Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Nov 2015
Randomized Controlled Trial[PROTEIN KINASE C EXPRESSION FOLLOWING REMOTE ISCHEMIC PRECONDITIONING IN CARDIAC SURGERY].
To evaluate cardioprotective effects of remote ischemic preconditioning (RIPC) in cardiac surgery patients undergoing aortic valve replacement depending on the type of anesthesia and investigate the level of myocardial protein kinase C epsilon (PKC-ε) expression after RIPC. ⋯ RIPC was only effective when it was applied during sevofiurane anesthesia. This was confirmed by PKC-ε expression increase and lower value of cTnI. There were no evidence of preconditioning and cardioprotection when MPG was initiated during propofol anesthesia.
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The article is devoted to the existence of the problem of intraoperative provide patients with concomitant diabetes mellitus: a disease is not diagnosed in time, it increases the probability of death in the performance of surgery by 50%, where as the timely prevention and preparation reduces the chance of developing specific complications to the level of patients with the general population. The paper discusses the recommendations developed by the British Association ofEndocrinologists 2011 and Russia in 2015, as well as the Association ofAnaesthetists of Great Britain and Ireland (2015), provides practical recommendations for the preoperative preparation, anesthetic and resuscitation provide patients with concomitant diabetes mellitus.
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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 · Sep 2017
Randomized Controlled Trial[PULSE WAVE TRANSIT TIME - ONE MORE ATTEMPT OF NON-INVASIVE CARDIAC OUTPUT MEASUREMENT.]
Estimated continuous cardiac output (esCCOTM) based on pulse wave transit time is one of alternative non-invasive CO measurement techniques. ⋯ 1. Estimated continuous cardiac output measurement technique based on PWTT has a direct correla- tion with prepulmonary thermodilution and transoesophageal echocardiography, medium and high power respectively. 2. esCCO has significant differences with the referential techniques during general anesthesia in cardiac surgery pa- tients. 3. Calibration based on invasive blood pressure and outside cardiac output measurement does not increase the accuracy of measurements. 4. esCCO has a negative diagnostic value and cannot be recommendedfor the cardiac out- put evaluation during cardiac surgery. 5. This method can be useful for analyze general effectiveness of perioperative hemodynamics.
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Anesteziol Reanimatol · Nov 2016
OPTIMUM LEVEL OF POSITIVE END-EXPIRATORY PRESSURE IN ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY INFLUENZA A(H1NI)PDM09: BALANCE BETWEEN MAXIMAL END-EXPIRATORY VOLUME AND MINIMAL ALVEOLAR OVERDISTENSION.
to determine optimum level ofpositive end-expiratory pressure (PEEP) according to balance between maxi- mal end-expiratory lung volume (EEL V)(more than predicted) and minimal decrease in exhaled carbon dioxide volume (VCO) and then to develop the algorithm of gas exchange correction based on prognostic values of EEL K; alveolar recruitability, PA/FiO2, static compliance (C,,,) and VCO2. ⋯ PEEP adjustment in ARDS due to influenza A (H1N1) pdm09 in accordance with balance between recruitment and overdistension (based on EELV and VCO measurements) can improve gas exchange, probably, not leading to right ventricular failure. This value of "balanced" PEEP is in the range between 15 and 18 mbar: Low lung recruitabiilty is associated with poor prognosis. Measurements of EELV and VCO₂ at PEEP 8 and 20 mbar can be used to make a decision on whether to keep "high" PEEP level or switch to extracorporeal membrane oxygenation in patient with ARDS due to influenza A (N1H1).