Vestnik intensivnoi terapii最新文献

{"title":"The condition of newborns after the conversion of epidural analgesia to anesthesia during cesarean section: a prospective randomized study","authors":"Yu. S. Alexandrovich, Oksana V. Ryazanova, D. I. Karabaev, S. N. Nezabudkin, A. M. Ioscovich","doi":"10.21320/1818-474x-2023-4-90-98","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-90-98","url":null,"abstract":"INTRODUCTION: When performing epidural analgesia in childbirth, if surgical delivery is necessary, the question arises about the choice of further tactics of regional anesthesia. The article discusses the peculiarities of the effect of local anesthetics on the condition of a newborn during the conversion of epidural analgesia into anesthesia when caesarean section is necessary, depending on the local anesthetic used. OBJECTIVE: To assess the condition of a newborn baby during the conversion of epidural analgesia in childbirth through the natural birth canal into anesthesia during cesarean section, depending on the local anesthetic used. MATERIALS AND METHODS: A prospective randomized study of 143 children born to mothers who underwent the conversion of epidural analgesia into anesthesia for operative delivery by caesarean section was conducted. Depending on the local anesthetic used, the patients were divided into three groups, in the first group 20.0 ml of 2 % lidocaine in combination with 0.1 mg of epinephrine was injected into the epidural space, in the second group — 20.0 ml of 0.5 % bupivacaine, in the third — 20.0 ml of 0.75 % ropivacaine. The assessment of the condition of newborns was carried out on the Apgar scale at the 1st and 5th minutes of life and on the NACS scale in the first 15 minutes, 2, 24 and 72 hours after birth. RESULTS: The assessment of newborns on the Apgar scale, regardless of the local anesthetic used during epidural anesthesia at the first and fifth minutes, corresponded to 7 or more points (p > 0.05). The neuropsychiatric state of newborns when assessed on the NACS scale did not differ statistically significantly in all groups and at all stages of the study. Within each group, between the study stages, the average values of the NACS scores increased statistically significantly compared to the previous one. CONCLUSIONS: The conversion of epidural analgesia in childbirth through the natural birth canal into anesthesia during cesarean section is safe for the fetus and newborn when using 20.0 ml of 2 % lidocaine in combination with 0.1 mg of epinephrine or 20.0 ml of 0.5 % bupivacaine, or 0.75 % ropivacaine in a volume of 20.0 ml.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069597","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":"Septic shock in adults: guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”","authors":"M. Yu. Kirov, V. V. Kuzkov, D. N. Protsenko, A. V. Shchegolev, M. A. Babaev, B. Z. Belotserkovskiy, A. O. Bykov, A. I. Gritsan, V. V. Kulabukhov, A. V. Kulikov, V. L. Kupreichik, R. E. Lakhin, K. M. Lebedinskii, S. I. Rey, V. A. Rudnov, Alexey A. Smetkin, M. V. Surkov, E. M. Shifman, S. A. Shlyapnikov, M. B. Yarustovsky, I. B. Zabolotskikh","doi":"10.21320/1818-474x-2023-4-7-42","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-7-42","url":null,"abstract":"The paper represents the clinical guidelines for septic shock in adults, approved by the All-Russian public organization “Federation of anesthesiologists and reanimatologists” in 2023. Septic shock is a widespread condition with a high mortality rate. The recommendations cover the issues of etiology, pathogenesis, clinical signs and symptoms, methods of laboratory and instrumental diagnosis of septic shock. The clinical guidelines present initial therapy for septic shock, including approaches to vasopressor and inotropic therapy, recommendations for choosing antibacterial drugs, fluid and adjuvant therapy. The issues of surgical treatment of the infection are discussed. The article contains the criteria for the quality of medical care for the adult patients with septic shock and algorithms for the decision making in the diagnosis and intensive care of patients with septic shock.