PAIN, ANAESTHESIA & INTENSIVE CARE最新文献

{"title":"Materials of the Congress of Anaesthesiologists of Ukraine","authors":". .","doi":"10.25284/2519-2078.3(100).2022.267766","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267766","url":null,"abstract":"","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131339003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TWO-YEAR ANESTHESIOLOGY AND INTENSIVE CARE INTERNSHIP PROGRAM EFFICACY AND THE WAR INFLUENCE ON IT","authors":"K. Bielka, I. Kuchin, U. Kashiy, G. Fomina","doi":"10.25284/2519-2078.3(100).2022.267762","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267762","url":null,"abstract":"COVID-19 pandemic and full-scale Russia aggression in Ukraine have become a challenge for the medical schools. Internships in anesthesiology and intensive care in Ukraine is three times shorter, comparable with high-income countries. The aim of the study was to evaluate the efficacy of the internship training.\u0000A study was carried out at the department of surgery, anesthesiology and intensive care postgraduate education Bogomolets National Medical University named after O.O., Department of Surgery, Anesthesiology and Intensive Care Postgraduate Education. Among the most effective types of training, residents and teachers chose live practical classes, seminars and simulation trainings, self-study. The training efficacy of the Anesthesiology and Intensive Care internship program was acceptable for the anesthetic management of low-risk patients, but requires significant improvement for the anesthetic management of high-risk patients and the management of the critically ill.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130464387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WHOLE BLOOD TRANSFUSIONS FOR PEDIATRIC TRAUMA PATIENTS ACCORDING TO AMERICAN STANDARDS","authors":"N. Matolinets, S. Dubrov, J. Holcomb","doi":"10.25284/2519-2078.3(100).2022.267765","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267765","url":null,"abstract":"A full-scale russian-Ukrainian war has been going on for about nine months. Almost every day, Ukrainian cities suffer from enemy raids of missiles and drones, as a result, civilians become victims of hostilities. The prevalence of mine blast injury in these conditions is extremely high. Unfortunately, this type of injury is often accompanied by massive bleeding, which forces to make amendments in a treatment strategy. According to world standards, the first infusion solution for this category of patients should be whole blood, because of its numerous advantages. At the Multidisciplinary Clinical Hospital of Emergency and Intensive Care in Lviv, this strategy has been used almost since the first days of the war for patients of all age groups. In the article, we present a convincing evidence base of the advantages of using whole blood, as well as a clinical case of using whole blood infusion in a pediatric patient.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA & INTENSIVE CARE","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124328383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PERIOPERATIVE METABOLISM OF PATIENTS WITH ESOPHAGEAL HERNIA OF THE DIAPHRAGM","authors":"V. Cherniy, A. I. Denisenko","doi":"10.25284/2519-2078.3(100).2022.267763","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267763","url":null,"abstract":"Summary: Premedication – medical and non-medical preparation of the patient for surgery or examination, which will take place with The study of perioperative changes in metabolism in patients undergoing laparoscopic surgical interventions for esophageal hiatal hernia (EHH) is relevant.\u0000The aim of the study. To study the perioperative metabolism in patients with EHH and evaluate the possibilities of its correction.\u0000Material and methods. The study was prospective, not randomized. 127 patients, aged 31-76 years, who underwent laparoscopic operations in connection with EHH, were studied (m-59, w-68). Preoperative risk ASA II-III. General anesthesia using the inhaled anesthetic sevoflurane and the narcotic analgesic fentanyl in conditions of low-flow artificial lung ventilation. Perioperative intensive care was carried out in accordance with the International Standards of Safe Anesthesiological Practice of the WFSA (World Federation of Societies of Anesthesiologists, 2010). In group I (n=61), a retrospective energy audit was carried out according to protocols for analgesia of medical charts and calculations of indirect calorimetry with determination of current metabolism (CM) and basal metabolism (BM). In group II (n=66), operational monitoring was supplemented with the use of indirect calorimetry with the determination of CM, BM, target metabolism (TM) and the degree of metabolic disturbance (DMD = 100×(TM-CM) / TM) %, and intensive therapy was supplemented additional infusion therapy and glucocorticoids, accordingly to the dynamics of metabolic changes.