Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2000
Review Comparative Study[Sepsis on the threshold of the 21st century: the basic results. New problems and the immediate tasks].
The authors validate their positions in terminology of sepsis and evaluation of its severity, based on analysis of this problem evolution during the century, review of the most significant publications, and their own findings. Problems of intensive care are discussed. The authors claim that intensive care methods should be determined by the phase of the systemic inflammatory response syndrome (SIRS). One of the nearest goals for scientists and public health managers is an interdisciplinary consensus on terminology of sepsis and diagnostic criteria, creation of a standard protocol of laboratory studies and treatment, search for available markers of SIRS of infectious origin, regulation of cytokine response, creation of local data bases reflecting the etiological structure of the agents and their antibiotic resistance.
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Anesteziol Reanimatol · May 2000
Comparative Study[Ways to decrease blood loss during total hip joint endoprosthesis].
Total replacement (endoprosthesis) of the hip joint was carried out in 93 patients aged 18-60 years. Sixteen operations were performed under prolonged epidural blockade, 66 under neuroleptanalgesia, and 16 under ataralgesia. ⋯ Isovolemic hemodilution in patients with preoperative deficit of circulating blood volume decreased blood loss during long traumatic operations. Prolonged epidural blockade in combination with isovolemic hemodilution and spontaneous respiration led to a notable (70%) decrease of the true blood loss in comparison with the traditional neuroleptanalgesia.
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Anesteziol Reanimatol · May 2000
[Combined anesthesia using Diprivan and ketamine in pediatric surgery].
A total of 120 children aged 7-14 years were subjected to short-term elective and urgent interventions under combined intravenous anesthesia with diprivane and ketamine. The patients were divided into groups depending on methods of general anesthesia. ⋯ Ketamine ensured stable hemodynamics during induction anesthesia. A combination of diprivane and ketamine levelled some untoward effects of these anesthetics.
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Anesteziol Reanimatol · May 2000
[Abdominal sepsis: the integral assessment of the severity of patient condition and of multiple organ dysfunction].
Results of examinations of 247 patients with diffuse peritonitis and symptoms of abdominal sepsis are analyzed. Systemic inflammatory reaction in peritonitis patients can manifest by sepsis, severe sepsis, and infectious toxic (septic) shock. The severity of systemic inflammatory reaction syndromes can be evaluated by objective scores for evaluation of clinical states (APACHE II, SAPS) and the degree of multiple organ dysfunction/failure (MODS, SOFA). Application of objective scores for evaluation of clinical states provides clinical stratification of abdominal sepsis, helps predict the disease course and outcome, and improve treatment strategy.