Anesteziologiia i reanimatologiia
-
Anesteziol Reanimatol · Jul 2011
Randomized Controlled Trial[Using of tranexamic acid (Tranexam) for prevention and correction of coagulopathy during brain tumors removal].
The aim of the study is to estimate clinical effectiveness of fibrinolysis inhibitor Tranexam in neurosurgical patients with intracranial tumors. The medication was prescribed to 78 patients from 27 to 65 years old. The control group consisted of 57 patients. ⋯ Drainage blood loss was lower in the main group (267 +/- 23 ml a day) than in the control group (340 +/- 28 ml a day). Medication injection during diffuse bleeding from small vessels led to quick and visible bleeding reduction. Thus Tranexam decreases the risk of intraoperative blood loss in the patients with brain tumors.
-
Anesteziol Reanimatol · Jul 2011
[First experience of using adaptive support ventilation (ASV) mode in patients with severe traumatic brain injury].
Capabilities and limitations of ASV mode in TBI patients are studied. 12 patients with severe TBI were enrolled in the study. ICP, MAP, CPP were monitored in all the patients. Cerebral regional blood flow was monitored by thermal diffusion in four patients. ⋯ In one patient hyperventilation was caused by lung mechanics disorder when ventilator tried to achieve target minute volume by low tidal volume and high respiratory rate. ASV mode provides adequate lung ventilation during respiratory support period in most patients with severe TBI. It can prove ineffective for some patients with brainstem irritation or lung mechanics disorders.
-
Anesteziol Reanimatol · Jul 2011
[Impact of xenon anesthesia on cerebral oxygenation and metabolism in neurosurgical patients].
In recent years the background for xenon anesthesia implementation in neurosurgery has been created. A variety of researches have been conducted though very few of them concerned xenon effect upon cerebral metabolism. ⋯ Xenon inhalation was marked by higher jugular vein saturation, oxygen content and glucose level and lower arterio-venous difference. We conclude that compared to propofol xenon improves cerebral oxygenation and decreases cerebral metabolism in neurosurgical patients.
-
Anesteziol Reanimatol · Jul 2011
[Intracranial pressure changes during xenon anesthesia in neurosurgical patients without intracranial hypertention].
Xenon assures rapid awakening and stable hemodynamics, it also has some neuroprotective effect. This is the reason why it may become an anesthetic of choice in neurosurgery. ⋯ We report a slight increase in intracranial and a slight decrease in cerebral perfusion pressure during xenon anesthesia and show that cerebrovascular reactivity is preserved. Thus we conclude that xenon anesthesia is safe for neurosurgical patients without intracranial hypertension.
-
Anesteziol Reanimatol · Jul 2011
[Using ASV mode for respiratory support withdrawal in patients after posterior fossa surgery].
The study gives data on how to improve the way from mechanical to spontaneous breathing in patients with weakened respiratory drive after posterior fossa tumor removal. We compared the effectiveness of two methods of weaning from mechanical ventilation in these patients. The main group consisted of 6 patients weaned from ventilator with ASV mode. ⋯ Plmax index (respiratory effort index) measured once a day increased as well. Weakened respiratory drive is accompanied by P0,1 and Plmax indexes' decrease in patients after posterior fossa tumor removal. ASV mode in these patients allows quicker weaning from mechanical ventilation.