Anesteziologiia i reanimatologiia最新文献_第2页

[CORRECTION ENERGY DEFICIENT STATES AS POSSIBLE PERIOPERATIVE ADAPTATION OF CANCER HEPATOPANCREATODUODENAL ZONE PATIENTS.] [纠正能量不足状态作为癌症肝胰十二指肠区患者围手术期适应的可能。]

Anesteziologiia i reanimatologiia Pub Date : 2017-09-01

O I Kit, S V Tumanyan, O V Oros, L G Ivanova, N V Netyvchenko, E Y Sugak

{"title":"[CORRECTION ENERGY DEFICIENT STATES AS POSSIBLE PERIOPERATIVE ADAPTATION OF CANCER HEPATOPANCREATODUODENAL ZONE PATIENTS.]","authors":"O I Kit, S V Tumanyan, O V Oros, L G Ivanova, N V Netyvchenko, E Y Sugak","doi":"","DOIUrl":"","url":null,"abstract":"The aim of this study was to determine the role remaxol in complex intensive therapy of various jorms gipoergosis dur- ing the perioperative period in patients with hepatopancreatoduodenal zone malignancies. The treatment of 48 patients was analyzed. Immediately prior to surgery, at random, patients were divided into primary (n = 26) and control group (n = 22). In the study group for compensation the energy deficient states and organ hypoxia in the pancreas and the liver during the intra- and postoperative periods remaxol was included in the infusion therapy, the introduction ofwhich had been began before the start of anesthesia. In the control group antihypoxants weren't used. Integral assessment of prognosis and severity on a scale SAPS II and APACHE II. Status of energy and the type of energy deficit was estimated by the transport of oxygen and the concentration of lactate. In order to determine the level of stress exposure and the for- mation of adaptive reactions examined quantitative and qualitative composition of the peripheral blood. The study was conducted prior to surgery, on the 2nd and 5th day perioperative period. Inclusion in the scheme of metabolic remaxol program in the perioperative period in patients with malignant diseases of hepatopancreatoduodenal zone promotes the reduction of different types ofgipoergosis, efficient delivery and oxygen consumption, the adequacy of tissue oxygenation and restoration of adaptive physiological reactions such as.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 ","pages":"228-232"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850599","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}

引用次数: 0

[PULSE WAVE TRANSIT TIME - ONE MORE ATTEMPT OF NON-INVASIVE CARDIAC OUTPUT MEASUREMENT.] [脉搏波传递时间——无创心输出量测量的又一次尝试。]

Anesteziologiia i reanimatologiia Pub Date : 2017-09-01

B A Akselrod, L A Tolstova, T A Pshenichniy, S V Fedulova

{"title":"[PULSE WAVE TRANSIT TIME - ONE MORE ATTEMPT OF NON-INVASIVE CARDIAC OUTPUT MEASUREMENT.]","authors":"B A Akselrod, L A Tolstova, T A Pshenichniy, S V Fedulova","doi":"","DOIUrl":"","url":null,"abstract":"Background: Estimated continuous cardiac output (esCCOTM) based on pulse wave transit time is one of alternative non-invasive CO measurement techniques.Methods: Randomized study included 23 scheduled patients operated upon due to cardiovascular diseases. Cardiac index (CI) was measured Comparative analyses of esCCO and others CO measurement methods used intraoperative was carried out. In the first group (n = 9) esCCO was compared with transpulmonary thermodilution (PiCCO-plus); in the second group (n = 8) - with pulmonary artery thermodilution; in the third group (n = 6) - with transoesophageal echocardiography (velocity-time integral).Results: In the 1st group direct correlation was found (r = 0,773, p <0.0001), but overestimation was found in 39% of cases; underestimation in 4%. The 2nd group showed direct correlation (r = 0.586, p <0.0001). The 3d group showed direct relationship (r = 0.68, p = 0.0018), but 66.7% of the measurements were out of reference interval (more than ? 15%). Blend- Altman method showed the dispersion of results in all groups.Conclusions: 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.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 ","pages":"178-182"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35851216","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}

引用次数: 0

[EPISTAXIS DURING NASOTRACHEAL INTUBATION. ATTILA'S SYNDROME.] 鼻气管插管时鼻出血。阿提拉的综合症。

