Anesteziologiia i reanimatologiia
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This is a brief review of the literature on the use of noninvasive ventilation in intensive care units. The physiological bases of the use of noninvasive ventilation and some technical aspects are discussed. The data on the clinical effectiveness of this mode of ventilation are given. In addition, indications for and contraindications to the use of noninvasive ventilation and the specific features of its application in patients of different nosological entities are considered.
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Anesteziol Reanimatol · Jul 2005
Randomized Controlled Trial Clinical Trial[Renal protective function in surgical treatment for chronic infrarenal aortic aneurysms].
The authors analyzed different modes of prevention of acute renal failure (ARF) in the planned surgical treatment of abdominal aortic aneurysms. A hundred patients randomly divided into 4 groups were examined. In patients from a control group, prevention of renal failure included no use of aminoglycosides, prevention of hyperglycemia, and provision of steady-state hemodynamics. ⋯ According to the data on changes occurring in urinary enzymatic activities, the preventive load with antioxidants and their early postoperative use ameliorate renal lesion. The similar effect is achieved by the provision of high tissue oxygen supply and uptake at all the stages of surgical treatment. The best effect shown, in addition to enzymuria diminution, by a clinical reduction in the frequency of renal dysfunction is achieved by applying a comprehensive approach to preventing ARF.
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Anesteziol Reanimatol · Jul 2005
[Some disputable issues of transfusion therapy in wounded patients].
On the basis of an analysis of the tactics of transfusion therapy in 272 wounded persons and victims with acute massive blood loss, the authors conclude that it is necessary to strictly follow the principle of individual directionality during blood transfusions. By taking into account the high risk of development of iatrogenic complications in the postshock periods of traumatic disease, it is expedient to do away with hemotransfusions in the advancing mode.
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In the author's opinion, the uncertainty and incompleteness of the phenomenological concept of general anesthesia negatively affect researches. The basis of the vast majority of dissertations on anesthesiology and resuscitation is a comparison of 2-3 procedures of anesthesiological provision. The author considers the surgical stage of anesthesia as a type of the body's genetically determined passive defensive reaction. ⋯ Parallels are drawn with the naturally occurring states of biological objects, which are reminiscent of those of the surgical stage of anesthesia. The similarity of lethargy, catatonic stupor, and absence with the surgical stage of anesthesia is discussed. The author considers that anesthesiological supply adequate to the conditions of a surgical operation ensures the turning on and most complete realization of the body's natural compensatory capacities as an intricate self-regulating system.
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Anesteziol Reanimatol · Jul 2005
[Sedation and study of hormone dynamics in patients with severe brain injury during early postoperative period].
The paper presents the results of an investigation of the effect of sodium oxybutyrate, thiopental sodium, and propofol on the blood levels of cortisol, ACTH, TTH, T4 and T3 in patients with severe brain injury who have received artificial ventilation. The investigations showed that laboratory signs of the low T3-syndrome appeared by postoperative day 3 in all the patients. In patients receiving propofol, the manifestations of this syndrome were less pronounced and the parameters became normal more rapidly than in those taking oxyburate and thiopental sodium.