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069759","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":"Physical restraints practice in adult intensive care units: a review","authors":"Vladimir I. Gorbachev, N. V. Bragina, E. S. Netesin, I. L. Petrova, S. V. Gorbachev","doi":"10.21320/1818-474x-2023-4-112-124","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-112-124","url":null,"abstract":"OBJECTIVE: To describe the available evidence on indications, complications, care and alternative strategies in the use of physical restraint in adult patients in Intensive Care Units. MATERIALS AND METHODS: An integrative review conducted in the Cochrane, PubMed, Scopus, LILACS, Nursing Database and the eLibrary portal. The search was performed on the queries: “physical restriction”, “fixation devices in intensive care”, “patient safety”, “fixation of the patient”. RESULTS: The final selection was of 93 articles, from which the indications, complications, care and alternative strategies were extracted. CONCLUSIONS: The most common practices regarding physical restraints in Russia and foreign countries were described, and the need for the elaboration and implementation of protocols on intervention to support decision — making was observed.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069758","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":"The effect of a tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on oxidative stress in patients with severe combined trauma: a prospective clinical study","authors":"V. V. Antonova, A. K. Evseev, I. V. Goroncharovskaya, A. Yu. Ryzhkov, Oleg A. Grebenchikov, A. K. Shabanov","doi":"10.21320/1818-474x-2023-4-185-196","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-185-196","url":null,"abstract":"INTRODUCTION: Severe combined trauma remains the leading cause of mortality and disability of the workable population. Under damaging factor influence, a whole cascade of pathological processes is triggered, leading to development of multiple organ failure. OBJECTIVE: Exploration of the effects synthetic analogue of tyrosyl-D-alanyl-glycyl-phenylalanyl-leucyl-arginine diacetate (Dalargin) on the dynamics of oxidative stress markers in patients with severe polytrauma and the development of organ dysfunction. MATERIALS AND METHODS: 104 patients with severe combined trauma were included in study. There were 38 patients in the Dalargin group and 66 patients in the control group. Patients from main group received Dalargin in the form of a constant infusion through a syringe dispenser at the dose of 10 mcg/kg/hour at first 12 hours of hospitalization and 5 mcg/kg/hour up to 72 hours from the moment of admission. The control group received standard treatment. Indicators of oxidative stress were evaluated at the time of admission (0 days), 1, 3, 5, 7, 10 and 14 days from the therapy onset. RESULTS: In the main group, there was a significant decrease in oxidative stress markers such as malondialdehyde from the first day of treatment (p < 0.05), normalization of stable nitric oxide metabolites at day 10, and a decrease in total antioxidant activity below normal throughout the observation period. Mortality was comparable in both groups (p > 0.05), but the length of hospital stay was lower in surviving patients in the Dalargin group (p < 0.05). The development of organ dysfunction (acute respiratory distress syndrome, acute kidney injury) was less frequent in the Dalargine group (p < 0.05), but infectious complications (pneumonia, meningitis, wound suppuration) were comparable. CONCLUSIONS: Dalargin leads to a decrease of oxidative stress markers and normalization of endothelial function indicators, which contributes to a decrease of organ dysfunction frequency.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068628","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":"Sensory phenotypes of chronic pain in critically ill patients: a prospective observational study","authors":"Arina P. Spasova, A. V. Mironov, A. M. Dorozhenko, O. Yu. Barysheva, G. P. Tikhova","doi":"10.21320/1818-474x-2023-4-139-148","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-139-148","url":null,"abstract":"INTRODUCTION: Determining sensory phenotypes that reflect underlying pain mechanisms may be relevant for critically ill patients with chronic pain. OBJECTIVE: To evaluate the intensity, localization and sensory phenotypes of chronic pain in critically ill patients. MATERIALS AND METHODS: The study included 99 critically ill patients. Inclusion criteria: age 18–75 years, length of stay in the ICU > 3 days, duration of mechanical ventilation > 48 hours, APACHE II score ≥ 7 points, obtaining informed consent. Localization, intensity, and qualitative characteristics of long-term (at least 6 months) pain associated with ICU stay were assessed using the Brief Pain Inventory and the PainDetect Questionnaire, and the severity of anxiety and depression on the HADS scale. Before discharge, all patients underwent thermal quantitative sensory testing (CST) with assessment of cold detection thresholds and warm detection thresholds, paradoxical thermal sensations, cold pain thresholds and heat pain thresholds, conditioned pain modulation. RESULTS: After 6 months chronic pain syndrome developed in 59 % of