\u0000The results. The initial indicators of metabolism, in both groups, were without disturbance and significantly exceeded the basal level (in group I – by 30.5%, in group II – by 28.8%) and had the following values: in group I – 749±12 cal× min-1×m-2, in group II – 756±13 cal×min-1×m-2. In both groups, at the stage of reverse Trendelenburg position, imposition of pneumoperitoneum and the beginning of the operation, there were significant metabolic disturbances with a decrease to the basal level. In patients of group I, a slow recovery of PM was observed, the value of which at the moment of awakening remained 7.6% lower than the initial one (p<0.05). In patients of group II, against the background of increased infusion therapy and administration of glucocorticoids, PM recovery was more intense, and, at the moment of awakening, its value exceeded the corresponding value of group I by 10.4% (р<0.05). At the same time, CM and SPM were not high and did not differ from the initial values. Patients of group II, compared to group I, woke up faster and were transferred to the ward, and nausea and vomiting were 2.7 times less frequent: 7.35% in group II and 19.7% in group I (p<0, 05). After 6 and 12 hours after waking up, the feeling of pain on the VAS scale in group II was lower than in group I, respectively, by 24.3% and 34.4% (p < 0.05).\u0000Conclusions. Perioperative energy monitoring makes it safer to perform la","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"201 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134410435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ASSESSMENT OF THE NUTRITIONAL STATUS OF OVERWEIGHT AND OBESE PATIENTS BY AN ANESTHESIOLOGIST","authors":"Y. Lisun, O.І. Yalovytska","doi":"10.25284/2519-2078.3(100).2022.267764","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267764","url":null,"abstract":"According to WHO data, in 2016 the number of adults with excess body weight exceeded 1.9 billion (39 % of the inhabitants of our planet over the age of 18), of which more than 650 million (13 %) suffer from obesity. Due to the high prevalence, doctors meet more and more patients with overweight and obesity, and they need nutritional correction at the pre-hospital stage. Obesity as a result of overeating, but paradoxically, can be accompanied by nutritional deficiency, therefore nutritional deficiency is determined not only by low body weight, but also by the inability to maintain the optimal internal state of the body. Patients with overweight and obesity should be screened and examined according to such criteria (validated scales MUST and NRS-2002) that are used in general clinical practice, for a certain disease, and as a screening for nutritional insufficiency/inadequacy of nutrition. The publication used articles that are included in scientific search databases Cochran, GoogleScholar, PubMed.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125568558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"«BRIDGE» TO HEART TRANSPLANTATION: HEMOSORPTION, VENTRICULAR REMODELING OR LVAD? ABSTRACT","authors":"K. Denysiuk, O. Loskutov, O. Druzhyna","doi":"10.25284/2519-2078.3(100).2022.267761","DOIUrl":"https://doi.org/10.25284/2519-2078.3(100).2022.267761","url":null,"abstract":"Background. Heart failure (HF) is a global public health problem worldwide [2]. The most frequent cause of severe HF is dilated cardiomyopathy (DCM) [6]. The morbidity and mortality rate are constantly growing, which indicates the presence of unresolved issues in the therapy of this nosology [3].\u0000Aim. To determine the efficacy of alternative methods of treatment in patients with severe HF caused by DCM.\u0000Materials and methods. A retrospective analysis of the treatment results in 86 patients with severe HF on the background of DCM during the period from 2005 to 2021. All patients were divided into three groups depending on the type of treatment: in group 1 (n=59) – the standard protocol of conservative therapy was supplemented with a course of hemosorption (HS); in group 2.1 (n=21) – left ventricular remodeling surgery was performed; in group 2.2 (n=6) – left ventricular assist device (LVAD) was implanted. During the study we analyzed patients’ clinical condition, the results of transthoracic echocardiography, complications and mortality: before treatment, by the end of in-hospital treatment and in the long-term period (12 months later). Statistical evaluation was performed using Student’s test and Pearson’s χ2 test (significance level p<0.05).