Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2009
[Impact of preoperative levosimendan therapy on the volemic status and vascular tone of patients with chronic heart failure during anesthesia].
The impact of preoperative levosimendan therapy on the volemic status and vascular tone was studied in patients with chronic heart failure (CHF) during anesthesia and the ways of correcting the occurring changes were defined. The study included 21 patients with CHF in the presence of dilated cardiomyopathy, who underwent mitral valve replacement and tricuspid valvoplasty. Group 1 patients (n = 11) were given levosimendan (Simdax) in a dose of 0.05-0.1 mg/kg x min 2 days prior to surgery; Group 2 (n = 10) was control. ⋯ It has been established that the preoperative administration of levosimendan causes an increase in stroke index at critical surgical stages. With the use of levosimendan, peripheral microcirculation improves and nutritional blood flow increases. The preoperative use of levosimendan causes a reduction in the tone of resistance vessels during anesthesia, which can require vasopressor support in the postperfusion period; a levosimendan-induced decrease in preload requires infusion correction of relative hypovolemia.
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Anesteziol Reanimatol · Nov 2009
[The concept of training anesthesia-resuscitation specialists for high-technology medical aid-delivering health care facilities].
The paper presents the concept of training specialists in anesthesia-resuscitation for high-technology-delivering facilities. This concept is based on the module-axial type of education based on two basic principles: from complex to simple (from general to particular) (the so-called axis) and the modular organization of an educational process. Education implies the obligatory teaching of the axis (the structuring of the already available knowledge) and specialized programs (modules) are incorporated into a course of subjects if there is a practical need, which permits a student to achieve the necessary level of knowledge and skills.
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Anesteziol Reanimatol · Nov 2009
[Innovation structure of postgraduate medical education in the specialty of anesthesiology as a constituent of the continuing professional development concept in the light of the Bologna Declaration provisions].
To implement the basic provisions of the Bologna Declaration for postgraduate professional education of anesthesiologists-resuscitators, to upgrade the quality of training specialists, it is important that, by preserving the existing forms of an educational process, to introduce into continuing professional development the following innovation educational technologies, by taking into account the existing forms and technologies of the Russian higher medical school: to realize the continuing professional development (CPD) concept; a credit accumulation system as a generalizing function during CPD; distance and multimedia learning; and a modular organization of a learning and educational process.
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Anesteziol Reanimatol · Nov 2009
[The anesthetic service of a one-day hospital: is it an independent entity or a subdivision of the hospital?].
To evaluate the efficiency of the anesthetic service of a one-day hospital, the authors analyzed the anesthesias made over 5 years in 3219 (2119 males and 1100 females) patients in the Outpatient Surgery Center (OSC). Based on the given criteria for selecting patients for outpatient surgeries and the assessment of bed occupancy and load on an anesthetist, the author concluded that it is optimal to set up an anesthetic service in the OSC.
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Anesteziol Reanimatol · Nov 2009
[Use of current technical teaching aids in postgraduate training of anesthetists].
The paper describes the unique experience in using and introducing the elements of a virtual approach to teaching practical skills. The Department of Anesthesiology and Resuscitation has a large stock of various training mannequins at its disposal. ⋯ The mannequins have a broad spectrum of simulating the clinical situations, as well as a control system for the correctness of a trained physician's actions. The high professional training of the Department's students is also maintained by the application of a number of new technical training aids, including video materials and multimedia presentations.