Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2003
[Natural surfactant preparation in complex therapy of acute respiratory distress syndrome in adults following open-heart surgeries].
The clinical course and outcomes of cases of acute respiratory distress syndrome (ARDS) as evolved after open-heart surgeries under the conditions of traditional treatment and under the conditions of using the exogenous surfactant drug were comparatively analyzed. A reliably improved oxygenation was registered in the 1st group patients (18 subjects), who received surfactant, yet 24 hours later; while the identical improvement was noted in the 2nd group patients (19 subjects) only in 98 hours. ⋯ Thirteen (72.2%) patients in the 1st group and 9 (47.4%) patients in the 2nd group were transferred to independent breathing. The lethality rate in ARDS with the surfactant therapy made up 33.3%, it was 52.6% in traditional treatment.
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On the basis of an analysis of published data, the authors draw the attention of medical circles to generally- and little-known facts of using a variety of general and local anesthesia types by Russian doctors. It is pointed out that not the very first application based on a calendar date of using a method but the first contribution made into the medical science and supported by efforts promoting such method should be regarded as genuine priority. Prominent medical figures are listed, i.e. ⋯ Katsaurov, A. V. Vishnevsky, whose priority in certain anesthesia variations, as the authors believe it, is indisputable.
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Anesteziol Reanimatol · Jul 2003
[Use of epidural analgesia for the arresting of pronounced lumbar pains].
A combination of local anesthetics (2% lydokaine solution, 2 mg/kg; 0.5% bupivakaine solution, 0.4 mg/kg or 0.75% ropivakaine solution, 0.55 mg/kg), promedol (20 mg) and corticosteroids (125 mg hydrocortisone or 80 mg kenalog) was epidurally administered in 78 patients to arrest the pronounced root pain syndrome of the lumbar-sacral localization provoked by intervertebral disk hernias. The most prolonged analgesic effect was registered in groups, whose patients received bupivakaine or ropivakaine, which prevented the onset of pain before the antiinflammatory effect of corticosteroids started. The patient must be informed well in advance about the possibility of a momentary relapse of pains and about the intensification (at the same time moment) of pharmacotherapy prescribed by neuropathologist.
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Anesteziol Reanimatol · Jul 2003
[Effectiveness of oxygen therapy for pulmonary edema in patients with hypertensive crisis before hospitalization].
The oxygen therapy, involving the KI-3M respiratory apparatus administered in the positive pressure regimen on expiration (8-10 cm aq. c.), used, before hospitalization, within the complex therapy of patients with pulmonary edema triggered by hypertensive crisis arrests fast enough the pulmonary edema, cuts the working time of an ER crew and promotes the ER efficiency. The key clinical manifestations of pulmonary edema were found to begin to go down on minutes 5 to 10 after the administration of artificial lungs ventilation (ALV) by oxygen with the positive pressure being on expiration end; such signs were totally stopped in 20-25 minutes.
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Anesteziol Reanimatol · Jul 2003
[Assessment of anesthesia adequacy with spectral analysis of the heart sinus rhythm].
The information density of spectral analysis of the variability of sinus rhythm to be used in diagnosing the neurovegetative activity in operation trauma was studied in 32 patients in the course of anesthesia and operation. It is suggested on the basis of the found the method can in monitoring the anesthesia adequacy.