Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · May 2009
Case Reports[A case of transient complete suppression of cerebral electrical activity during anesthesia based on propofol].
In an anesthesiologist's practice, except the occurrence of clinical death on the operating table a long-term complete suppression of the electrical activity of the brain may arise only from the medical staff's crude error when administering intravenous anesthetics from the unlikely breakage of the anesthesia apparatus vaporizer. However, the authors assert that such a phenomenon may develop during general anesthesia using propofol given in its usual doses. Clinical examples are given. Whether the depth of general anesthesia should be controlled by the principle of feedback, by making neurophysiological monitoring is discussed.
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Despite the extended potentials of modern medicine, noncompensated blood loss remains one of the leading causes of death in the able-bodied population all over the world. At present, there is no uniform policy of transfusion maintenance and intensive care in victims with severe decompensated blood loss. The purpose of the study was to assess the results of compensation for acute blood loss in victims with concomitant injury and wounds at various sites, which were attended by the loss of a circulating blood volume (CBV) with the use of new technologies. ⋯ CBV was compensated for by the currently available infusion media; globular blood volume deficit was restored via intraoperative instrumental reinfusion of autoblood and donor blood. The proposed procedure for infusion-transfusion therapy made it possible to stabilize the patient's condition and to perform emergency surgical treatment in victims with fatal blood loss. Total mortality in the chosen intensive care modality was 62.1%.
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Anesteziol Reanimatol · May 2009
[Infectious safety in neurosurgical patients. The specific features of infectious complications in patients with subtentorial tumors, their diagnosis and treatment].
The paper analyzes the incidence of the major infectious complications (regional and systemic) developing in neurosurgical patients (3630 patients with neurosurgical diseases and 872 with abnormalities of the posterior cranial fossa (PCF)) in the postoperative period after removal of subtentorial tumors. Regional pyoseptic complications are shown to occur in patients with PCF abnormalities three times more frequently. The basic diagnostic and therapeutic approaches to pyoseptic complications in neurosurgical patients are also considered.
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Anesteziol Reanimatol · May 2009
[The problem of a patient's safety in neuroanesthesiology (lecture)].
The paper analyzes the problem of a patient's safety during neurosurgical interventions. The considered complications occurring in the perioperative period are divided into specific and nonspecific to neurosurgery. General and partial complications are identified among the specific ones. These and those complications, their diagnosis, therapy, and prevention are considered briefly.