Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2006
Clinical Trial[Postoperative epidural bupivacaine infusion in pediatric oncology].
The paper presents the results of use of continuous epidural bupivacaine infusion for postoperative anesthesia in 88 children operated on for malignant tumors. Two groups of patients differing in the procedure of epidural bupivacaine infusion are compared. The use of bupivacaine at a higher concentration (0.25%) within the first 12 hours of the early postoperative period can provide a more effective anesthesia than that at a concentration of 0.125%. The efficacy and tolerability of the above procedures for injecting the local anesthetic are studied and their after-effects are analyzed.
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The study deals with infusion therapies in children with thermal injury and with its impact of its qualitative composition at the local (tissue) and systemic levels. The investigations have indicated that the best qualities' in replenishing the volume of circulating blood and in eliminating hypovolemia are shown by hydroxyethylated starch (the study used voluvene) that offers advantages in the rate of correction of blood concentrations and in the maintenance of a volumic effects and that increases oxygen delivery, resulting in a rapider emergency from shock and improving the trophism of a burn wound.
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Anesteziol Reanimatol · Jan 2006
[Temperature balance and the possibility of its maintenance during general anesthesia in children].
The problems of hypothermia in the perioperative period, which are one of the most important ones in pediatric practice, in babies in particular, are solved, by using a broad spectrum of methods for preventing and correcting the patients' thermal balance. Convection heating systems exercise an on-line control over the baby's thermal regime during a surgical intervention and intensive care. The authors' own experience allows these systems to be recommended for wide practical application in the activities of anesthesiology and intensive care services.
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Anesteziol Reanimatol · Jan 2006
[Diagnosis and treatment of ventilator-associated pneumonia in children].
The purpose of the investigation was to optimize the diagnosis and treatment of ventilator-associated pneumonia (VAP) in children. The prevalence, etiology, and onset of VAP in a pediatric intensive care unit, and the diagnostic value the clinical pulmonary infection score scale were studied. ⋯ The most common causative agents of VAP were Enterobacteriaceae spp, and its major pathogen is P. aeruginosa. Early adequate antibacterial therapy prevents and treats VAP, without causing any complications.
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The paper deals with the efficiency of postoperative analgesia after thoracoplasty in 43 adolescents with the funnel chest. Within the first 64-72 postoperative hours, the patients received a continuous epidural infusion of 0.2% ropivacaine solution at a rate of 0.3 ml/kg/hr. Analyses of hemodynamic parameters and the pain scale demonstrated the efficiency of this postoperative analgesia in 74.4% of the adolescents.