Anesteziologiia i reanimatologiia
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Critical illness polyneuropathy is an acquired critical illness syndrome of neuromuscular problems as polyneuropathy and/or myopathy that is caused by long-term immobilization, clinically manifested by general muscle weakness and a main reason for difficulty weaning from the ventilator. The review gives an update on the history, epidemiology, etiology, pathogenesis, clinical picture, diagnosis, differential diagnosis, course, outcome, prevention, and treatment of critical illness care polyneuropathy.
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A respiratory failure (RF) rating scale has been developed to objectify indications for artificial ventilation (AV). The scale consists of three blocks gauging the level of consciousness, the degree of swallowing problems, cough, airway patency, and lung parenchymatous injury. The scale was tested in the period December 2009 to March 2010. ⋯ The developed scale allows one to optimize the time of AV initiation. Single patient assessment can ascertain a direct cause of respiratory failure (RF) while dynamic assessment can determine the sequence of changes in the magnitude of individual determinants of RF. In patients with unsuccessful tracheal intubation, the scale will optimize the time of reintubation, thereby reducing the incidence of nosocomial and aspiration pneumonia.
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Anesteziol Reanimatol · Jul 2010
Clinical Trial[Characteristics of central hemodynamics and cerebrovascular circulation during various anesthesia modes in reconstructive surgeries for the extracranial vessels].
The purpose of the study was to choose an optimal anesthetic method to ensure adequate cerebral blood flow and to reduce the number of perioperative complications during carotid endarterectomy. Total intravenous anesthesia with diprivan, combined cervical plexus block anesthesia, and inhaled sevoflurane anesthesia were assessed in 190 patients undergoing carotid endarterectomy. The study of cerebral blood flow and central hemodynamic parameters indicated that deprivan anesthesia suppressed the major hemodynamic parameters, causing associated cerebral circulation depression. ⋯ The studies revealed that deprivan anesthesia was followed by a considerable number of both cardiac and neurological complications. The patients with cervical plexus block had fewer neurological disorders, but the increased postload accompanying these changes caused an increase in the number of cardiac complications. The most optimal parameters of cerebral blood flow and central hemodynamics during sevoflurane anesthesia induced a statistically significant reduction in the number of cardiac and neurological complications.
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Anesteziol Reanimatol · Jul 2010
Case Reports[Compression cervical spine cord injury in patients with posterior cranial fossa tumors operated on in the sitting position: two cases with different outcomes].
The paper describes two cases of posterior cranial fossa pathology, operated on in the sitting position on the operating table. In one case, symptoms of cervical spine injury caused by undiagnosed preoperative cervical spine pathology emerged in a female patient in the early postoperative period. In the other case, cervical spine pathology was diagnosed before surgery and evoked potentials were monitored to prevent possible cervical spine injury in the sitting position during an operation.