Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2015
Review[VOLEMIC STATUS AND THE PHASIC APPROACH TO THE TREATMENT OF CRITICAL STATES--NEW OPPORTUNITES AND PROSPECTS].
Current guidelines suggest that an early and aggressive fluid therapy is the best rescue approach to restore and preserve cardiac index, organ function and decrease the risk of multiple organ failure in shock of various origin. However, escala- tion of fluid resuscitation is a double-edged sword often associated with reperfusion, glicocalyx injury, capillary leakage, delayed weight gain and heperhydration. ⋯ The type and volume of the fluid should be thoroughly selected in accordance with the phase of shock, risk of impending organ dysfunction and individual co-morbidity. The phasic approach, along with individualized early and delayed goal-directed protocols might fasten the resolution of organ dysfunction, reduce the duration of shock and mechanical ventilation and improve the outcomes.
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Anesteziol Reanimatol · Nov 2015
Review[EFFECTS OF XENON ANESTHESIA ON HEMODYNAMICS: WHAT DO WE KNOW UNTIL 2015? (REVIEW)].
Xenon is known as an anesthetic in many ways closer to the ideal. In recent years, despite a number of objective reasons limiting its widespread use, the search continues for understanding how xenon influences on central hemodynamic parameters and regional blood flow. ⋯ Foreign researchers in animal experiments notice vasoconstrictor properties of Xe with increased vascular resistance in the systemic and pulmonary circulation. The place of Xe as an anesthetic in the anesthetist's arsenal yet to be seen.
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Anesteziol Reanimatol · May 2015
Review[INTRATHECAL OPIOID ANALGESIA - STATE IN THE WORLD AND IN THE RUSSIAN FEDERATION].
Intrathecal opioid analgesia has been used in clinic practice since 1979 and has gained a great popularity till now due to its high analgesic potency Unfortunately it is impossible to use opioids intrathecally in Russian Federation by law because of nowadays official limitations. Russian national anaesthesiologic society should comprehend benefits and side effects of this method and make a decision if it is worth fighting for.
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Anesteziol Reanimatol · May 2015
Review[EPIDURAL ANALGESIA FOR INTRAOPERATIVE AND POSTOPERATIVE CARE IN NEWBORNS].
Anesthesia care in newborns has to be complex, balanced and safe. Nowadays epidural analgesia (EA) in neonates during intra- and postoperative period is widely used in Russia. ⋯ Newborns have special anatomy, physiology and pharmacodynamics which have to be taken in mind when EA is used. At the present moment Ropivacine (2 mg/ml) is approved for peripheral nerve blocks in newborns.
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Anesteziol Reanimatol · Mar 2015
Review[EFFECT OF NEONATAL RESPIRATORY SUPPORT STRATEGIES IN THE ICU].
This review deals with the current trends in protective ventilation in newborns. Volumotrauma is the most common variant of ventilator-induced lung injury. The modern research is devoted to the study of biotrauma, which is the release of inflammatory mediators in response to mechanical ventilation. ⋯ The modern protective ventilation involves two main principles to reduce ventilator-induced lung injury: a decrease in tidal volume (V) and the principle of permissive hypercapnia. Application ofthe method of permissive hypercapnia and modes of the target volume can reduce the likelihood of ventilator-induced lung injury in newborn infants. Despite the limitation of the indications for mechanical ventilation in modern neonatology and widespread use of noninvasive ventilation for patients who really need mechanical ventilation, the use of modes with the target volume provides the best chance to reduce the complications of ventilation.