Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 2013
[Modes of mechanical ventilation during transferring the patient to spontaneous breathing].
Mechanical ventilation (MV) has become a general treatment in the intensive care unit in recent years. Mechanical ventilation is a resuscitation treatment; however MV causes many implications therefore it is to be finished as soon as the patient's condition begins improve. Modern transferring the patient to spontaneous breathing decreases implications number. ⋯ Many ventilation modes have introduced in clinical practice through the microprocessor technologies development. Supporting ventilation modes help to avoid some adverse effects of mechanical ventilation. The article deals with historical approaches development their advantages and limitations.
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Anesteziol Reanimatol · Jan 2013
[Modern approach to the neuromuscular blocking agents use in pediatric patients].
Myorelaxants use decrease trend appeared since the end of 80 years of the 20th century. The trend is connected with use of the new narcotic analgesics (Remifentanil), intravenous (Propofol) and inhalation (Sevoflurane) anaesthetics. These drugs are manageable and predictable, they have not many side effects and can suppress laryngeal-pharyngeal reflex during the tracheal intubation. ⋯ As a result the patient's activation is delayed. Nevertheless myorelaxants use refusal impairs the tracheal intubation conditions, increases the arterial hypotension and heart failure risk especially in newborns and children with severe pathology. If myorelaxants is not used, comfortable conditions of surgical manipulations impossible without big analgesics and anaesthetics doses use.
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Anesteziol Reanimatol · Jan 2013
[Peripheral regional block role in orthopedics in pediatric patients with cerebral palsy].
Haemodynamics of 58 Pediatric patients with cerebral palsy was studied during combined anaesthesia based on sevoflurane and peripheral nerve block. Sevoflurane and peripheral nerve block with infusion support 14-15 ml/kg/ hr provide stable cardiac output during orthopedic surgeries in Pediatric patients with cerebral palsy. Excessive arterial hypotension and total peripheral vascular resistance decrease were registered in older patients as results of more pronounced vascular effect of anaesthetics in patients with decreased adaptive-compensatory possibilities and insufficient infusion support. The proposed anaesthesia method provides adequate intraoperative analgesia, fast recovery and comfortable postoperative period.
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Dexmedetomidine is a novel a,-agonist with unique characteristics. The review contains description of main pharmacological and physiological features of this drug. ⋯ Authors consider that dexmedetomidine can improve anesthesia management in various clinical situations due to specific sedation profile similar to natural human sleep pattern. It can be helpful in neurosurgery in overweight patients or in patients with high cardiac risk as well as in pediatric practice.
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Anesteziol Reanimatol · Jan 2013
Comparative Study[Prognostic criteria of the premature infants weaning from mechanical ventilation during trigger ventilation].
Modern mechanical ventilation modes do not prevent ventilator-associated lung injury therefore respiratory cessation must be stopped as soon as possible. However extubation recommendations absence makes difficulties in process of weaning the infants from the mechanical ventilation. ⋯ Positive dynamics and stabilization of compliance and resistance are essential criteria of the successful weaning from mechanical ventilation and extubation. RVR can be used as objective criterion of an extubation.