Anesteziologiia i reanimatologiia Pub Date : 2017-09-01

Zaycev A Yu, Svetlov V A, Dubrovin K V, Khrustaleva M V, Dehtjar M A, Titova I V

{"title":"[EPISTAXIS DURING NASOTRACHEAL INTUBATION. ATTILA'S SYNDROME.]","authors":"Zaycev A Yu, Svetlov V A, Dubrovin K V, Khrustaleva M V, Dehtjar M A, Titova I V","doi":"","DOIUrl":"","url":null,"abstract":"Background: Nasal bleeding is a common complication during nasotracheal intubation (NTI). This is due to the ana- tomical prerequisites and the hemostatic system failure. Using of various research methods in practice can reduce the frequency of such complications. The purpose of the study is to identify predictors of high probability of epistaxis associated with the NTI and the pecu- liarities of the anatomical mucous membrane structure of the nasal passages, and to assess significance of blood coag- ulationfailures in these cases.Materials and methods: 45 patients (f-25 and m-20), aged 23 to 47 years, with physical status I-IIASA were analyzed. Depending on the degree of surgical trauma manipulation during intubation were formed three groups of patients in whom the NTI was atraumatic, moderately traumatic and overly traumatic. During preoperative period all patients underwent a rhinoscopy. Intubation trauma of the trachea was assessed by visual analogue scale. The results and discussion. The study of the nasal mucosa structure showed that with atraumatic intubation (Group 1; n=9) were dominated by deep type of bedding nonplethoric nonkinking vessels (66.7% ofpatients (n=6)). During mod- erate trauma intubation (Group 2; n=24), superficial and deep vessels were found equally (50% and 50%). In patients with severe trauma during intubation (Group 3; n=13), 100% of the patients, the vessels were located superficially, 75 % were convoluted, plethoric, mucosa contact bleeding. There were no anatomical changes.Conclusion: The source of bleeding are superficial, plethoric, kinking vessels of the mucous membrane. Hypocoagu- lation disorders, observed in patients during reconstructive surgeries, exacerbate such bleeding and can lead to fatal complications.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 ","pages":"164-168"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35850212","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}

引用次数: 0

[INJURY PREVENTION WHILE ENSURING THE AIRWAY DURING SURGERY IN THE NOSE AND SINUSES.] [在手术过程中，在确保鼻腔和鼻窦气道通畅的同时预防伤害。]

Anesteziologiia i reanimatologiia Pub Date : 2017-09-01

E V Ivlev, E A Ruben

{"title":"[INJURY PREVENTION WHILE ENSURING THE AIRWAY DURING SURGERY IN THE NOSE AND SINUSES.]","authors":"E V Ivlev, E A Ruben","doi":"","DOIUrl":"","url":null,"abstract":"The aim: A comparative analysis of the injuries of upper airways flexible reinforced laryngeal mask and endotracheal intubation by examining the stress response reaction of the cardiovascular system, as well as the frequency and variety of complications. Blood pressure, heart rate, glucose and cortisol, and complications of airway management in children were analyzed.Methods: The influence of the method of airway management with surgery in nose and sinuses in children in the stress response, hemodynamics, injuries of the airway were studied. The study included 140 patients aged 3 to 17 years.Results: LMA FlexibleTMhas a minimal negative impact on the hemodynamics. Stress response is less pronounced when installing laryngeal mask than with tracheal intubation, which manifests itself in less cortisol concentration of 3.7%, 11.4% glucose. After removing the flexible reinforced laryngeal mask less than after extubation occurs: cough by 21%, 10% hoarseness, and sore throat by 26%.Conclusion: The use of the laryngeal mask airway during surgery in the nose and paranasal sinuses safer and less trau- matic manipulation compared with tracheal intubation.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 ","pages":"168-172"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35851213","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}

引用次数: 0

EPIDURAL ANESTHESIA IN A PATIENT WITH LUNG APLASIA AND SKELETON DEFORMATION UNDERGOING ABDOMINAL HYSTERECTOMY: A CASE REPORT. 硬膜外麻醉在腹式子宫切除术中肺发育不全及骨骼变形患者的应用:1例报告。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01 DOI: 10.18821/0201-7563-2017-62-1-54-56

A. Kasatkin, A. Nigmatullina, A. A. Vorozhtsova, E. Matveeva, I. G. Martyshko

引用次数: 0

CORRECTION PARAMETERS OF RESPIRATORY SUPPORT IN ENDOSCOPIC RESECTION OF THE STOMACH IN PATIENTS WITH THE MORBID OBESITY. 病态肥胖患者胃内镜切除术中呼吸支持的校正参数。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01 DOI: 10.18821/0201-7563-2017-62-1-46-50

