Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2003
Review[Volumetric monitoring based on transpulmonary thermodilution in anesthesiology and intensive care].
The review elucidates the technique of transpulmonary thermodilution in volumetric monitoring of critically ill patients. The experimental and clinical studies, now underway, are indicative of a great value of the discussed method for practical medicine. ⋯ The evaluation of volumetric parameters and of invasive monitoring of hemodynamics provide for an excellent guidance in fluid resuscitation in an overwhelming majority of ICU patients. The PiCCO technology of continuous cardiac output (CO) measurements or, the so-called "pulse contour CO" is also under discussion.
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Anesteziol Reanimatol · Jul 2003
Case Reports[Monitoring of extravascular lung water in patients with severe sepsis].
The key objective of the case study was the possibility to monitor the extravascular lung water (EVLW) in severe cases. Twelve mechanically ventilated patients with severe sepsis complicated by septic shock and by an acute lung injury (ALI) were involved in the prospective study. The measurements, performed on days 1 and 3 after the onset of sepsis, comprised hemodynamics, EVLW as assessed by Pulsion PiCCO method, blood gases and severity scores. ⋯ The EVLW and lung injury scores were found to be essentially higher in non-survivors on day 3. The clinical situations, described in the present article, are indicative of a potential EVLW value applicable to sepsis treatment. Finally, the monitoring of EVLW is a useful tool in the purpose-oriented therapy of sepsis-induced ALI; moreover, the method has an important prognostic value.
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Anesteziol Reanimatol · Jul 2003
Historical Article[The Military-Medical Academy contribution to the establishment and development of anesthesiology and resuscitation in Russia (to 45th anniversary of the chair for anesthesiology and resuscitation of the Military-Medical Academy)].
Contributions made by some researchers of the Military-Medical Academy (former Imperial Medical-Surgical Academy) made to establishing and promoting the home anesthesiology and intensive care are historically revised in the paper. In particular, the related activity of N. I. ⋯ Delitsin, P. A. Kupriyanov and of other widely-known public figures is shortly described.
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Anesteziol Reanimatol · Jul 2003
[Effect of premedication on the formation of postoperative pain syndrome].
The pronouncement degree and dynamics of pain syndrome were assessed after surgeries in the abdominal cavity organs with regard for a nature of the analgetic component of premedication and of the postoperative analgesic therapy (n = 155). The administration of analgesics before extra-traumatic surgeries was found to be compulsory in order to prevent the onset of a persistent postoperative pain syndrome. ⋯ It was demonstrated that the application of "the forestalling analgesia" by ketonal (100 mg in 30 min before the beginning of moderate- and mild-trauma surgical interventions and immediately after the finalization of such surgeries) contributed to an essentially lower pronouncement degree of the postoperative pain syndrome and made the administration of narcotic analgesics unnecessary. Finally, it is pointed out that promedol could not be regarded as a drug ensuring a safe prophylaxis of the central sensitization and hyperalgesia.