Center for Anesthesiology, Intensive Care and Pain management

 

The department covers a wide variety of surgical procedures. Perioperative anesthesia care is provided for patients undergoing abdominal, vascular, urological, orthopedic-trauma surgery, as well as ambulatory or day-case procedures. Special attention is paid for solid organ transplantation, including liver, kidneys, or kidney-pancreas complex.

 

Anesthesiologists also administer sedation or general anesthesia for multiple diagnostic procedures, such as computed tomography, magnetic resonance imaging, minimally invasive endoscopic or interventional radiological procedures.

 

In general, around 12 000 cases of anesthesia (general, regional, or combined) are performed annually in this department. The staff has experience commonly dealing with the patients that have multiple comorbidities and undergo complex surgery, for instance liver or pancreatic resection, cancer surgery, intraoperative chemotherapy, or vascular bypass. A large proportion of the patients are critically ill ones, requiring emergency surgery, f. e. ruptured aortic aneurysm, sepsis, or multiple organ dysfunction syndrome. Emergency cases make up to a third of all patients arriving to the operating room.

Professionals in the department care about the quality of anesthesia care and postoperative analgesia. Many procedures are performed under an ultrasound control to improve the safety for the patients. The staff constantly renew their knowledge in modern anesthesia management and translate the newest research into clinical practice to ensure the best outcomes for the patients.

 

The department also focuses on education and scientific research. Continuous medical education for specialists is organized here, as well as rotations for residents and medical students.

 

 

In our department anesthesia services are provided for patients undergoing eye (including corneal transplantation), ENT, gynecological, infertility, plastic-reconstructive surgery in both in-hospital and ambulatory fields. The department specializes in neuroanesthesia bringing the challenge of long, complicated, or even multidisciplinary procedures that require a fluent teamwork within professionals from multiple specialties.

Similarly, particular attention is paid for obstetric anesthesia, since our specialists deal with the most complex cases, including severe maternal comorbidities such as congenital cardiac abnormalities.

 

In addition to surgery, here anesthesia is also provided for patients undergoing diagnostic or minimally invasive procedures, f. e. magnetic resonance imaging, computed tomography, angiography, thrombectomy, embolization, colonoscopy, etc.

 

Approximately 12 000 anesthesia cases are completed in our department annually. The staff not only ensures 24-hour anesthesia services for the patients, but also provide postoperative analgesia (epidural, regional), perform central vein catheterizations, and treat patients in postoperative care unit and 4-bed intensive care ward. We also constantly share our knowledge and experience with the rotating residents and medical students.

 

Qualified specialists and large arsenal of medication and medical equipment help to improve postoperative outcomes, safety, and satisfaction of our patients.

 

Our Department’s 1^st Intensive Care Unit treats medical patients with pulmonary, endocrinological, gastrointestinal, nervous system, metabolic and/or renal diseases. Also provides complex care for surgical patients after upper and lower gastrointestinal tract, vascular and orthopedics surgeries, trauma, and transplant. A significant proportion of patients are coming with life-threatening conditions, severe infections, septic shock with multiple organ failures, severe necrotic pancreatitis, emaciated with various types of malnutrition, anorexia nervosa or short bowel syndrome.

Our Unit treats more than 1,000 patients a year. We are committed to provide high-quality, complex, evidence-based critical care for our patients.

In addition to conventional hemodialysis, the following treatment methods are also provided in our Unit:

-                                         Continuous Renal Replacement Therapy (hemofiltration or hemodiafiltration),

-                                         MARS - Molecular Adsorbents Recirculating System (artificial liver),

-                                         Bilirubin Adsorption (liver dialysis),

-                                         Cytosorption - removal of inflammatory mediators and liver toxins.

Non-invasive (NIV) or mechanical ventilation are used in severe respiratory failure. NIV could be performed with a mask, helmet or High-Flow nasal oxygen. In case of mechanical ventilation failure for selected patients we use ECMO (extracorporeal membrane oxygenation). The Unit focuses on the assessment of nutrition, metabolism and malnutrition in critically ill patients. All parenteral and enteral nutrition methods are widely used, with routine bioimpedance testing and continuous monitoring of indirect calorimetry.

  

 

Department of Pediatric Anesthesiology and Intensive care specializes in the comprehensive treatment of critically ill children and in the treatment of patients undergoing cardiac surgery.  Children are treated after kidney transplantation, vascular and ENT surgery procedures. The department also specializes in Extracorporeal Membrane Oxygenation (ECMO) for newborns with severe acute respiratory failure and congenital diaphragmatic hernia.

 

It is the only department in Lithuania that provides treatment for children during and after cardiac surgery, heart transplantation procedures. 200 cardiac surgery procedures are performed yearly. In 2009 with the support of the Republic of Lithuania and the “Norway Grants” foundation, the department and medical equipment were substantially renovated.