Saratov JOURNAL of Medical and Scientific Research

Moscow Regional Scientific Research Clinical Institute n.a. M.F. Vladimirsky

Efficacy evaluation of cerebral perfusion pressure in complex treatment of eclamptic coma

Year: 2010, volume 6 Issue: №3 Pages: 559-561
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Podolsky Yu.S., Hapy I.H.
Organization: Moscow Regional Scientific Research Clinical Institute n.a. M.F. Vladimirsky
Summary:

The aim of this research is to study influence of cerebral perfusion pressure on the effectiveness of treatment of maternity patient in eclamptic coma. Fluctuation of average arterial pressure defines dynamics of the cerebral perfusion pressure. Active hypotensive therapy leads to reduction of cerebral blood flow, breaking perfusion balance of brain. The principal objective of treatment in eclamptic coma is to restore volemic indices by using stabizol, decrease of average arterial pressure (10-15% from the initial one), which is provided by magnesium sulfate and nimodipine. Providing the cerebral perfusion pressure above the level of 75 mm for maternity patient in eclamptic coma allowed to reduce lethality from 15,7 to 4,8%

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Eclamptic coma. New algorithm of intensive therapy

Year: 2009, volume 5 Issue: №4 Pages: 541-543
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Yu.S. Podolskiy, I.Kh. Khapiy
Organization: Moscow Regional Scientific Research Clinical Institute n.a. M.F. Vladimirsky
Summary:

The aim of this research is to increase effectiveness of treatment of patients in eclamptic coma. Current algorithm of intensive therapy corresponds to coma states methodology treatment of metabolic genesis accepted in neurological and neurosurgical practice. The main principal of intensive therapy tactics has been to restore volemic figures and perfusion-metabolic balance of brains. Decrease of mean arterial pressure (5-10% from the initial one) which defines the central perfusion pressure has been provided by magnesium sulphate and nimodipine. Stabizol has been used as plasma-substituting component to circulate in bloodstream till 36 hours. Nimodipine has provided increased cerebral
bloodflow. Proposed algorithm of intensive therapy has allowed to reduce lethality from 15.7% to 4.8%. Key words: eclamptic coma, cerebral bloodflow, cerebral perfusion pressure

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Hydrosectoral Disorders of Patients in Birth in Eclamptic Coma

Year: 2009, volume 5 Issue: №2 Pages: 185-186
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: Y.S. Podolsky, I.H. Hapy
Organization: Moscow Regional Scientific Research Clinical Institute n.a. M.F. Vladimirsky
Summary:

Research objective is to detect hydrosectoral disorders of patients in birth in eclamptic coma. It has been shown that hyper-hydration of isotonic character in patients in eclamptic coma has been revealed. Total liquid volume has been in 31,26 % higher than the normal one and it has occured due to extracellular fluid expansion. The expansion has been due to hyper-hydration in the interstitial sector in all cases, its volume has been in 97,4% higher than the normal one. The volume of blood circulation has been reduced and its deficiency has been due to plasma circulation volume reduction. It is worth mentioning that these indices are much lower than those of normal pregnancy. The state of eclamptic coma is characterized by considerable decrease of protein — 80% of norm which is manifested by the low collodno-oncotic pressure.

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