Anesteziologiia i reanimatologiia
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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
[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.
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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.
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Anesteziol Reanimatol · Jul 2011
[Intracranial pressure and jugular venous oxygenation influence on outcome in patients with severe traumatic brain injury].
Different criteria are used to predict outcome of TBI including jugular venous oxygenation (SjvO2) and ICP. However, there is no data on their combined use. ICP measure by ophtalmodynamometry (ODM) of central retinal vein (CR V) never was used for outcome prediction. ⋯ The main risks for them are extracerebral complications. It is necessary to use complex monitoring that includes ICP and SjvO2 for accurate prediction of the outcome of TBI. ICP should be measured by minimally invasive method.
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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.