patients. Data were obtained on the intensity, localization, and severity of the neuropathic and dysfunctional components of pain. When assessing the thermal parameters of QST, a statistically significant difference in the distribution of values for the thresholds of sensitivity to cold and heat was obtained between the group of patients with chronic pain and the group without pain (p < 0.0001) Hierarchical cluster analysis revealed a statistically significant relationship between changes in static and dynamic parameters of thermal sensory testing, the formation of an “irritated” and “deafferent” sensory phenotype depending on the duration of mechanical ventilation, stay in the ICU and assessment on the SOFA scale. CONCLUSIONS: sensory phenotypes make it possible to identify patients with dysfunction of small diameter fibers, impaired endogenous pain control mechanisms, which will allow selecting an individual program to pain relief.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068629","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":"Modifed Delphi analysis of the guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” “The use of non-invasive lung ventilation”","authors":"Pavel V. Dunts, A. A. Andreenko, A. E. Bautin, S. V. Grigoryev, S. V. Doroginin, M. N. Zamyatin, A. N. Kuzovlev, V. V. Lazarev, I. N. Leyderman, V. V. Lomivorotov, V. I. Potievskaya, V. V. Subbotin, N. V. Trembach, V. V. Fisher, E. M. Shifman, A. V. Shchegolev, I. B. Zabolotskikh","doi":"10.21320/1818-474x-2023-4-99-111","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-99-111","url":null,"abstract":"INTRODUCTION: The need for an independent assessment of the guidelines before their planned revision based on the third-party opinion of competent specialists is beyond doubt. This analysis allows to adapt the implementation of recommendations in practice, regarding equipment and knowledge of physicians. OBJECTIVE: To analyze the effectiveness, safety and availability of implementation in clinical practice of the guidelines “Application of non-invasive lung ventilation” using the modified Delphi method. MATERIALS AND METHODS: The expertise consisted of three stages. The first stage consisted in the analysis of the guidelines “The use of non-invasive lung ventilation” and the preparation of a questionnaire. At the main stage, a questionnaire was sent out and panel members were asked to evaluate the positions using ten-point Likert scale. The analytical stage consisted in calculating the weighted average, median and mode. The weighted average score were taken into account; the value of the median or mode of criteria for the quality of medical care, weighted average. RESULTS: Fifteen panel members was enrolled. The main remarks and additions were to clarify the terminology, concretize certain recommendations and style. Panel members determined the possibility of implementing the recommendation of the guidelines in practice. The lack of equipment makes therapeutic measures limited. This fact confirms the low results of the weighted average assessment of the criteria for the quality of medical care. CONCLUSIONS: Consensus was reached on 20 of the 21 thesis recommendations, on four of the eight criteria for the quality of medical care, and on the amended wording of certain recommendations. The Delphi analysis made it possible to look at the implementation of the giudelines from the perspective of practicing anesthesiologist and intensive care physician, including in structural units with a low level of material and equipment.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068636","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":"Prediction model for postoperative pneumonia in abdominal surgery: results of an observational multicenter study","authors":"R. V. Veyler, N. V. Trembach, T. S. Musaeva, M. A. Magomedov, A. S. Popov, V. V. Fisher, V. E. Khoronenko, A. I. Gritsan, P. V. Dunts, A. Zh. Bayalieva, A. M. Ovezov, K. M. Lebedinskii, D. V. Martynov, A. P. Spasova, V. V. Stadler, D. A. Levit, K. G. Shapovalov, V. N. Kokhno, Igor B. Zabolotskikh","doi":"10.21320/1818-474x-2023-4-43-59","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-43-59","url":null,"abstract":"INTRODUCTION: Taking into account the prevalence of postoperative pneumonia and the increase in the number of surgical procedures, forecasting its development is an urgent task that allows taking measures to reduce the frequency of its occurrence by optimizing the perioperative period. Despite their value, the existing scales for predicting postoperative pneumonia do not provide domestic specialists with a reliable and consistent method by which to stratify the risk of developing postoperative pneumonia in our population. OBJECTIVE: To develop a model for predicting postoperative pneumonia based on the identification of risk factors for its development. MATERIALS AND METHODS: A multicenter prospective study of 6844 patients over 18 years of age undergoing elective abdominal surgery. 