Annals of pulmonary and critical care medicine最新文献

{"title":"A modern view on the treatment of acute bronchiolitis in pediatric intensive care units: a review","authors":"A. E. Tsygankov, D. Ovsyannikov, I. Afukov, O. N. Solodovnikova, O. Gosteva, D. M. Kostin, I. N. Tyurin, D. Protsenko","doi":"10.21320/1818-474x-2022-3-111-123","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-3-111-123","url":null,"abstract":"INTRODUCTION. The literature has accumulated enough data on the treatment of children with acute bronchiolitis (OB). However, this information is formed mainly on the general population of patients with OB and is often not applicable to patients with a severe course of the disease. From the standpoint of evidence-based medicine, routine use of medications is not recommended in modern consent documents, and there are also no clear recommendations on respiratory support and certain aspects of intensive care in children with OB. OBJECTIVES. To analyze approaches to therapy in children with severe acute course in need of intensive care, and to assess the validity, effectiveness and safety of the use of the analyzed groups of drugs and respiratory strategies. MATERIALS AND METHODS. The analysis of publications in the electronic databases PubMed and the Russian Scientific Citation Index on the keywords “bronchiolitis”, “intensive care units”, “critical care”, “fluid therapy”, “respiratory therapy”, “ventilation”, “co-morbidity”; “respiratory syncytial virus”; “hypertonic saline” was carried out, “corticosteroids”; “epinephrine”; “high-flow oxygen therapy”, “inhalation”, “infant”, “bronchiolitis in children”. The date of the last search is January 15, 2022. RESULTS. This systematic review provides information on the etiology and risk factors of severe acute respiratory syndrome in children, from the standpoint of evidence-based medicine, studies on the treatment of severe acute respiratory syndrome are characterized, including in the intensive care unit with glucocorticosteroids, inhalations of bronchodilators, epinephrine, 3 % hypertonic sodium chloride solution, respiratory support, high-flow oxygenation, noninvasive ventilation, artificial ventilation, antibiotics, air-helium mixture. CONCLUSIONS. Currently, there is more information that infants with OB show a high degree of heterogeneity, while the main uncertainty lies in a misunderstanding of the processes, which patients will benefit most from a particular treatment method. Further research is needed to fill the research deficit in children with a severe course of OB.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85896677","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":"National multicenter prospective observational study “The role of concomitant diseases in poSTOPerative complications RISK stratification - STOPRISK”: study protocol","authors":"I. Zabolotskikh, N. Trembach, T. Musaeva, P. Dunts, V. V. Golubtsov, E. Grigoryev, A. Gritsan, M. Zamyatin, V. N. Kokhno, A. Kuzovlev, K. M. Lebedinskii, M. Magomedov, Y. Malyshev, A. Ovezov, A. S. Popov, D. Protsenko, V. V. Fisher, V. Khoronenko","doi":"10.21320/1818-474x-2022-4-24-35","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-4-24-35","url":null,"abstract":"INTRODUCTION: Advances in modern anesthesiology have significantly reduced the risk of anesthesia compared to the last century, however, the level of perioperative in-hospital mortality after elective major abdominal surgery is still high at the moment. Poor outcome prediction is the cornerstone of individualized perioperative management of high-risk patients aimed at preventing complications. Despite the fact that a large number of risk assessment tools have been developed over the past decades, the accuracy of the forecast is still far from required. According to the literature data, models based on the study of risk factors in the national population of patients, of which comorbidities make the greatest contribution, have the greatest accuracy. MATERIALS AND METHODS: Design: prospective observational study. Setting: National multicenter study of patients in surgical hospitals. Patients: Patients undergoing abdominal surgery. Interventions: Not provided. RESULTS: The developed design was registered in the ClinicalTrials.gov database, a study organized by the Federation of Anesthesiologists and Resuscitators of Russia in cooperation with the Kuban State Medical University has now begun, 38 centers are participating in it, two papers have been published based on the results of an interim analysis. CONCLUSIONS: The study is of great scientific and medical and social importance, as a result of the analysis of the data obtained, the role of concomitant diseases in the development of an adverse outcome will be studied and a national risk assessment model will be developed. REGISTRATION: Clinicaltrials.gov identifier: NCT03945968. Registered May 10, 2019.