 2017

Transcranial Cerebral Oxymetric Monitoring Reduces Brain Hypoxia in Obese and Elderly Patients Undergoing General Anesthesia for Laparoscopic Cholecystectomy

Tomislav Ružman; Boris Mraovic; Tatjana Šimurina; Danijela Gulam; Nataša Ružman; Maja Miškulin

The aims of this prospective, observational study were to evaluate the changes of the regional cerebral saturation (rSO2) measured by near-infrared spectroscopy during elective laparoscopic cholecystectomy under total intravenous anesthesia and the association between patient’s characteristics and critical decline of rSO2. Hemodynamics, rSO2, and oxygen saturation were recorded in different time points: before the anesthesia (Tbas), 2 minutes after the induction (supine position) (Tind), 2 minutes after CO2 insufflation (supine) (TCO2), 10 minutes after CO2 insufflation (reverse Trendelenburg) (TrevT), and 2 minutes after deflation (supine) (Tpost). Average age was 53±13 (range: 22 to 79 y). In 12 of a total of 62 patients (19.4%) the rSO2 decreased >20% (20.5% to 28.4%) in TCO2 or TrevT times. Significantly higher decrease of the rSO2 was found in patients older than 65 years and those with body mass index >30 kg/m2 (P<0.05). Noninvasive monitoring of cerebral oxygenation could be an important part of perioperative care in obese and older patients.


Wiener Klinische Wochenschrift | 2013

In-hospital cardiac arrest: can we change something?

Tomislav Ružman; Ozana Katarina Tot; Dubravka Ivić; Danijela Gulam; Nataša Ružman; Jelena Burazin


Periodicum Biologorum | 2015

Arterial pressure and heart rate changes in patients during “beach chair position” for shoulder surgery: comparison of the regional and general anesthesia techniques

Ivana Haršanji Drenjančević; Domagoj Drenjančević; Danijela Gulam; Slavica Kvolik; Tomislav Ružman; Gordana Kristek


Periodicum Biologorum | 2015

Patient satisfaction with regional anesthesia in orthopedic surgery

Tomislav Ružman; Nataša Ružman; Gordana Kristek; Ivana Haršanji-Drenjančević; Danijela Gulam; Slavica Kvolik


VI. Hrvatski kongres anesteziologije i intenzivne medicine s međunarodnim učešćem/6th Croatian Congress of Anaesthesiology and Intensive Care Medicine with international participation | 2014

Changes in heart rate and blood pressure of anesthesiologists at University Hospital Center Osijek during work on call and free days

Haršanji Drenjančević Ivana; Domagoj Drenjančević; Tomislav Ružman; Danijela Gulam


Signa Vitae | 2014

Premedication with midazolam is equally effective via the sublingual and intravenous route of administration

Tomislav Ružman; Marina Krešić; Dubravka Ivić; Danijela Gulam; Nataša Ružman; Jelena Burazin


Periodicum Biologorum | 2013

The use of an ultrasound-guided popliteal block for hallux valgus surgery in a patient with myasthenia gravis

Gordana Kristek; Ivana Haršanji Drenjančević; Slavica Kvolik; Danijela Gulam; Tomislav Ružman


Archive | 2008

Clinical Anaesthesiology : Reanimatology and Intensive Care Medicine

Kata Šakic-Zdravčević; Danijela Gulam; Dubravka Ivić; Boris Kratofil; Slavica Kvolik; Branka Maldini; Ivo Matić; Ivan Radoš

Collaboration


Dive into the Danijela Gulam's collaboration.

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Tomislav Ružman

Our Lady of Lourdes Hospital

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Nataša Ružman

Josip Juraj Strossmayer University of Osijek

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Slavica Kvolik

Josip Juraj Strossmayer University of Osijek

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Dubravka Ivić

Josip Juraj Strossmayer University of Osijek

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Ivana Haršanji Drenjančević

Josip Juraj Strossmayer University of Osijek

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Borna Kovačić

Josip Juraj Strossmayer University of Osijek

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Domagoj Drenjančević

Josip Juraj Strossmayer University of Osijek

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Maja Miškulin

Josip Juraj Strossmayer University of Osijek

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Tatjana Šimurina

Josip Juraj Strossmayer University of Osijek

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Andreja Rakipović-Stojanović

Josip Juraj Strossmayer University of Osijek

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