Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 1997
Comparative Study[Calculation of the dose of sodium bicarbonate for correcting metabolic acidosis in surgery with circulation arrest and deep hypothermia].
The study was aimed at detecting the factors which determine the amount of 7% sodium bicarbonate solution needed to correct metabolic acidosis in patients subjected to repair surgery on the aorta involving long arrest of circulation under conditions of deep hypothermia. The total dose of 7% sodium bicarbonate solution was calculated as the sum of volumes of this solution needed to neutralize certain concentrations of underoxidized metabolites and BE. Accumulation of acid metabolites in tissues is caused by ineffective compensation of energy expenditure during warming of a patient after circulation arrest and deep hypothermia. ⋯ That is why the routine method for calculating the dose of 7% sodium bicarbonate solution for correcting metabolic acidosis is not adequate in cases with abnormal body temperature. Estimation of the dose with consideration for venous blood temperature and pO2 is more correct. An algorithm of calculation is proposed.
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The authors analyze early neonatal morbidity in 87 preterm babies and the values of perinatal mortality of newborns born to mothers whose labor was anesthesized by different methods. The task of this study was to assess the effect of long epidural anesthesia (LEA) used for preterm labor pain relief on the survival of small-for-date babies. Standard anesthesia of labor is compared to LEA. LEA ensured adequate analgesia and stable hemodynamics; moreover, it protected the intrauterine fetus from hypoxic injuries to the central nervous system due to normalization of uterine contractility and uteroplacental bloodflow and relaxation of the muscles of the fundus of the uterus.