M. I. Nevmark, R. Kiselev, V. V. Shmelev

{"title":"CORRECTION PARAMETERS OF RESPIRATORY SUPPORT IN ENDOSCOPIC RESECTION OF THE STOMACH IN PATIENTS WITH THE MORBID OBESITY.","authors":"M. I. Nevmark, R. Kiselev, V. V. Shmelev","doi":"10.18821/0201-7563-2017-62-1-46-50","DOIUrl":"https://doi.org/10.18821/0201-7563-2017-62-1-46-50","url":null,"abstract":"BACKGROUND In recent years, steadily increasing the number of operations for morbid obesity. One of the most frequently performed worldwide operations at this pathology is the sleeve gastrectomy are approximately 28% of all bariatric surgeries per year It must be stressed that obesity is accompanied by hard changes andfunctional disorders of all body systems, including the respiratory and cardiovascular The aim: to study the effect of respiratory support options combined with high thoracic epidural analgesia, as a component of anesthetic management on central hemodynamics during anesthesia providing endoscopic gastroplasty in patients with morbid obesity. MATERIALS AND METHODS a randomized study of 37 patients with morbid obesity who underwent endoscopic sleeve gastroplasty under anesthesia combined with high thoracic epidural analgesia. Depending on the choice of tactics respiratory support patients were divided into two groups; In group 1 (n-17), the traditional mode of ventilation in group 2 (n-20) modified the ventilation mode. Intraoperative central hemodynamic parameters, external respiration were monitored; acid-base balance is achieved partly by recycling carbon dioxide in a closed breathing circuit using NICO 7300 system (Novametrix Medical Systems Inc. USA), based on the Fick principle. RESULTS the use of ventilation mode with inversion of the respiratory cycle, high-level application of PEEP titration in stages so you can optimize the parameters of external respiration, gas exchange without adverse effects on the central hemodynamics. The continued elevated levels PaCO₂, PvCO₂, when applying carboxiperitoneum, did not cause gross changes in acid-base balance.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"10 1","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76411408","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}

引用次数: 0

PROTOCOL NUTRITION THERAPY OF CRITICALLY ILL CHILDREN. 危重儿童营养治疗方案。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01 DOI: 10.18821/0201-7563-2017-62-1-14-23

A. N. Shmakov, Y. Aleksandrovich, S. Stepanenko

{"title":"PROTOCOL NUTRITION THERAPY OF CRITICALLY ILL CHILDREN.","authors":"A. N. Shmakov, Y. Aleksandrovich, S. Stepanenko","doi":"10.18821/0201-7563-2017-62-1-14-23","DOIUrl":"https://doi.org/10.18821/0201-7563-2017-62-1-14-23","url":null,"abstract":"The Protocol isn't seen as directive. The goal of the Protocol is to define theframes ofdiagnostic criteria and therapeutic action, within which a doctor working in an intensive therapy children have freedom of choice. The Protocol takes into account that the critical and postagressive states are characterized by the features of malnutrition, particularly manifested in the period of intensive growth (first life year). The Protocol submitted by: contraindications to artificial nutricion in any form; indications for parenteral nutrition; components ofparenteral nutrition; calculation of water and energy needs; calculation of substrate requirements; the system of \"two in one\" and \"three in one \"; monitoring the effectiveness ofparenteral nutrition; the use of adjuvants and active additives to artificial nutrition, indications for early enteral nutrition, time of the beginning of enteral nutricion and tolerance to it: trial feeding; trophic nutricion; the technique ofprobe feeding; selection offormulas for enteral nutrition; monitoring the effectiveness of enteral nutrition. The Protocol does not discuss the issues of planned nutritional preparation for surgery, nutritional support in chronic malabsorption, sipping.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"1 1","pages":"14-23"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88037888","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}

引用次数: 2

ANESTHETIC MANAGEMENT OF DELIVERY IN PATIENTS WITH COMPLEMENT-ASSOCIATED DISORDERS. CLINICAL OBSERVATION OF A PREGNANT WOMAN WITH PAROXYSMAL NOCTURNAL HEMOGLOBINURIA. 补体相关疾病患者分娩的麻醉管理。孕妇阵发性夜间血红蛋白尿1例临床观察。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01 DOI: 10.18821/0201-7563-2017-62-1-56-60

