Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2010
[Diagnosis and correction of thrombohemorrhagic complications in cardiosurgical patients in the early postoperative period].
The methods of the prevention, diagnosis, and correction of hemostatic disorders are discussed in cardiosurgical patients. Prevention of hemorrhages requires hemostatic history data collection that allows identification of patients with concomitant hemophilia and those, taking antithrombotic drugs. The benefits of an extended study of blood coagulation disorders are shown in neonates and babies of the first year of life due to the physiological features of the hemostatic system and the pattern of heart disease. ⋯ The efficiency of using the Russian drug tranexam versus epsilon-aminocapronic acid and aprotinin in the perioperative period was evaluated. The blood coagulative system was monitored in the treatment of disseminated intravascular coagulation in multiple organ dysfunction and sepsis, which promoted the timely use of recombinant human activated protein C and human antithrombin III. A diagnostic and treatment algorithm for replacement therapy of congenital heart disease concurrent with hemophilia A is given.
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Anesteziol Reanimatol · Sep 2010
[Intensive care for newborns and babies of the first year of life with acute heart failure after cardiosurgical interventions].
After cardiosurgical interventions, the incidence of low cardiac output syndrome (LCOS) is 3-10% depending on age and surgery. The basis for management of patients with LCOS and high pulmonary hypertension is to maintain low total peripheral vascular resistance and to exclude volume overload. Due to the fact that the Russian Federation lacked phosphodiesterase (PDE) III inhibitors that are basic intensive care drugs in pediatric surgery in the West, levosimendan was used as an inodilator in the complex intensive care for postoperative LCOS in 75 infants aged 3 days to 2 years 10 months in October to December 2007. ⋯ LVEF significantly rose from 21 to 27% following 12 hours of levosimendan therapy start. The major adverse reaction was a tendency towards systemic hypotension within the first hour of levosimedan infusion requiring bolus injection of 20% albumin in 11 cases and infusion of epinephrine (0.03-0.05 microg/kg/min) in 14 cases. Thus, levosimedan may be used as an inodilator in pediatric cardiosurgery as an alternative to PDE III inhibitors in LCOS after surgical correction for congenital heart disease (CHD), accompanied by LV hypoplasia, after surgical correction of CHD with baseline low LVEF, as well as a basic drug during extracorporeal circulation and after its cessation.
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Anesteziol Reanimatol · Sep 2010
[Possibility of using vibration response imaging in resuscitation and intensive care].
Lung monitoring and visualization in intensive care unit (ICU) patients is a difficult task. Chest X-ray and auscultation are the most commonly used methods today. ⋯ This method provides clinicians with an easy-to-use, non-radiation, non-invasive acoustic-based imaging technique of visual and quantitative evaluation of the lung. VRI objective dynamic image is a clinical addition to the existing static visual modalities used in the ICU.
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Anesteziol Reanimatol · Sep 2010
[High thoracic epidural anesthesia as a component of optimization in the perioperative period in elderly and senile cardiosurgical patients].
The paper presents the results of assessing the methods of standard general anesthesia and combined anesthesia in elderly and senile surgical cardiosurgical patients.