Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2011
[Sepsis in patients with intracranial hemorrhage: incidence and influence on outcome].
The aim of the study is to analyze sepsis and septic shock incidence and their influence on the outcome in critically ill patients with intracranial hemorrhage. Sepsis incidence (33,7%) and septic shock incidence (18,6%) in the patients studied did not depend on intracranial hemorrhage etiology. ⋯ Sepsis and septic shock risk factors are defined. The problem of sepsis and septic shock diagnosis in critically ill patients with intracranial hemorrhage are highlighted.
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The review contains brief description of modem anesthetic approaches used in intractable epilepsy surgery. The authors describe main types of neurosurgery operations for intractable epilepsy, as well as the basic anesthetics and anesthetic plans and their influence on the intraoperative ECoG. Another issue raised is awake craniotomy - an anesthetic method with intraoperative emergence for verbal contact between patient and psychologist. We conclude that epilepsy surgery is one of the neurosurgery fields where anesthesiologist can significantly affect the outcome of the operation.
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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.
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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.
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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.