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75759325","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":"Comparative evaluation of scales for predicting an unfavorable postoperative outcome: Preliminary results of the multicenter study “The role of concomitant diseases in the stratification of the risk of postoperative complications in abdominal surgery STOPRISK\"","authors":"I. Zabolotskikh, N. Trembach, M. Magomedov, V. G. Krasnov, L. Chernienko, S. N. Shevyrev, A. S. Popov, E. Tyutyunova, S. Vatutin, Y. Malyshev, E.A. Popov, A. A. Smolin, I. Kitiashvili, A. A. Dmitriev, E. Grigoryev, E. Kameneva, V. V. Fisher, E. V. Volkov, I. Yatsuk, D. Levit, A. Sharipov, V. Khoronenko, M. Shemetova, V. N. Kokhno, E. Polovnikov, A. P. Spasova, A. V. Mironov, V. R. Davydova, K. Shapovalov, A. Gritsan, S. V. Sorsunov, K. M. Lebedinskii, P. Dunts, V. Rudnov, V. Stadler, A. Bayalieva, M. Prigorodov, V. Antonov, D. Voroshin, A. Ovezov, A. Pivovarov, D. Martynov, O.A. Batigyan, M. Zamyatin, S. Voskanyan, A. A. Astakhov, A. Khoteev, D. Protsenko, N. Arıkan, I. Zakharchenko, A. S. Matveev, I.A. Trembach, T. Musaeva","doi":"10.21320/1818-474x-2022-3-27-44","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-3-27-44","url":null,"abstract":"INTRODUCTION. The need for accurate risk stratification is obvious. Modern methods are quite cumbersome, which can cause difficulties when applied in routine practice, and therefore relatively simple but accurate forecasting methods have become very popular, which, however, have not been validated in Russia: SORT (Surgical Outcome Risk Tool), SRS (Surgical Risk Scale), POSPOM (Preoperative Score to Predict Postoperative Mortality), NZRISK (New Zealand RISK), SMPM (Surgical Mortality Probability Model). OBJECTIVES. The aim of this work is to determine the prognostic value of risk assessment scales in predicting an unfavorable postoperative outcome based on the analysis of data obtained in the STOPRISK study in patients undergoing open abdominal surgery. MATERIALS AND METHODS. The analysis of data on perioperative parameters of 1,179 patients who underwent open abdominal surgery is presented. RESULTS. The fatal outcome was recorded in 14 patients (1.18 %). A total of 135 complications were registered in 92 patients (7.8 %). All scales demonstrated satisfactory prognostic value in assessing the risk of complications (the area under the operating characteristic curve (AUROC) for the Physical Status Scale of the American Society of Anesthesiologists (ASA) was 0.714 (0.687-0.739), for the Surgical Risk Scale (SRS) - 0.727 (0.701-0.753), for the Surgical Outcome Risk Scale (SORT) - 0.738 (0.712-0.763), for the New Zealand Risk Scale (NZRISK) - 0.763 (0.738-0.787)), for the Surgical Mortality Probability Scale (SMPM) - 0.732 (0.706-0.757), for the Preoperative Postoperative mortality Prediction Scale (POSPOM) - 0.764 (0.738-0.788)) and good in assessing the risk of death (AUROC for the ASA scale was 0.82 (0.804-0.843), for the SRS scale - 0.860 (0.838-0.879), for the SORT scale - 0.860 (0.838-0.879), for the NZRISK scale - 0.807 (0.783-0.829), for the SMPM scale - 0.852 (0.831-0.872), for the POSPOM scale - 0.811 (0.788-0.833)). CONCLUSIONS. All the studied scales have good prognostic value in assessing the risk of 30-day mortality after major abdominal surgery. The NZRISK and POSPOM scales demonstrate good prognostic value for cardiovascular complications, POSPOM and SRS scales - for acute renal injury. POSPOM and NZRISK scales showed an excellent prognostic value in relation to the risk of postoperative delirium.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75427879","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":"Legal regulations of errors and complications in anesthesiology and intensive care in Russian Federation: a review","authors":"V. Gorbachev, E. Netesin, M. Itygilov, S. Gorbachev, N. Utkin","doi":"10.21320/1818-474x-2022-4-83-100","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-4-83-100","url":null,"abstract":"The literature review reflects the existing approaches to the structural organization of medical care in Russia and its provision with regulatory legal acts. A critical analysis of the list of medical services in the profile of anesthesiology and intensive care is being carried out, which requires significant adjustments and optimization. A variant of the formation and structuring of medical services as a purposeful concretized process of medical care is proposed. Various options for the development of the classification of complications of anesthesia and intensive care are presented. The paper substantiates the urgent need to form a database of various complications and adverse reactions of anesthesia and intensive care, which currently does not exist, as there are no official documents regulating and obliging to conduct this monitoring, and some documents on this issue are related exclusively to the undesirable effects of drugs.