Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2009
[Some problems in teaching anesthesiology and reanimatology at a higher medical educational establishment].
The paper describes the experience of the Department of Anesthesiology and Resuscitation, Chita Medical Academy, in upgrading the quality of teaching at the pre- and postgraduate stages of education and the prestigiousness of the specialty for students. The forms of collaboration of the department's collective body with the Academy's governing body and the territory's health care structures are described. ⋯ The innovation approach to solving the organizational and professional problems, which is proposed and tested by the authors, resulted in the provision of the health care facilities of the Transbaikal Territory with educated anesthetists-resuscitators (by 98.8%). The use of innovation educational technologies, including internet bases and internet libraries, and audiovisual and telecommunication technologies for distance education and counseling, makes an educational process interesting to young specialists and, overall, serves to increase the prestigiousness of the specialty.
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Anesteziol Reanimatol · Nov 2009
[From continuing medical education to anesthesia skill assessment].
The global approach to continuing medical education is needed not only to maintain the adequate level of knowledge, but also to adjust an anesthesiological practice to the emergence of new technologies. In addition to technological progress, the future of anesthesiology is seen to assure the maximum quality of performed therapy by the most cost-effective manner.
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Anesteziol Reanimatol · Sep 2009
Clinical Trial[Effectiveness and safety of using 6% hydroxyethyl starch 130/04 and 4% modified liquid gelatin in neurosurgical patients with massive intraoperative blood loss].
The results of using three infusion solutions, such as 6% hydroxyexyethyl starch (HES) 200/0.5 (HaesSteril), HES 130/0.4 (Voluven), and 4% modified gelatin solution (Gelofusin), were compared in 33 patients with neurosurgical diseases of the brain (supratentorial meningovascular tumors) and predictable massive intraoperative blood loss during acute isovolemic hemodilution and compensation for later blood loss. The evaluation criteria were volemic, hemostatic and cerebrovascular effects. ⋯ The least hemostatic changes were seen in the Gelofusin group. The findings suggest that among the test infusion solutions, Voluven is most effective and Gelofusion is safest.
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Anesteziol Reanimatol · Sep 2009
[Effect of hemotransfusion on brain oxygenation and metabolism in patients with intracranial hemorrhages].
The paper analyzes the impact of anemia correction on the time course of changes in oxygen tension in the brain and on the biochemical composition of brain interstitial fluid (tissue microdialysis) in the affected and conditionally intact hemisphere in 8 patients with intracranial hemorrhages and a reduced awakening level up to 4-8 scores by the Glasgow coma scale. Anemia correction in patients with intracranial hemorrhage was shown to fail to change oxygen tension in the brain and to be followed by a reduction in lactate/pyruvate ratio in the involved cerebral hemisphere. Only in significant anemia (Hb < 7 g/dl), hemotransfusion elevated cerebral perfusion pressure, by increasing mean blood pressure.
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Anesteziol Reanimatol · Sep 2009
Randomized Controlled Trial Multicenter Study Comparative Study[Evaluation of the effectiveness and safety of synthetic colloid solutions in the treatment of severe abdominal sepsis: a randomized comparative study].
Infusion therapy, surgical debridement of an infection focus, and antimicrobial therapy are basic treatments for severe sepsis. At the same time there are no uniform guidelines on how to choose fluids for infusion therapy. ⋯ The presented multicenter, randomized comparative study has evaluated different synthetic colloid solutions in early targeted therapy for severe sepsis. Evidence is provided for the identical effectiveness of the compared solutions in correcting hypovolemia and stabilizing hemodynamics in patients with severe sepsis and septic shock.