Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Postoperative analgesia of newborns using local anesthetic administered through wound irrigation catheter of permanent action].
The analysis of publications is devoted to the application of skin conductance monitoring in anesthesiology and intensive care. Rates of skin conductance (baseline values, the amplitude and frequency of the waves) are closely linked with the state of the sympathic nervous system. According to their dynamics it is possible to judge on the pain and stress in patients with whom the contact is difficult: newborns, infants, patients of all age groups during general anesthesia and in critical condition. According to published data monitoring skin conductance showed itself as a sensitive and promising method to identify and determine the severity of pain in all age groups, approaching by its characteristics the theses of the pain assessment perfect tool.
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Anesteziol Reanimatol · Jan 2011
Clinical Trial[Effect of anesthesia on neurological status of newborns in abdominal delivery during early postnatal period].
The publication is devoted to the case of the successful application of alveolus mobilization maneuver in infants with respiratory distress syndrome and demonstrates the high clinical efficacy of this method of respiratory support, not only during expressed hypoxemia, but also during hypercapnic respiratory failure.
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Anesteziol Reanimatol · Jan 2011
[Application of bis monitoring in children during intensive therapy of severe traumatic brain injury].
The article presents the experience of the BIS monitoring in comparison with indicators of the pediatric Glasgow coma scale in 20 children with severe traumatic brain injury. Analyzed sample consists of 881 observations that contain two variables that contain high-quality sequence (a score on a scale of Glasgow in grades) and quantitative discrete values (the values of BIS). ⋯ The Spearman's coefficient rank correlation between scoring on Glasgow coma scale and the magnitude of BIS was R = 0.85 p < 0.001. Thus, the results showed that during severe traumatic brain injury in children the values of BIS have a high degree of correlation with the depth of coma on the Glasgow coma scale.
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Anesteziol Reanimatol · Jan 2011
[Various modes of lung ventilation in children during transition to spontaneous breathing].
The purpose of the study is to compare the effect of SIMV and BIPAP ventilation modes for the duration of mechanical ventilation, duration of the "weaning" from a respirator, the condition of gas metabolism and hemodynamics in children transferring to spontaneous breathing. In a retrospective cohort study included 30 children (16 boys and 14 girls) aged from 1 month to 18 years, which were on mechanical ventilation for more than 24 hours and required a gradual "weaning" from the unit. The children were treated in the department of general intensive care unit of Tushino City Pediatric Hospital from January 2008 to August 2010. ⋯ In the SIMV group the frequency of desynchronization episodes was greater (SIMV--an average of 3.75 + 1.4 episodes per day compared to 2.37 + 0.85 episodes in the BIPAP group, p = 0.003). The advantages of using BIPAP+ PS mode are the duration of weaning from the unit and the synchronization with the respirator. The statistically significant estimates of the parameters of pulmonary ventilation and hemodynamics require further study.
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Traumatic brain injury among other injuries of human body reaches up to 30-50% and, according to the WHO, it grows by 2%. Severe traumatic brain injury (such as severe brain contusion, epidural, subdural and intracerebral hematoma, intracerebral hygroma, diffuse axonal injury) in the structure of general trauma amounts 4-20%. ⋯ It is advised for children with severe traumatic brain injury to be directed to specialized neurosurgical or trauma hospitals, where it is possible to provide them with adequate medical care. This work is dedicated to the enhancement of the intensive care quality during severe traumatic brain injury in children of Chuvash Republic, by the means of integrated patient assessment.