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74843756","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":"Treatment option for diaphragm dysfunction after cardiac surgery: a review and a clinical case","authors":"K. Paromov, D. Svirskii, M. Kirov","doi":"10.21320/1818-474x-2022-3-57-68","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-3-57-68","url":null,"abstract":"INTRODUCTION. Dysfunction of diaphragm postoperatively is associated with worsened quality of life and increased health care costs due to prolonged respiratory support and morbidity. After cardiac operations, dysfunction of diaphragm can take place in up to 10 % of patients but often remains underdiagnosed. At the same time, histologically revealed changes, such as muscle atrophy in the diaphragm, start within 12 hours of mechanical ventilation. The therapy of diaphragm weakness is not well established and has a limited efficacy. Current analytic review describes therapeutic option for treatment ventilator-induced diaphragm dysfunction with emphasis on electric neuromodulation of phrenic nerve. OBJECTIVE. To optimize respiratory function by bilateral electrostimulation of phrenic nerves on the neck level in patient with diaphragm dysfunction after cardiac operation. MATERIALS AND METHODS. 82-year-old female patient after elective aortic valve replacement was diagnosed with dysfunction of diaphragm and respiratory failure. These changes caused the weaning failure from respirator and led to prolonged ventilator support. On the 20, 22, 24 and 26 days of postoperative period we performed invasive bilateral phrenic nerve stimulation on the neck level for 10 minutes with ultrasound navigation. RESULTS. After electrical modulation of phrenic nerves, diaphragm excursion, detected by ultrasound, was improved. After four procedures, duration of spontaneous breathing trial increased from 1 to 12 hours. On postoperative day 30, the patient was successfully weaned from respiratory support and decannulated without recurrent respiratory failure. There were no any complications during procedure, it was well-tolerated and associated with emotional improvement. CONCLUSIONS. Phrenic nerve stimulation on the neck level can be a valuable option in selected patients with respiratory failure and difficulties with ventilator weaning.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81905175","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":"Evaluation of volemic status during combined extracorporeal detoxification in patients with severe acute pancreatitis: a retrospective observational study","authors":"S. V. Masolitin, D. Protsenko, I. N. Tyurin, O. Mamontova, M. Magomedov, T. G. Kim, L. Grishina, A. V. Yaralyan, A. Popov, E. Y. Kalinin","doi":"10.21320/1818-474x-2022-4-111-124","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-4-111-124","url":null,"abstract":"INTRODUCTION: The morbidity and mortality of severe acute pancreatitis (SAP) remains high. Intensive therapy aimed at stopping hypovolemia, systemic endotoxicosis is a debatable problem. OBJECTIVE: Improving treatment results in patients with SAP by assessing the dynamics of volumetric criteria and the degree of fluid therapy (FT). MATERIALS AND METHODS: The study included 25 patients. First, study group of 9 patient, used standard therapy in conjunction with selective hemoperfusion and continuous veno-venous hemofiltration. Second, control group of 16 patients, who received standard intensive care. FT in the groups was 2.5-3.5 ml/kg/h. Volemic parameters were measured by transpulmonary thermodilution. The central venous pressure and the diameter of the vena cava inferior were assessed. Comparative analysis was performed between two groups. RESULTS: FT in the amount of 58.7 (52.459.4) ml/kg/day in group 1, and 58.3 (54.2-61.4) ml/kg/day in group 2 in the first day, up to 83.9 (72.4-86.1) and 79.3 (72.4-84.1) ml/kg/day, was observed by day 3 (p < 0.05), according to the results of transpulmonary thermodilution. From the 1st to the 3rd day, Global end-diastolic volume index increased from 345 (328-412) to 648 (590-690) ml/m2 in group 1, and from 375 (348-413) to 654 (599-701) ml/m2 in group 2 (p < 0.05). Intrathoracic blood volume index increased from 440 (420-510) to 780 (750-840) ml/m2 in group 1 and 430 (417.5-465) to 750 (665-780) ml/m2 in group 2 (p < 0.05). Extravascular lung water index and pulmonary vascular permeability index by 5 days in group 2 increased by 1.8 - 11 (10.5-11.8) and 2.2 times - 6.5 (5.75-7), respectively (p < 0.05). CONCLUSIONS: FT 3.5 ml/kg/h, reaches isovolemia by the 3rd day of therapy. The use of extracorporeal detoxification methods in complex therapy is accompanied by an improvement in clinical and laboratory parameters.