Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jul 2005
Randomized Controlled Trial Clinical Trial[Renal protective function in surgical treatment for chronic infrarenal aortic aneurysms].
The authors analyzed different modes of prevention of acute renal failure (ARF) in the planned surgical treatment of abdominal aortic aneurysms. A hundred patients randomly divided into 4 groups were examined. In patients from a control group, prevention of renal failure included no use of aminoglycosides, prevention of hyperglycemia, and provision of steady-state hemodynamics. ⋯ According to the data on changes occurring in urinary enzymatic activities, the preventive load with antioxidants and their early postoperative use ameliorate renal lesion. The similar effect is achieved by the provision of high tissue oxygen supply and uptake at all the stages of surgical treatment. The best effect shown, in addition to enzymuria diminution, by a clinical reduction in the frequency of renal dysfunction is achieved by applying a comprehensive approach to preventing ARF.
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Anesteziol Reanimatol · May 2005
Randomized Controlled Trial Clinical Trial[Exogenous activated protein C in severe sepsis].
Exogenous activated protein C combines a marked anti-inflammatory effect on the vascular endothelium and anticoagulative and profibrinolytic activities. The total results of this action are better multiple organ microcirculation and, as a result, elimination and even prevention of irreversible changes in the vitally important organs. ⋯ The Russian cooperative study of the efficacy of the exogenous activated protein C--drotrecogine alpha (activated)--has shown that its inclusion into therapy for sepsis with multiple organ dysfunction and septic shock results in longer estimated survival. With this, the best results are observed when therapy is initiated within 48 hours since the development of multiple organ deficiency.
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Anesteziol Reanimatol · Jul 2004
Randomized Controlled Trial Clinical Trial[A risk of myocardial ischemia and the nature of infusion-transfusion therapy in scheduled surgical treatment of infrarenal aneurisms of the aorta].
The authors analyzed effects produced by different variations of the infusion-transfusion therapy on the risk of cardiovascular complications that can develop in the scheduled surgical treatment of the aorta abdominal part. The patients were randomized in 2 groups. Intraoperative hemodilution was made in group-1 patients (n = 50) before aorta clipping. ⋯ The below results were obtained on the basis of conducted research: preventive infusion load aggravates, before aorta clipping, the risk of cardiac complications. Maintenance of Hb below the level of 90 g/l is accompanied by an impaired transport of oxygen to tissues; it speeds up the heart beat and provokes an increased cardiac need in oxygen, which enhances the risk of myocardium ischemia. Preparation of autoblood and hardware-based reinfusion of autoerythrocytes provide for an adequate compensation of blood losses and diminish the risk of cardiac complications in the scheduled surgical treatment of infrarenal aneurisms of the aorta.
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Anesteziol Reanimatol · Mar 2004
Randomized Controlled Trial Clinical Trial[Effect of different colloid volume-replacing solutions on a changed hemostasis system].
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Anesteziol Reanimatol · Jul 1998
Randomized Controlled Trial Clinical Trial[The use of propofol (Diprivan) for inducing anesthesia in neurosurgical patients. II. Its effect on intracranial pressure and on cerebral perfusion pressure].
Clinical study of the effect of propofol (diprivan) on intracranial and cerebral perfusion pressure (ICP and CPP, respectively) in 30 patients with neurosurgical diseases of the brain showed that propofol without narcotic analgesics did not block ICP increase in response to tracheal intubation. If it was combined with narcotic analgesics, the optimal combination was with pyritramide in a dose of 0.4 mg/kg, because this combination blocked ICP increase in response to laryngoscopy and tracheal intubation and did not appreciably decrease CPP. Propofol for decreasing acute intracranial hypertension (like bolus injection of thiopental) during surgery is unjustified, because during anesthesia, bolus injection of propofol just negligibly decreases ICP.