Danijela Gulam
Josip Juraj Strossmayer University of Osijek
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Featured researches published by Danijela Gulam.
Regional anesthesia | 2014
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
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
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
Tomislav Ružman; Ozana Katarina Tot; Dubravka Ivić; Danijela Gulam; Nataša Ružman; Jelena Burazin
Periodicum Biologorum | 2015
Ivana Haršanji Drenjančević; Domagoj Drenjančević; Danijela Gulam; Slavica Kvolik; Tomislav Ružman; Gordana Kristek
Periodicum Biologorum | 2015
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
Haršanji Drenjančević Ivana; Domagoj Drenjančević; Tomislav Ružman; Danijela Gulam
Signa Vitae | 2014
Tomislav Ružman; Marina Krešić; Dubravka Ivić; Danijela Gulam; Nataša Ružman; Jelena Burazin
Periodicum Biologorum | 2013
Gordana Kristek; Ivana Haršanji Drenjančević; Slavica Kvolik; Danijela Gulam; Tomislav Ružman
Archive | 2008
Kata Šakic-Zdravčević; Danijela Gulam; Dubravka Ivić; Boris Kratofil; Slavica Kvolik; Branka Maldini; Ivo Matić; Ivan Radoš