ANAESTHESIA AND INTENSIVE CARE

The discipline of Anaesthesia and Intensive Care within the University of Medicine and Pharmacy ”Victor Babeș” Timișoara is part of Department X, Surgery II and provides education in Anaesthesia and Intensive Care specialty for the sixth year students of the Faculty of  Medicine, specialty General Medicine, for the fourth year students of the speciality General Medical Assistance and for the resident doctors from Anaesthesia and Intensive Care as well as for other specialties that have Anaesthesia and Intensive Care included in their curricula (medical emergencies, general surgery, paediatric surgery, infectious diseases, internal medicine, cardiology, neurology, pneumology, haematology, clinical pharmacology, etc.).

The headquarters of the Discipline of Anaesthesia and Intensive Care is in the Clinic of Anaesthesia and Intensive Care within The Emergency Clinical County Hospital ”Pius Brînzeu” Timișoara, which is the largest University Clinic of Anaesthesia and Intensive Care in the western part of the country. In 2021 the Clinic included a total of 70 ICU beds, organized in the following compartments:

• Intensive Care – 35 beds, including 5 beds for Toxicology
• Intensive Care Multitraumatology, Plastic Surgery and Burns Department – 5 beds
• Intensive Care – Orthopedics – 11 beds
• Intensive Care in Obstetrics and Gynaecology – 6 beds
• Postoperative Intensive Care – 9 beds
• Paediatric Intensive Care – 4 beds

The Clinic of Intensive Care provides care to critically ill patients suffering from life threatening organ disfunctions of different etiologies. Due to its characteristics of a regional, 1^st degree and teaching hospital,  the Emergency Clinical County Hospital Timișoara admits to the ICU Department patients coming both from Timiș but also from neighbour counties (Arad, Hunedoara, Caraș-Severin, Mehedinți and other counties).

In the same time with the ICU activity, the Anaesthesia Department from different operating theatres/sectors provides complex anaesthetic procedures, using high safety standards, for different categories of surgical patients in the surgery clinics (general surgery, vascular surgery, urology, neurosurgery, plastic surgery and burn patients, orthopedic section,  poly-traumatology, thoracic surgery, obstetrics and gynecology) as well as for diagnostic and therapeutic gastroenterological interventions (superior and inferior digestive endoscopy, ERCP, echo-endoscopy, etc.) and peripheral cerebral and vascular angiography.

Since 2001, the Discipline of Anaesthesia and Intensive Care within the University of Medicine and Pharmacy ”V. Babeș” Timișoara and the Clinic of Anaesthesia and Intensive Care within the Emergency Clinical Hospital ”Pius Brînzeu” Timișoara are managed by Professor Doctor Dorel Săndesc.

Since 2003, the Clinic of Anaesthesia and Intensive Care took part in a continuous process of modernization. The most obvious change took place in 2012, when the Clinic of Intensive Care had been completely renovated and the structure of the rooms had been changed to its actual form, having rooms with 1 and with 2 beds.

The Clinic of Anaesthesia Intensive Care was updated with modern facilities (lodging, technological equipment), being able today to provide all the specific procedures of anaesthesia and intensive care existing at the european level:

• protective artificial ventilation for patients suffering from acute respiratory distress with different etiologies
• non-invasive ventilation and high-flow oxygen therapy (High Flow Nasal Canula)
• oxygenation and extracorporeal CO₂ elimination using high-end devices such as Novalung (Xenios) and Cardiohelp (Maquet) for patients in which artificial ventilation is not efficient
• extracorporeal CO₂ elimination for patients with hypercapnia using Prolung (Estore) or Omni (BBraun) devices
• continuous renal replacement techniques (continuous hemodiafiltration) for patients with different degrees of renal failure
• absorption techniques of pro-inflammatory endotoxins and cytokines for patients with sepsis or septic shock
• therapeutic plasma exchange (plasmapheresis)
• controlled hypothermia
• total parental nutrition
• managing the organ donor
• diagnostic ultrasonography for the critically ill patient
• diagnostic and therapeutic bronchoscopy, etc.
• hemodynamic complex monitoring
• locoregional and general anaesthesia with complete intraoperative monitoring, etc.

