Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2012
Case Reports[Spinal neurosurgical intervention in a patient with end-stage renal disease (ESRD)].
The article presents the description of clinical observation, in which spinal neurosurgical intervention was successfully made in a patient with ESRD, receiving chronic hemodialysis for 20 years. In this context, we discuss the various clinical and tactical aspects of the management of patients with this severe co-pathology: infusion-transfussion therapy, peculiarities of anesthetic management and intra-operation monitoring, diagnostics and correction of hemostasis disorders, hemodialysis organization.
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Anesteziol Reanimatol · May 2012
Clinical Trial[Ketamine versus propofol during one-lung ventilation in thoracic surgery].
A comparative analysis of gas, the metabolic rate, pressor, resistive and volumetric characteristics of pulmonary blood flow, central and intracardiac hemodynamics in patients undergoing thoracic surgery was conducted. 2 methods of anesthesia maintenance: on the basis of ketamine - fentanyl - pipecuronium and propofol - fentanyl - pipecuronim were compared. Invasive monitoring system PiCCOplus for the behaviour of the transpulmonary thermodilution (TT) in combination with VoLEF for the pulmonary thermodilution (PT) the change of ventilation mode ALV - OLV - ALV was used. OLV lasted for more than 1.5 hours.
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Anesteziol Reanimatol · May 2012
Clinical Trial[Modern aspects of diabetic ketoacidosis treatment in children].
The aim of the research - the analysis of the regularities of diabetic ketoacidosis treatment in children and adolescents with type 1 diabetes mellitus, the explanation of the results obtained with the use of biological systems stability theory elements. MATHERIALS AND METHODS: The study included 90 children with type I diabetes mellitus in a state of diabetic ketoacidosis of different severity degree. With newly diagnosed type 1 diabetes mellitus - 56 children, with the "courced" diabetes - 34 children. In the evaluation of patients status was defined glucose, pH, and other indicators of acid-base status, using gas analyzer GEM Premier 3000 ("Instrumental laboratory", USA). ⋯ The offered technique for diabetic ketoacidosis treatment on the basis of the glucose solutions infusion throughout the treatment and "small" doses of insulin values pH and glucose in a safe range, even in patients with high risk of brain edema, which is confirmed by biological systems stability theory.
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Anesteziol Reanimatol · May 2012
[Prognostic criteria for tracheostomy in the neuroresuscitation unit].
The aim is to specify prognostic criteria for tracheostomy on the basis of long-term (more than 14 days) ALV and prolonged (more than 14 days) trachea canmulation. ⋯ Prognostic criteria for tracheostomy in patients in neuroresuscitation unit are: criteria for prolonged ALV: level of 8 or less points on the Glasgow coma scale and subarachnoid hemorrhage and criteria for prolonged trachea cannulation: constrained basal cisterns, detected on CT scan of the brain and to the consciousness level of 8 or less points on the Glasgow coma scale.
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Anesteziol Reanimatol · May 2012
Clinical Trial[Haemostasis disturbances as the component of the surgical stress-response and possibilities of their correction].
An estimation of haemostasis parameters in the major abdominal surgery in comparision with surgical stress-response markers depending on anaesthesia and analgesia technique. ⋯ Hemostasis changes can be considered as a component of the surgical stress-response. The role of intraoperative regional anaesthesia is much more significant, than postoperative analgesia.