30-day mortality and postoperative pneumonia were assessed. In the first phase of the study, a comparison was made between the pneumonia and non-pneumonia group of baseline patient data, as well as factors associated with surgery and anesthesia. At the second stage of the study, a logistic regression analysis was performed to assess the contribution of factors to the development of postoperative pneumonia. At the third stage of the study, a model for predicting postoperative pneumonia was built according to the data of multivariate logistic regression analysis. At the final stage, the obtained model was compared with the forecasting models of other authors found in the world literature. RESULTS: Pneumonia was detected in 53 patients (0.77 %). A lethal outcome was observed in 39 patients: in patients with pneumonia in 15 cases (28.3 %), and without pneumonia in 24 cases (0.4 %). Retrospectively, taking into account the obtained model, 933 patients were assigned to the high-risk group for developing pneumonia, the incidence of pneumonia was 4.5 %. In the low-risk group for developing pneumonia — 5911 patients, the incidence of pneumonia was 0.19 %. CONCLUSIONS: Eight independent variables associated with postoperative pneumonia were identified: duration of surgery, smoking, complete functional dependence, perioperative anemia requiring iron supplementation, intraoperative use of vasopressors, American Society of Anesthesiologists classification 3 functional class, use of bronchodilators for chronic obstructive pulmonary disease, and high operative risk. The postoperative pneumonia prediction model has excellent predictive value (AUROC = 0.904).","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069769","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":"Diagnosis of difficult airways: a review","authors":"Andrey Yu. Zaytsev, E. G. Usikyan, K. V. Dubrovin, V. A. Svetlov, M. A. Vyzhigina, S. G. Zhukova","doi":"10.21320/1818-474x-2023-4-149-168","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-149-168","url":null,"abstract":"INTRODUCTION: Complications arising from maintaining the patency of the upper airways in the practice of an anesthetist remain the most dangerous for the life and health of the patient. The problem of predicting difficult airways has been studied for decades and has not yet been solved. OBJECTIVE: To analyze the problem of the difficult airways diagnosis. MATERIALS AND METHODS: There was search on PubMed (MEDLINE), eLibrary, Google Scholar databases for the period 01.1985–01.2022. Keywords: Difficult airways prediction, difficult airways, difficult intubation, mask ventilation, endoscopy intubation, ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), difficult airways, difficult intubation, difficult laryngoscopy, mask ventilation, ultrasound diagnostics, computed tomography (CT), magnetic resonance imaging (MRI). Inclusion criteria: original, review articles, randomized and non-randomized clinical trials, meta-analyses and systematic reviews devoted to the diagnosis of TDP. Exclusion criteria: clinical cases, comments on articles, abstracts of dissertations. RESULTS: Measurement of various distances, tests for congenital or acquired deformity of the facial skull and malocclusion, tests for the relationship between the structures of the facial skull and the cervical spine, for the most part, have limited diagnostic effectiveness. The instrumental methods allows diagnosing difficult airways with greater confidence. The thickness of the tongue, the distance from the skin to the epiglottis or vocal folds, and the long epiglottis can accurately predict difficulties at various stages of maintaining airways from face mask ventilation to laryngoscopy and tracheal intubation. Ultrasonography should be considered the most optimal method for diagnosing difficult airways. At the same time, less accurate indicators compared to magnetic resonance and x-ray studies should not stop clinicians, as they are compensated by a faster examination. CONCLUSIONS: Instrumental methods for difficult airways diagnosis are more effective than physical ones.