Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2011
Randomized Controlled Trial[Clinical effectiveness of the infusion therapy under control of the transesophageal dopplerography in acute period of severe combined trauma].
In 72 patients with combined trauma the impact of volume and consistence of infusion therapy on severity of the disease, frequency and severity of infectious complications, duration of MV and ICU stay was assessed. The patients were divided into 2 groups depending on the volemic status control method and infusion algorithm. The main group (35 patients) was controlled by transesophageal dopplerography Cardio Q apparatus ("Deltex Medical", GB) and the infusion therapy was carried out under the control of stroke volume and Ftc. ⋯ Infectious complications occurred in 12 patients out of 35 in main group and 25 out of 37 in the control group. The conclusion of this study is that infusion therapy control with central hemodynamic parameters can shorten the MV time and ICU stay an lower the rate of infectious complications in patients with combined trauma. A mortality decrease in patients with transesophageal dopplerography controlled infusion is not shown.
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Anesteziol Reanimatol · May 2011
Randomized Controlled Trial[Comparison of sevoflurane and propofol anesthesia for aortocoronary bypass surgery without artificial circulation].
The purpose of the study was to compare the effectiveness of sevoflurane and propofol during combined anesthesia with epidural component during aortocoronary bypass surgery without artificial circulation. ⋯ Use of sevorane as a component of combined anesthesia during aortocoronary bypass surgery allows to improve the performance of the myocardium, reduce the severity of hypoperfusion in the perioperative period and reduce the severity of pain after the surgery compared to propofol anesthesia.
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Xenon is widely used for maintenance of anesthesia, however the analgesic effect of this noble gas brings to an idea of its use in analgesic schemes. The first time antinociceptive features of Xe were described by B. ⋯ It is well known that Xe realises its analgesic potential through powerful non-competitive blockade of NMDA-glutamate receptors, by that suppressing the development of hyperalgesia process in neurons of posterior horns of spinal cord, which take part in the process of pain transmission and forming of central sensitization and becoming the actual "gates of pain". In the given review the literature data on mechanisms, effectiveness, safety and farmacoeconomic justification of the use of Xe as an analgesic in clinical practice are brought up.
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Anesteziol Reanimatol · May 2011
Comparative Study[Assessment of cardiac output and intrathoracic blood volume by means of transpulmonary thermodilution and ultrasound dilution: similarities and differences].
The aim of the study is to compare results of the assessment of cardiac output and intrathoracic blood volume by two methods--transpulmonary (TTD) and ultrasound (UTD) thermodilution. ⋯ Both methods demonstrate close values of CO. GEDV was higher than TEDV and physiological heart volume. The absolute values of GEDV and ITBV measured by TTD are higher than the actual ones, although they reflect the changes of blood volume and can be used as dynamic preload parameters.
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Anesteziol Reanimatol · May 2011
Randomized Controlled Trial[Evaluating the effectiveness of "open lung" maneuvre].
The purpose of this study--a comparative evaluation of the treatment of postoperative acute respiratory insufficiency in cardio surgical patients with lung opening maneuver and conventional mechanical ventilation. The study included 81 patients operated on the heart and magistral vessels in which the immediate postoperative period was complicated by the development of acute lung injury. Patients were divided into 2 groups: 1 (main) group (48 patients), on which the open lung technique was used, 2 (control) group (33 patients) who underwent a standard respiratory support. ⋯ As a result of the recruiting maneuver in the first group sustained improvement of arterial oxygenation was achieved in 35 patients. In patients with acute postoperative respiratory failure recruiting maneuver led to a significant increase in arterial oxygenation and reduce the fraction of intrapulmonary shunt. Application of "open lung" maneuver leads to the resolution of respiratory failure, which greatly reduces the timing of mechanical ventilation and length of stay of patients in intensive care units in comparison with traditional methods of respiratory therapy.