\u0000Results. After the therapy, all groups showed improvement of clinical condition of the patients by one NYHA class (p<0.05). There was an increase of left ventricular ejection fraction (LVEF) from 21.1±4.66 % to 34±2.59 % in group 1 and from 22.4±2.27 % to 35.65±5.25 % in group 2.1 (p<0.05). We also observed inverse LV remodeling with marked decrease of LV end-diastolic volume (LV EDV) and LV end-systolic volume (LV ESV) to 242.16±26.11 ml and 148.6±21.3 ml ( p<0.05) in group 1, to 228.75±20.5 ml and 141.5±17.5 ml (p<0.05) in group 2. 1 and a significant decrease in these indices in group 2.2 to 261, 2±103.56 ml (by 29.15%) and to 193±92.27 ml (by 36.23%) (p<0.05), respectively.\u0000Conclusion. Extracorporeal and surgical methods of treatment of patients with severe HF against DCM background reliably improve their clinical condition and can be used in addition to the protocol of conservative therapy.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"696 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130379753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EXPERIENCE OF USING ECMO IN CHILDREN WITH SEVERE COVID-19 (DESCRIPTION OF CLINICAL CASES)","authors":"V. Mishchuk, V. Pryimakova","doi":"10.25284/2519-2078.2(99).2022.265843","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265843","url":null,"abstract":"Summary: Among pediatric patients with COVID-19, about 0,8-1 % require admission to the intensive care unit. The main syndromes that determine the severe course and mortality in children are acute respiratory distress syndrome, multisystem inflammation syndrome and multiple organ failure. In our report, we present two clinical cases of successful use of ECMO in children with COVID-19 who have developed acute respiratory distress syndrome.\u0000Description of clinical cases. Children aged 3 years (case 1) and 17 years (case2) were admitted to the intensive care unit with signs of severe respiratory failure. Both patients were diagnosed with SARS-CoV-2 virus infection. Traditional methods of respiratory support in combination with prone position ventilation and myoplegia have not improved oxygenation. With PaO2 / FiO2 – 60 (case 1) and PaO2 / FiO2 – 75 (case 2), children were started V-V ECMO. The duration of ECMO in both patients was 7 days. As a result, improved oxygenation was achieved: PaO2 / FiO2 – 310 (case 1), PaO2 / FiO2 – 264 (case 2) after decannulation, as well as the condition of pulmonary mechanics (Cst increased from 8 to 22 ml / cmH2O in the first case and from 15 ml / cmH2O to 57 ml / cmH2O in the second case, both patients survived and were discharged with minimal cognitive impairment.\u0000Conclusion: In cases where critical hypoxemia caused by severe ARDS is not eliminated by traditional methods of respiratory support, ECMO can be an effective rescue technology.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129514364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PLACE OF MODERN REGIONAL ANESTHESIA TECHNIQUES IN THE PERIOPERATIVE PERIOD. ADVANTAGES OF LONG-TERM EPIDURAL ANALGESIA WITH ROPIVACAINE","authors":"S. Dubrov, D. Dmytriiev","doi":"10.25284/2519-2078.2(99).2022.265831","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265831","url":null,"abstract":"The article deals with the use of modern regional analgesia techniques in the perioperative period. A review of the literature was also conducted, which includes issues of pain control in patients in the perioperative period, characteristics of pain in surgical patients, features of pain relief methods, and certain aspects of the characteristics of local anesthetics. Based on the review of the literature, it can be concluded that neuraxial anesthesia, as well as blockade of peripheral nerves and plexuses have become an integral part of the modern clinical practice of an anesthesiologist. Due to a number of advantages, various methods of local and regional anesthesia are gaining acceptance, and the use of extended catheter techniques for central and peripheral blockades is now recognized as a standard technique in the perioperative management of surgical patients. In modern regional anesthesia and analgesia, both in outpatient settings and in surgical hospitals, the effectiveness and safety of local anesthetics are of fundamental importance","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114318540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VISUAL ANALOGUE SCALE AS A TOOL FOR ASSESSING QUALITY OF LIFE (PEDSQL™) AND EMOTIONAL STRESS IN CHILDREN AFTER ANTERIOR ABDOMINAL WALL