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87855762","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":"Correlation between changes in arterial blood oxygen partial pressure, oxygen uptake and carbon dioxide elimination by the lungs with changes in positive end expiratory pressure: a prospective observational study","authors":"R. Ovsiannikov, K. M. Lebedinskii","doi":"10.21320/1818-474x-2022-4-36-43","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-4-36-43","url":null,"abstract":"INTRODUCTION: Since mechanical ventilation remains the main tool of respiratory support, ventilatory aspect of lung function fixed researchers’ attention during last decades, which is reflected by open lung concept and lung-protective ventilation strategy. However, it seems logical to assess function of the lung - biphasic mass exchanger with limited capacity - measuring its gas exchange performance, depending upon lung perfusion the same extent as ventilation. Recently clinicians have got routine access to metabolographers, providing figures of lungs oxygen absorption (VO2) and carbon dioxide exhalation (VCO2). OBJECTIVE: To evaluate interchangeability of metabolographer data and arterial blood gases analysis as tools for positive end-expiratory pressure (PEEP) titration by comparison of dynamic VO2 and VCO2 changes with PaO2 shifts after standardized PEEP changing. MATERIALS AND METHODS: A single-center prospective observational study included 41 patients underwent mechanical ventilation during general anesthesia for elective non-cardiothoracic surgery. After anesthesia induction and monitored parameters stabilization, PaO2, VCO2 and VO2 were measured before and after PEEP increasing from 2 to 5 mbar. Correlation was evaluated using Spearman coefficient in R-Studio with ggplot2 visualization package. RESULTS: After PEEP level increase, in 14 patients PaO2 changes were < 5 %, in 15 patients PaO2 increase was observed, and in 12 patients PaO2 has decreased. The Spearman correlation coefficient (rh) between VCO2 and PaO2 was 0.77 (р-value = 3.75 х 10-9), between VO2 and PaO2 - rh = 0.92 (p-value = 2.2 х 10-16). CONCLUSIONS: The VCO2 and VO2 dynamic changes obtained using metabolographer demonstrates high correlation with PaO2 shifts followed PEEP changes, which makes the dynamic analysis of the first two indicators a possible non-invasive alternative for repeated arterial blood gases analysis during РЕЕР level titration. Notable fact is that in significant proportion of observations, PEEP level of 5 mbar, often recommended “by default” for lung-protective ventilation, is excessive from gas exchange performance point of view.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"305 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78282914","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 management of patients with respiratory failure: methodological recommendations of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists\"","authors":"I. Zabolotskikh, A. Gritsan, M. Kirov, A. Kuzovlev, K. M. Lebedinskii, V. Mazurok, D. Protsenko, N. Trembach, R. Shadrin, A. Yaroshetskiy","doi":"10.21320/1818-474x-2022-4-7-23","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-4-7-23","url":null,"abstract":"Perioperative respiratory complications are one of the main problems in anesthesiology and intensive care, in some areas of surgery they occupy the first place in the structure of all complications of the perioperative period. Initial respiratory failure, as well as the presence of disorders of respiratory functions increase the risk of its development, often leading to an unfavorable outcome of the disease. The recommendations on perioperative management of patients with respiratory failure include modern standards of preoperative assessment of risk factors for respiratory insufficiency, prevention and treatment of perioperative respiratory disorders in Russian Federation. The recommendations describe the principles of diagnosis of respiratory failure, the choice of anesthesia in concomitant lung diseases, the basics of protective ventilation and prevention of postoperative pulmonary complications.