Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2001
Comparative Study[Ganglion block in cardiopulmonary bypass surgery].
Ganglion blockers increase the antinociceptive defense in anesthesiological support of cardiopulmonary bypass operations for mitral and aortic valve failure. Benzohexonium decreased total peripheral vascular resistance, increased cardiac and stroke indexes, and increased systolic potency of the heart. Ganglionar blocking was associated with an increase of systemic oxygen transport, arrhythmias developed rarely, blood concentrations of epinephrine, norepinephrine, ACTH, vasopressin, and leukinferon were lower.
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Anesteziol Reanimatol · Jul 2001
Comparative Study[Concept of specialized training of nurses in anesthesiology and intensive care].
The need in improving the training of medical workers necessitated the development of the concept of vocational training of nurses in anesthesiology and intensive care. The key points of this concept were discussed and approved as the basis at the Seventh All-Russian Congress of Anesthesiologists and Intensive Care Specialists in September 2000 in St. Petersburg.
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Anesteziol Reanimatol · Jul 2001
[Algorithm of cardiopulmonary resuscitation in a cardiological hospital].
Recent comments and amendments to routine algorithm of P. Safar's cardiopulmonary resuscitation, known as the ABCD principle, are critically analyzed. ⋯ Based on their studies and practical and training experience, the authors suggest a new algorithm of cardiopulmonary resuscitation: UNIVERSAL, with the following steps: precordial stroke, indirect massage of the heart, forced ventilation of the lungs, venipuncture, electrocardiography, defibrillation by electric pulse therapy, electrocardiostimulation, and injections of adrenalin, atropine, and lidocaine. Introduction of this algorithm decreased hospital mortality of acute coronary patients, increased the rate of reanimation of suddenly dead patients, and reduced the incidence of iatrogenic complications of resuscitation.
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The major ethical and legal problems in anesthesiology, intensive care, emergency and disaster medicine are discussed. Special attention is paid to violation of patient's rights, limits of intensive care and resuscitation, evaluation of iatrogenic complications and unfavorable outcomes from clinical physiological and legal viewpoints, and legal responsibility of anesthesiologists, intensive care specialists, and emergency physicians. Occupational hazards and protection of specialists in critical medicine are discussed.