Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Sep 2007
Review[Intensive care and anesthetic maintenance in intra-abdominal hypertension].
The purpose of this review to show recent advances in the treatment of intraabdominal hypertension and abdominal compartment syndrome and to evaluate their clinical implication. To identify relevant publications, the authors have looked through the MEDLINE, EMBASE, and Cochrane Library for the original papers published since 1980. ⋯ However, laparotomy and various laparostomic techniques remain the only effective methods in treating intraabdominal hypertension in the presence of the abdominal compartment syndrome. The staf of surgical and general intensive care units should be aware of the prevention and treatment of intraabdominal hypertension and abdominal compartment syndrome.
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Anesteziol Reanimatol · Sep 2007
[Ultrasound transcranial monitoring during aortocoronary bypass surgery under extracorporeal circulation].
The paper deals with the assessment of hemodynamic parameters in the region of the circle of Willis, by using various exercise tests and transcranial Doppler study during cardiac operations under extracorporeal circulation. Some points of the timely diagnosis of air and material microembolisms are specified. There is evidence that the application of these procedures is substantiated and they may be employed in clinical practice to undertake earlier preventive measures against cervical circulatory disorders.
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Anesteziol Reanimatol · Sep 2007
[Training of anesthesiology-resuscitations physicians in clinical residency: resident's experience].
An educational process in clinical residency is discussed in terms of the results of anonymous questionnaire survey: the respondents were 77 residents in anesthesiology. A significant proportion (28%) of the trainees felt knowledge shortage and even more (47%) were diffirent in their own professional future. There were serious problems regarding practical training organization. ⋯ In the residents' opinion, the best clinical teacher is a staff anesthetist (42%) or assistant professor (39%). The vast majority (84%) of the trainees believe that one tutor should teach more than two trainees. The ways of solving these or those problems in clinical residency training and the prospects for primary postgraduate education in anesthesiology are discussed.
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Anesteziol Reanimatol · Sep 2007
[Does nitroglycerin show the properties of a selective venodilator?].
The central hemodynamic effect of continuous intravenous nitroglycerin infusion at an increasing rate (0.01-0.1 microg x kg(-1) x min(-1)) was evaluated by noninvasive (tetrapolar rheography) and invasive (pulmonary arterial catheterization) techniques. The study included 10 healthy volunteers and 30 patients having usual indications for nitroglycerin infusion. The findings suggest that when even infused at low rates, nitroglycerin canses mainly arteriolar vasodilatation, which appears as increased stroke volume due to the predominance of diminished postload over lowered preload. It is obvious that the notion of nitroglycerin as a selective venodilator should be revised.
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Anesteziol Reanimatol · Sep 2007
[Quality assurance of the therapy of patients in the department of anesthesiology and intensive care].
Emphasis is laid on the fact that the normative legal basis of an anesthesiological-resuscitative service is contrary to the real conditions of its operation at the present stage. Data on the age-sex and nosological structures of patients treated at an intensive care unit of a large multidisciplinary hospital, the scope of their examination and treatment, and the results of work time-keeping in the employees of the unit are given. The authors' proposals to improve the organization of service work and to upgrade its quality are presented in conclusion.