Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2011
Review[Concept of mechanisms of anesthetic and therapeutic properties of xenon].
The molecular theory of L. Poling is a genius example of scientific prediction, made in the middle of 20th century, when the studies about clathrates and methods of roentgen structured analysis were doing their first steps. The views expressed in this message are some additions on the structure of xenon clathrates, function-free xenon water associates and the use of cameras in the liberated associates of the water molecules, for the process of supramolecular detoxification and attempts to develop this theory more widely, to better understand the mechanisms of xenon anesthesia and treatment for further justification of its therapeutic features as well as for the use of other inert gases (Ar, Kr) in modern medicine.
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Anesteziol Reanimatol · Mar 2011
Review[Thrombophilia and principle of thrombosis prevention in obstetrics].
One of the major causes of maternity death are complications of venous thromboembolism (VT). Risk of their occurrence during pregnancy is 5 to 10 times higher comparing to non-pregnant women. Hereditary trombophilia and antiphospholipid syndrome increase the risk of complications of venous thromboembolism significantly. ⋯ The aggravating factor is the presence of certain limitations in administration of some medications for thrombosis prophylaxis during pregnancy. Issues of medical care in pregnant patients with thrombophilia, artificial heart valves or acute VT complications are highlighted in the article, as well as principles of thrombosis prophylaxis during cesarean section or in women with VT in anamnesis. Evidence based recommendations of the recent American College of Chest Physicians consensus conference are presented for each issue.
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Anesteziol Reanimatol · Mar 2011
[First experience of using CoolGard system in intensive care patients after neurosurgical interventions: series of 10 observations].
Fever is a proven factor in secondary brain damage and worsens outcome in neuro intensive care patients. However, large randomized studies have shown neuroprotective effects of induced hypothermia only in patients with cardiac arrest and in neonates with perinatal hypoxic-ischemic brain damage. Nevertheless, now there is an active search for alternative modes of temperature correction, which would have been effective in other groups of patients with brain damage. ⋯ Thus, the CoolGard system effectively lowers the body temperature to the target values for neuro intensive care patients. Application of this system is relatively safe. However, the most dangerous are the thromboembolic complications, thus the daily ultrasound scanning of lower limb veins and the possible early use of low molecular weight heparins is crucial.
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Anesteziol Reanimatol · Mar 2011
Clinical Trial[High level thoracic epidural analgesia as a special component of anesthesia during thoracic surgeries].
This article is devoted to assessing the adequacy and safety of total intravenous anesthesia based on constant dosed infusion of propofol and high thoracic epidural analgesia in thoracic surgical procedures requiring an artificial one-lung ventilation in patients with concomitant chronic cardiorespiratory disorders compared to TIVA without a high thoracic epidural analgesia. Comparative analysis of gas exchange, metabolic rate, pressor, resistance and volumetric characteristics of pulmonary blood flow, central and intracardiac hemodynamics was conducted. We used high technology invasive monitoring system PICCOplus for transpulmonary thermodilution in combination with VoLEF for pulmonary thermodilution in changing modes of ventilation MV-MSL V-MV. MSL V lasted more than 1.5 hours.
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Anesteziol Reanimatol · Mar 2011
[Bilateral bispectral index monitoring during surgery for posterior cranial fossa tumors].
The analysis of the results of bilateral monitoring of the depth of anesthesia in 22 patients with neurosurgical pathology of the posterior cranial fossa using the technique bispectral index (BIS). The results showed that more than half of the observations (at 19 and 22 patients) during the main phase of the operation (removal of the tumor) were observed differences in the BIS index values between the right and left side. In 1/3 of patients, these differences were driven by higher values of BIS on the side of surgery. By the end of removal of the tumor and, particularly, by the end of surgery there was a complete alignment of values of the BIS on the right and left.