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77574598","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":"Reaction pattern of the autonomic nervous system to the infusion load in the intensive care in children: a prospective comparative study","authors":"K. V. Budarova, A. N. Shmakov, N. L. Elizar’eva, V. N. Kokhno","doi":"10.21320/1818-474x-2022-3-133-144","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-3-133-144","url":null,"abstract":"INTRODUCTION. The leading role in the water and electrolyte balance in critical conditions belongs to infusion therapy. Hemodynamic stabilization is achieved by fluid bolus with risk of hypervolemia. Non-invasive monitoring in ICU is relevant in children. Cardiointervalography is characterized by nosological non-specificity and high sensitivity to neurohumoral changes. The stress index and spectral analysis allow the assessment of therapeutic efficacy. OBJECTIVES. To study the features of the electrophysiological response to the emergency rehydrate volume in children upon admission to the intensive care unit. MATERIALS AND METHODS. A prospective comparative study was conducted with the participation of 172 patients, the age from 0 to 15 years. There were 71 newborns in the first group (21 surgical cases, 50 somatic ones). The second group enrolled children aged 1 to 15 years, in 40 % of all underwent surgical treatment. The characteristic of the electrophysiological response to the hydration was carried out in an intergroup and interstage comparison in different age and nosological groups. DISCUSSION. The autonomic nervous system response to infusion therapy has not been studied in children of different ages. The stress index and frequency analysis reflect the degree of regulatory systems tension and are promising in intensive care monitoring. RESULTS. In newborns with sensory block, it was expressed by tachycardia (p = 0.02); without block - arterial hypotension (p = 0.000) without chronotropic component. The implementation of sympathetic reactions was suppressed in children in the early postoperative period. In children without surgical treatment, the volume of infusion had a sympatholytic effect. CONCLUSIONS. In the early postoperative period, the electrophysiological response in children was limited. Age-related features of reactions to hydration in children with somatic pathology were revealed. In children, infusion therapy contributed to a cardiovascular economical work; in newborns, it was associated with a breakdown in sympathetic adaptation.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"103 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78428239","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":"Optimization of analgesia algorithm in strabismus surgery in children: a single-center randomized controlled prospective study","authors":"I. Oleshchenko, T. Iureva, L. N. Bachaldina, A. Mankov, D. Zabolotskii","doi":"10.21320/1818-474x-2022-3-124-132","DOIUrl":"https://doi.org/10.21320/1818-474x-2022-3-124-132","url":null,"abstract":"INTRODUCTION. The postoperative period during strabismus surgery in children is often complicated by pain syndrome of different intensity and postoperative nausea and vomiting (PONV), which negatively affects postoperative rehabilitation. Intraoperative regional techniques have a sufficiently high analgesic profile, which serves as a justification for their use. Subtenon blockade refers to minimally invasive interventions. OBJECTIVES. To evaluate the efficacy of subtenone blockade for postoperative anesthesia of children after strabismus surgery. MATERIALS AND METHODS. A single-center open randomized controlled prospective longitudinal study was conducted in parallel groups. Group 1-36 patients, acetaminophen 1.5 mg/kg was used for postoperative anesthesia; Group 2-38 patients, a subtenon blockade was performed at the end of surgery. The main indicators of hemodynamics at the stages of the study, the level of cortisol and the redox coefficient, the level of pain and the frequency of PONV were taken into account. RESULTS. After surgery, patients reported of pain of different intensity 4 hours after surgery: Group 1-66.6 % of patients, Group 2-5.2 % of patients. PONV was present in 6 (16.6 %) patients of Group 1. There were no PONV in Group 2. The cortisol level in the group with subtenon blockade after 4 hours was 32 % lower (p < 0.05) than in patients of the 1st group. In Group 2, the FORT/FORD coefficient significantly increased 4 hours after surgery from 0.45 ± 0.5 to 0.62 ± 0.2 (p < 0.005). CONCLUSIONS. The use of subtenone blockade in strabismus surgery at the end of the operation allows to achieve pronounced and prolonged analgesia, to limit the manifestation of PONV in the postoperative period, as well as to limit the level of surgical stress in general, which in turn reduces the degree of inflammatory reaction of the eye.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"224 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89168597","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}