Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2013
[Dynamics of intracranial pressure in patients with massive ischemic stroke after decompressive craniotomy].
The goal of the study was assessment of the value of ICP monitoring in patients with massive ischemic stroke after decompressive craniotomy. 12 patients with massive ischemic stroke were performed ICP monitoring after decompressive craniotomy. We identified 3 types of ICP dynamics: a) normal ICP, which no need to treat; b) ICP elevation to 20 mm Hg and more in postoperative period, which can be treated by nonsurgical therapy; c) refractory to therapy ICP elevation to 20 mm Hg and more with development of intracranial hypertension. We consider that ICP monitoring in patients with massive ischemic stroke after decompressive craniotomy can be useful for optimization of the therapy and correction of intracranial hypertension.
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Anesteziol Reanimatol · Jul 2013
[Endoscopic diagnosis, treatment and prevention of intubation related injuries of the larynx and trachea in neurosurgical patients].
The goal of the study was to assess of efficacy of endoscopic diagnosis, prevention and treatment of intubation related larynx and tracheal injuries in patients with acute neurosurgical pathology and prolonged mechanical ventilation. 199 patients with different neurosurgical pathology were enrolled in the study group. Mean age was 50 +/- 14. Control group consisted of 399 patient. ⋯ Such injuries weren't mentioned in 83 patients in study group and in 146 patients of the control group. Tracheal stenosis was developed in the study group in 0,8% of patients, which is by 7,9 times lower than in the control group (6.3%). We consider that this result was achieved due to our approach to treatment and prevention of tracheal stenosis.
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Anesteziol Reanimatol · Jul 2013
[Influence of cerebral perfusion pressure and cardiac output on brain oxygenation and metabolism].
The article contains results of examination of correlation between systemic hemodynamic and brain oxygenation and metabolism in patients with intracranial hemorrhage. Cardiac index (CI) and cerebral perfusion pressure (CPP) levels were compared to brain oxygenation and metabolism in 8 patients with intracranial hemorrhage (137 measurements). CI alterations didn't influence on PbrO2, glucose level or lactate/pyruvate ratio in the brain interstitial fluid in patients with traumatic brain injury. ⋯ CPP elevation led to PbrO2 increasing in patients with subarachnoid hemorrhage due to aneurism rupture. This phenomenon can be explained by damage mechanisms of cerebral blood flow autoregulation. In these cases CI elevation was accompanied by worsening of aerobic metabolism in theoretically intact regions and improving it in injured brain regions.
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Anesteziol Reanimatol · Jul 2013
[Morphological changes in the lumbar dorsal root ganglion of the domestic porcine after pulsed radiofrequency stimulation].
Pulsed radiofrequency (PRF) is a percutaneous minimal invasive procedure that can be used when conservative pain therapy methods have been ineffective. The effectiveness of PRF was demonstrated in various good quality randomized control studies, but mechanisms of action are still unclear. The aim of our study is to analyse the histological effects of PRF on the domestic porcine dorsal root ganglion (DRG), and evaluate the expression of biomarkers in gangliocytes. 3 domestic porcines were investigated. ⋯ PRF in spinal gangliocytes of lumbar region increases neural tissue cytoskeleton factors like NF and GFAP suggesting about active regeneration processes into the cells 1 month after the procedure. Spinal gangliocytes one month after PRF treatment notably increases Hsp-70 expression suggesting about activation of cellular activity and inhibitory role reducing of oxidative stress. Similar number of apoptotic cells in spinal ganglia of lumbar region after PRF and control side suggests about inhibitory role of PRF on programmed cell death and stimulation of cell survival.