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136067519","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":"The effect of nitric oxide donation on the severity of mitochondrial disfunction to the renal tissue in cardiopulmonary bypass simulation: an experimental study","authors":"Mark A. Tyo, N. O. Kamenshchikov, Yu. K. Podoksenov, A. V. Mukhomedzyanov, L. N. Maslov, B. N. Kozlov","doi":"10.21320/1818-474x-2023-4-176-184","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-176-184","url":null,"abstract":"INTRODUCTION: Acute kidney injury is one of the common complications in cardiosurgical operations with cardiopulmonary bypass (CPB). A number of studies have shown that donation of exogenous nitric oxide (NO) reduces episodes of аcute kidney injury. However, subcellular mechanisms of realization the nephroprotective properties of NO remain unknown. OBJECTIVE: To study the safety of the technology of plasma-chemical synthesis of nitric oxide and to evaluate the effect of the delivery resulting nitric oxide on mitochondrial damage to the renal tissue in the simulation of cardiopulmonary bypass. MATERIALS AND METHODS: Experiment included 12 rams of the Altai breed. Animals were divided into 2 groups: 6 animals were modeled CPB; 6 animals were simulated CPB with NO delivery. Mitochondrial damage was assessed by calcium-binding capacity and transmembrane potential of mitochondria 1 h after weaning from the CPB. The safety of the NO delivery according to the proposed method was assessed by the concentration of nitrogen dioxide on inspiration, the level of methemoglobin. The efficiency of NO delivery according to the proposed method was assessed by the level of stable NO metabolites: endogenous nitrite, nitrate and total concentration of NO metabolites. RESULTS: In the group of animals with NO delivery the average level of transmembrane potential of mitochondria was (171.66 ± 20.41 vs 126.66 ± 18.61; p = 0.00256) and calcium-binding capacity of mitochondria was (1466.66 ± 216.02 vs 866.66 ± 216.02; p = 0.000712) of renal parenchyma. Methemoglobin levels above the recommended thresholds in clinical practice were not recorded in the CPB+NO group. The values of total concentration of NO metabolites and nitrate in the CPB+NO group compared to the CPB group are statistically significantly higher, p = 0.00006; p = 0.0035, respectively. CONCLUSIONS: Plasma-chemical synthesis of nitric oxide is a safe technology, and the use of the resulting nitric oxide in cardiopulmonary bypass leads to a decrease in the severity of mitochondrial dysfunction in the kidney parenchyma.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069761","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":"The ultrasound assessment of the inferior vena cava collapsibility in the prone volunteers through a new acoustic window: a prospective observational study","authors":"Anton A. Kasatkin, V. A. Matreshkin","doi":"10.21320/1818-474x-2023-4-169-175","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-4-169-175","url":null,"abstract":"INTRODUCTION: Ultrasound assessment of inferior vena cava (IVC) collapsibility is used in clinical practice to assess patients' volume status. Finding the subject in the prone position limits the ability to assess IVC collapse by the traditional method, which requires the use of alternative methods. OBJECTIVE: Conducting a comparative assessment of the IVC collapse index in healthy volunteers in the back position and in the pro position using a new acoustic window. MATERIALS AND METHODS: Ultrasound observation was performed in 25 adult healthy volunteers of both sexes. Ultrasound measurement of IVC was carried out sequentially in the position of volunteers on the back and abdomen. The mean (M) and standard deviation (SD) of the maximum and minimum IVC size. The values of the collapsing index (CI) obtained during the study are presented as a median (Me) and quartiles (Q1–Q3). Wilcoxon's nonparametric test was selected for comparative analysis (significance level accepted 0.05). RESULTS: Measurements of the diameter of the inferior vena cava obtained the following results: the average maximum and minimum vein size in volunteers in the supine position were 1.58 ± 0.37 cm and 1.30 ± 0.36 cm, respectively; in prone — 1.51 ± 0.37 cm and 1.24 ± 0.36 cm, respectively. Me (Q1–Q3) IVC-CI values (%) in volunteers in the supine and in the prone position of the voice were 16.84 (8.86–24.39) and 15.63 (10.23–24.77), respectively. Statistical analysis of the obtained results did not reveal a significant difference between CI values (p = 0.861). CONCLUSIONS: The absence of a statistically significant difference in IVC-CI values in the supine and abdominal volunteers demonstrates the possibility of using a new acoustic window to assess volume status in the clinical setting in patients in the prone position.","PeriodicalId":34876,"journal":{"name":"Vestnik intensivnoi terapii","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069768","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}