Anesteziologiia i reanimatologiia
-
Anesteziol Reanimatol · Jan 2011
[Application of bis monitoring in children during intensive therapy of severe traumatic brain injury].
The article presents the experience of the BIS monitoring in comparison with indicators of the pediatric Glasgow coma scale in 20 children with severe traumatic brain injury. Analyzed sample consists of 881 observations that contain two variables that contain high-quality sequence (a score on a scale of Glasgow in grades) and quantitative discrete values (the values of BIS). ⋯ The Spearman's coefficient rank correlation between scoring on Glasgow coma scale and the magnitude of BIS was R = 0.85 p < 0.001. Thus, the results showed that during severe traumatic brain injury in children the values of BIS have a high degree of correlation with the depth of coma on the Glasgow coma scale.
-
Anesteziol Reanimatol · Jan 2011
[Various modes of lung ventilation in children during transition to spontaneous breathing].
The purpose of the study is to compare the effect of SIMV and BIPAP ventilation modes for the duration of mechanical ventilation, duration of the "weaning" from a respirator, the condition of gas metabolism and hemodynamics in children transferring to spontaneous breathing. In a retrospective cohort study included 30 children (16 boys and 14 girls) aged from 1 month to 18 years, which were on mechanical ventilation for more than 24 hours and required a gradual "weaning" from the unit. The children were treated in the department of general intensive care unit of Tushino City Pediatric Hospital from January 2008 to August 2010. ⋯ In the SIMV group the frequency of desynchronization episodes was greater (SIMV--an average of 3.75 + 1.4 episodes per day compared to 2.37 + 0.85 episodes in the BIPAP group, p = 0.003). The advantages of using BIPAP+ PS mode are the duration of weaning from the unit and the synchronization with the respirator. The statistically significant estimates of the parameters of pulmonary ventilation and hemodynamics require further study.
-
Traumatic brain injury among other injuries of human body reaches up to 30-50% and, according to the WHO, it grows by 2%. Severe traumatic brain injury (such as severe brain contusion, epidural, subdural and intracerebral hematoma, intracerebral hygroma, diffuse axonal injury) in the structure of general trauma amounts 4-20%. ⋯ It is advised for children with severe traumatic brain injury to be directed to specialized neurosurgical or trauma hospitals, where it is possible to provide them with adequate medical care. This work is dedicated to the enhancement of the intensive care quality during severe traumatic brain injury in children of Chuvash Republic, by the means of integrated patient assessment.
-
Anesteziol Reanimatol · Jan 2011
[Experience in managing patients with acute epiglottitis in the intensive care unit].
Tushino City Pediatric Hospital disposes years of experience treating patients with stenosis of the larynx in specialized units. The problem of acute epiglottitis is interesting for a number of specialists. This article discusses the clinical symptoms of acute epiglottitis, diagnosis and risk factors of acute epiglottitis in children.
-
The regional methods of analgesia are the "golden standard" of choice during trauma surgeries. The supraclavicular block of the bracheal plexus is the method of choice during the cubital joint surgeries. The purpose of the study is to improve the effectiveness of anesthesia and postoperative analgesia for surgical interventions on the cubital joint in children by developing and implementing the clinical practice of peripheral blockade of the brachial plexus by the supraclavicular access. ⋯ The duration of effective postoperative analgesia due to long-acting local anesthetic (0.5% solution of naropin) was 8-9 hours. There were no complications registered as a result of supraclavicular. Thus, this study proves that the supraclavicular brachial plexus block provides effective intra and postoperative analgesia in trauma operations on the cubital joint in children.