Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Mar 2015
Practice Guideline[PERIOPERATIVE CARE FOR PATIENTS WITH UNDERLYING ARTERIAL HYPERTENSION (CLINICAL GUIDELINES)].
These clinical guidelines apply to the implementation of health care for all patients with concomitant hypertension in the perioperative period in a hospital. The guidelines specify the method of stratifying the risk of perioperative cardiac complications. We described methods for the treatment of urgent conditions with hypertension and hypertensive crises and identified the main features of the preoperative evaluation and preparation of patients with concomitant hypertension. The clinical guidelines contain recommendations on the management of intra- and postoperative period
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Anesteziol Reanimatol · Mar 2015
Observational Study[PREVENTION OF VENTILATOR ASSOCIATED INFECTION IN NEONATES WITH RESPIRATORY DISTRESS SYNDROME].
The aim of the research was to reduce the risk ventilator-associated infections (VAI) in neonates with respiratory distress syndrome. ⋯ Closed suction system with hand hygiene and early weaning from the respirator are acceptable methods of prevention of lower respiratory tract infection associated with mechanical ventilation in neonates with respiratorv distress syndrome.
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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.
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So far, the ongoing debate about the appropriateness of combining drugs with different mechanisms of analgesic action for optimal antinociceptive protection. The review deals with the theoretical calculations arguing with the physiological rationality for the inclusion of central α2-agonists in the scheme of modern multimodal analgesia. We have presented data from recent reviews regarding the efficacy and safety of intraoperative application of dexmedetomidine as a one of the latest drugs in this class.
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Anesteziol Reanimatol · Mar 2015
Randomized Controlled Trial[COMPARISON OF THE EFFECTIVENESS OF ILIOINGUINAL-ILIOHYPOGASTRIC BLOCKADE AND TRANSVERSUS ABDOMINIS PLANE BLOCK FOR ANALGESIA AFTER CESAREAN SECTION].
In this prospective randomized study we compared the analgesic efficacy of the ilioinguinal-iliohypogastric nerves block and transversus abdominis plane block for analgesia after caesarean delivery performed by suprapubic laparotomy. The study includes 164 healthy women with ASA status I-II class, undergoing elective surgery under spinal anaesthesia. During the first postoperative hour patients in the "block's" groups received ultrasound-guided blocks of the anterior abdominal wall with ropivacaine 100 mg both. ⋯ Patients were monitored for visual analogue scale (VAS) scores at rest and during movement (at 3, 6, 9, 12 and 24 hours after surgery), concentration of the cortisol and glucose were measured, and consumption of the tramadol and its adverse effects were controlled. We concluded that both blocks improve postoperative analgesia after caesarean delivery. The Ilioinguinal-iliohypogastric block showed greater efficacy than the transversus abdominis plane block.