Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2003
Review[Volumetric monitoring based on transpulmonary thermodilution in anesthesiology and intensive care].
The review elucidates the technique of transpulmonary thermodilution in volumetric monitoring of critically ill patients. The experimental and clinical studies, now underway, are indicative of a great value of the discussed method for practical medicine. ⋯ The evaluation of volumetric parameters and of invasive monitoring of hemodynamics provide for an excellent guidance in fluid resuscitation in an overwhelming majority of ICU patients. The PiCCO technology of continuous cardiac output (CO) measurements or, the so-called "pulse contour CO" is also under discussion.
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Anesteziol Reanimatol · Jul 2003
[Effect of premedication on the formation of postoperative pain syndrome].
The pronouncement degree and dynamics of pain syndrome were assessed after surgeries in the abdominal cavity organs with regard for a nature of the analgetic component of premedication and of the postoperative analgesic therapy (n = 155). The administration of analgesics before extra-traumatic surgeries was found to be compulsory in order to prevent the onset of a persistent postoperative pain syndrome. ⋯ It was demonstrated that the application of "the forestalling analgesia" by ketonal (100 mg in 30 min before the beginning of moderate- and mild-trauma surgical interventions and immediately after the finalization of such surgeries) contributed to an essentially lower pronouncement degree of the postoperative pain syndrome and made the administration of narcotic analgesics unnecessary. Finally, it is pointed out that promedol could not be regarded as a drug ensuring a safe prophylaxis of the central sensitization and hyperalgesia.
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Anesteziol Reanimatol · Jul 2003
Case Reports[Monitoring of extravascular lung water in patients with severe sepsis].
The key objective of the case study was the possibility to monitor the extravascular lung water (EVLW) in severe cases. Twelve mechanically ventilated patients with severe sepsis complicated by septic shock and by an acute lung injury (ALI) were involved in the prospective study. The measurements, performed on days 1 and 3 after the onset of sepsis, comprised hemodynamics, EVLW as assessed by Pulsion PiCCO method, blood gases and severity scores. ⋯ The EVLW and lung injury scores were found to be essentially higher in non-survivors on day 3. The clinical situations, described in the present article, are indicative of a potential EVLW value applicable to sepsis treatment. Finally, the monitoring of EVLW is a useful tool in the purpose-oriented therapy of sepsis-induced ALI; moreover, the method has an important prognostic value.
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On the basis of an analysis of published data, the authors draw the attention of medical circles to generally- and little-known facts of using a variety of general and local anesthesia types by Russian doctors. It is pointed out that not the very first application based on a calendar date of using a method but the first contribution made into the medical science and supported by efforts promoting such method should be regarded as genuine priority. Prominent medical figures are listed, i.e. ⋯ Katsaurov, A. V. Vishnevsky, whose priority in certain anesthesia variations, as the authors believe it, is indisputable.
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Anesteziol Reanimatol · Jul 2003
[Effectiveness of oxygen therapy for pulmonary edema in patients with hypertensive crisis before hospitalization].
The oxygen therapy, involving the KI-3M respiratory apparatus administered in the positive pressure regimen on expiration (8-10 cm aq. c.), used, before hospitalization, within the complex therapy of patients with pulmonary edema triggered by hypertensive crisis arrests fast enough the pulmonary edema, cuts the working time of an ER crew and promotes the ER efficiency. The key clinical manifestations of pulmonary edema were found to begin to go down on minutes 5 to 10 after the administration of artificial lungs ventilation (ALV) by oxygen with the positive pressure being on expiration end; such signs were totally stopped in 20-25 minutes.