SURGERY","authors":"Y. Semkovych, D. Dmytriiev","doi":"10.25284/2519-2078.2(99).2022.265838","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265838","url":null,"abstract":"Introduction. The prevalence of chronic postsurgical pain can be as high as 54%. Almost 17% of adult chronic pain patients report a history of chronic pain in childhood or adolescence. Untreated chronic pain in children increases the risk of developing mental disorders later in life. Health-related quality of life (HRQoL) is a commonly used indicator of health and well-being that demonstrates the impact of health on quality of life and reflects the desirability of health states relative to perfect health. The simplicity, reliability, validity, and easy determination of visual analogue scale (VAS) scores provides for its wide-ranging application in various clinical cases.\u0000The aim of this study was to assess quality of life in children after anterior abdominal wall surgery using the PedsQL™ 3.0 Present Functioning Visual Analogue Scales.\u0000Materials and Methods. Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic regimens. The patients were asked to fill in the questionnaires repeatedly three and six months after hospital discharge.\u0000Results. According to the VAS, three and six months after surgery, quality of life was significantly lower in children who underwent anterior abdominal wall surgery under general anesthesia with opioids and were diagnosed with chronic pain syndrome (p<0.01). Their quality of life was significantly lower due to excessive emotional stress secondary to chronic pain syndrome (p<0.001).\u0000Discussion. Three months after surgery, children with chronic pain syndrome who underwent conventional anesthesia had high VAS scores experiencing reduced quality of life and elevated emotional stress as compared to the control group (p<0.001). Six months after surgery, in children who underwent regional analgesia, the levels of quality of life and emotional stress almost approached those in the control group as compared to children who underwent conventional anesthesia (p<0.001).\u0000Conclusions. Chronic pain syndrome reduced quality of life in children at the age of 7-18 years who underwent anterior abdominal wall surgery by increasing overall emotional stress. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"39 8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125743055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RHABDOMYOLYSIS: HOW MUCH DO WE KNOW ABOUT IT? MODERN CLINICAL CONSENSUS (Literature review)","authors":"O. Tkhorevskiy, T. Levchenko, V. Moshkivskyi","doi":"10.25284/2519-2078.2(99).2022.265834","DOIUrl":"https://doi.org/10.25284/2519-2078.2(99).2022.265834","url":null,"abstract":"The article presents a review of the world data on modern approaches to the treatment of patients with rhabdomyolysis according to the principles of evidence-based medicine. Rhabdomyolysis is a condition occurring in critically ill and injured patients. But only 20 % of all cases of rhabdomyolysis are usually related to direct trauma. Diagnosis is made based on a combination of clinical and laboratory findings, determining the need for surgical intervention to stop any processes causing muscle damage and to prevent or treat known complications of the disease.\u0000Careful examination of patients and identification of potential risk factors associated with myocyte damage and release of breakdown products (myoglobin, creatinine, potassium, phosphorus) into the systemic bloodstream, which can lead both to asymptomatic elevations of muscle enzymes in the blood and to life-threatening acute renal damage and severe electrolyte disturbances.\u0000Although early volume resuscitation for rhabdomyolysis is a well-established principle for improving renal tubular function, diluting nephrotoxins such as myoglobin, and providing adequate renal perfusion to prevent acute kidney injury (AKI), choosing the best type of crystalloid for this purpose. Existing protocols and benefits of infusion therapy, rate of administration, target recommendations, and diuresis rate to prevent ARF in rhabdomyolysis are analyzed. The appropriateness of diuretics and/or bicarbonate administration for the prevention of AKI is considered. Whether extracorporeal removal of myoglobin can be an effective preventive strategy and taking into account the molecular weight of myoglobin or effective use of different dialysis regimens, filters and flow types to treat and prevent AKI.","PeriodicalId":306479,"journal":{"name":"PAIN, ANAESTHESIA &amp; INTENSIVE CARE","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125853993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}