E. Y. Uptyamova, A. Golovin, E. Shifman

引用次数: 0

INTRA-OPERATIVE NEED FOR GLUCOSE IN NEWBORNS. 新生儿术中葡萄糖的需求。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01 DOI: 10.18821/0201-7563-2017-62-1-10-13

Y. U. Kucherov, M. M. Nasser, Y. V. Zhirkova

{"title":"INTRA-OPERATIVE NEED FOR GLUCOSE IN NEWBORNS.","authors":"Y. U. Kucherov, M. M. Nasser, Y. V. Zhirkova","doi":"10.18821/0201-7563-2017-62-1-10-13","DOIUrl":"https://doi.org/10.18821/0201-7563-2017-62-1-10-13","url":null,"abstract":"INTRODUCTION One ofthe important goals of intraoperativefluid therapy in neonates is to ensure normal glycemic status. However there is no definitive guidance on the issue of intraoperative administration solutions containing glucose. MATERIALS AND METHODS a single-center study of intraoperative glycemic status in 60 newborns with congenital malformations was conducted. Age at the time of surgery amounted to Me 48 [24; 120] hours of life, the duration of surgery was 70 [60; 101] minutes. The children were divided into two groups: in group 1 (n = 30) intraoperative infusion therapy was only saline; in group 2 (n = 30) with salt solutions were simultaneously injected glucose in a dose of 2,3 mg/kg/ min. The glucose level in the blood was evaluated before operation, during operation every 30 minutes and at the end of surgical intervention, if it was necessary, was corrected. RESULTS the study revealed high incidence of hypoglycemic conditions in children in group 1, especially during tracheal intubation and skin incision (40 episodes in 20 children). However the blood glucose level subsequently normalized and remained within the reference values. In group 2, the average glucose level in these stages was significantly greater than 4,4 [3,3; 5,2] mmol/l (p = 0,03), and did not go beyond normal values, remaining stable in all phases of the operation. There was a decrease in 2 times the frequency of episodes of hypoglycemia in group 2 (19 episodes in 12 patients). At the same time, more often fixed hyperglycemia in group 2. CONCLUSIONS intraoperative blood glucose in newborns is unstable indicator and requires a precise dosing of glucose in the infusion to avoid Hypo- and hyperglycemia.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"56 1","pages":"10-13"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91054643","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}

引用次数: 0

CORRECTION PARAMETERS OF RESPIRATORY SUPPORT IN ENDOSCOPIC RESECTION OF THE STOMACH IN PATIENTS WITH THE MORBID OBESITY. 病态肥胖患者胃内镜切除术中呼吸支持的校正参数。

Anesteziologiia i reanimatologiia Pub Date : 2017-01-01

M I Nevmark, R V Kiselev, V V Shmelev

{"title":"CORRECTION PARAMETERS OF RESPIRATORY SUPPORT IN ENDOSCOPIC RESECTION OF THE STOMACH IN PATIENTS WITH THE MORBID OBESITY.","authors":"M I Nevmark, R V Kiselev, V V Shmelev","doi":"","DOIUrl":"","url":null,"abstract":"Background: In recent years, steadily increasing the number of operations for morbid obesity. One of the most frequently performed worldwide operations at this pathology is the sleeve gastrectomy are approximately 28% of all bariatric surgeries per year It must be stressed that obesity is accompanied by hard changes andfunctional disorders of all body systems, including the respiratory and cardiovascular The aim: to study the effect of respiratory support options combined with high thoracic epidural analgesia, as a component of anesthetic management on central hemodynamics during anesthesia providing endoscopic gastroplasty in patients with morbid obesity.Materials and methods: a randomized study of 37 patients with morbid obesity who underwent endoscopic sleeve gastroplasty under anesthesia combined with high thoracic epidural analgesia. Depending on the choice of tactics respiratory support patients were divided into two groups; In group 1 (n-17), the traditional mode of ventilation in group 2 (n-20) modified the ventilation mode. Intraoperative central hemodynamic parameters, external respiration were monitored; acid-base balance is achieved partly by recycling carbon dioxide in a closed breathing circuit using NICO 7300 system (Novametrix Medical Systems Inc. USA), based on the Fick principle.Results: the use of ventilation mode with inversion of the respiratory cycle, high-level application of PEEP titration in stages so you can optimize the parameters of external respiration, gas exchange without adverse effects on the central hemodynamics. The continued elevated levels PaCO₂, PvCO₂, when applying carboxiperitoneum, did not cause gross changes in acid-base balance.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"62 1","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36248995","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}

引用次数: 0