Anesteziologiia i reanimatologiia
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The article deals with an analysis of the publications devoted of local anaesthetics' systemic toxicity (LAST) due to regional anaesthesia and symptoms of this potentially lethal complication. The review discusses features of systemic absorption and forms of local anaesthetics' neurotoxicity and cardiotoxicity in children, including newborns, differences of clinical signs of the LAST in adults and children and dosage of racemic bupivacaine. Moreover, the article deals with a modified treatment protocol for LAST and a method of lipid resuscitation with 20% lipid emulsion in the form of Intralipid. In conclusion the article discusses recommendations for LAST prophylaxis and scenarios during cardiopulmonary and cerebral resuscitation.
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Anesteziol Reanimatol · Sep 2014
Randomized Controlled Trial[Neutrophil gelatinase-associated lipocalin (u-NGAL) in the assessment of renal function in patients after kidney allotransplantation].
Early dysfunction of transplanted kidney is a serious complication that can lead to the premature loss of transplant. Ischemic and reperfusion injury of donor kidney leads to the disturbance of the function of the graft, which is a form of post-transplantation acute kidney injury that causes the relevance of search of early markers for diagnosis. ⋯ Due to prolonged period of ischemia in kidney transplantation from a donor with established brain death the level of u-NGAL in these patients was significantly higher than in the kidneys transplantation from living human-related donor. In patients after transplantation dynamics of u-NGAL allows to identify patients with delayed graft function recovery and the need for renal replacement therapy already in the early postoperative period.
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Anesteziol Reanimatol · Sep 2014
Multicenter Study["Evidance"--Russian national epidemiological study].
The article deals with results of epidemiological study of 2516 ICU patients received prophylaxis of a deep vein thrombosis (DVT) and venous thromboembolic complications (VTEC). ⋯ An analysis of drugs for prophylaxis of DVT and VTEC which were used in patients with ARF showed that the prophylaxis was performed without a taking in account a significance of such complication.
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Anesteziol Reanimatol · Sep 2014
Observational Study[Clinical application of dexmedetomidine in patients after thoracic and abdominal surgeries].
To study efficacy and safety of dexmedetomidine application for long-term (more than 12 hours) artificial lungs ventilation (ALV) and for psychomotor agitation. ⋯ Dexmedetomidine infusion provides target level of sedation from 0 to -3 according to RASS in 91% of patients requiring prolonged ALV after thoracic and abdominal surgeries. Bradycardia occurred in 15% of patients and arterial hypotension in 12% of patients. Bolus administration of dexmedetomidine should be avoided.
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To study possibilities of enteral oxygen therapy for the improvement of systemic oxygenation. We studied 34 critical patients. ⋯ Taking into account low volumes of insufflated oxygen (from 2 to 6 L) and the duration of achieved systemic oxygenating effect, we may suggest that mechanism of systemic oxygenation was not based on the direct intestinal oxygen absorption, but rather due to normalization of the gastrointestinal tract functions and followed systemic metabolism change improving pulmonary gas exchange. Future investigations are needed to clarify mechanisms.