Some statistical data related to the activity of the Clinic of Anaesthesia and Intensive Care in 2021: more than 2250 patients were admitted every year in the Intensive Care Clinic, different national programs for critical patients customized to their benefit (for example: the Anaesthesia and Intensive Care Priority Actions). Moreover, every year more than 30.000 anaesthetic procedures are performed in the operating theatres of the Emergency Clinical County Hospital Timisoara.

The Non-Profit Association for Anaesthesia and Intensive Care ”Aurel Mogoșeanu” Timișoara (founded in 2003) has an important role in sustaining the activities of the Clinic of Anaesthesia and Intensive Care, a non-governmental organisation that financially and organizationally sustained the  development projects, the scientific and the educational projects of the clinic. With the support of the association several resuscitation courses have been organized for the public and private institutions in Timiș county and also numerous charity projects for the Clinic of Anaesthesia and Intensive Care (rock concerts IRIS, CARGO, WEST Phoenix Cover, Gheorghe Zamfir concerts, folk concerts, symphonic concerts, etc.).

The ”Golden Hour” project managed by the Association for Anaesthesia and Intensive Care ”A. Mogoșeanu” Timișoara and paid from European funds contributed to the education of the medical staff involved in the management of stroke patients.

Since 2018 the Association for Anaesthesia and Intensive Care ”Aurel Mogoșeanu” has organised several activities meant to increase access to healthcare services through the seven medical caravans that took place at Ineleț (Cerna Mountains), Orăștioara de Sus (Șureanu Mountains), Nadăș (Zarand Mountains), the Romanian sketes from Mount Athos, Avram Iancu (Apuseni Mountains –Bihor area) and Râu de Mori (Retezat Mountains), Salciua de Sus (Apuseni Mountains). In each of these journeys, the population from these isolated areas was exposed to clinical and specialized consultations, biological samples collection and high quality imaging examinations.

In 2021, this type of activity continued with 6 medical caravans organised for anti SARS-COV-2 vaccination, providing vaccination of more than 1200 people from isolated areas in Sureanu Mountains (Orăștioara de Sus village), Cerna Mountains (Cornereva village) and Metalliferous Mountains (Certeju de Sus village).

During 23^rd – 6^th of April 2021, the Vaccination Marathon hosted in Timisoara, organized by the Association for Anaesthesia and Intensive Care ”Aurel Mogoșeanu” provided vaccination in record time (64 hours) of 6722 people with the help of more than 300 volunteer medical professionals. The repeated action for the second dose of vaccin was held between 13^th – 15^th of May 2021, with over 8000 people vaccinated. This project was taken by the local authorities across the country, the vaccination marathons becoming popular and organized throughout the whole country.

The COVID-19 Pandemic imposed redefining the priorities and the transformation of some areas in areas that are dedicated to this new type of patients with special needs. The Emergency Clinical Department Hospital ”P. Brînzeu” Timișoara organized a maximal number of beds COVID-19, this hospital still being opened for the medical and surgery non-COVID19 emergency cases. Temporarily, in the period September 2020 – December 2020, in the court of the hospital there was installed an additional mobile intensive care unit with a capacity of 12 beds. More than 500 critical patients who were suffering from acute respiratory distress determined by SARS-COV-2 infection were treated in the Clinic of Anaesthesia and Intensive Care.

The modernization of the Clinic of Anaesthesia and Intensive Care is a continuous process, in  2021 there were 4 major projects ongoing, paid with European and governmental funds:

• the extension of the Clinic of Anaesthesia and Intensive Care with 8 beds at the level of the small part of the second floor within the main building body of the Emergency Clinical Department Hospital – financing assured by the County Council Timiș;
• the complete digitization of the Clinic of Anaesthesia and Intensive Care – financed from European funds;
• the modernization of the medical gas installation of the Emergency Clinical Department Hospital – financed with European funds;
• the building of a modular structure, which is adjacent to the Emergency Clinical Department Hospital and that can have 22 Intensive Care beds for the COVID-19 critical cases – financed with European funds.