Saratov JOURNAL of Medical and Scientific Research

Anaesthesiology and Reanimatology

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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Use glucose tolerance and galactose tolerance tests in dynamics of acute experimental injury of the liver

Year: 2010, volume 6 Issue: №2 Pages: 309-313
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: J.V. Tishkova, O.V. Molotkov
Organization: Smolensk State Medical Academy
Summary:

At adult rats are caused experimental toxic liver injury of the various severity by introduction of carbon tetrachloride in a doze of 0.25 ml and 0.5 ml on 100 g of weights. It is investigated the functional condition of the liver with use glucose tolerance test (GTT) and galactose tolerance test (СаlТТ). It is revealed, the most informative for the investigation of liver function was the end of the first hour from beginning GPr and GаlТТ. Use of the coefficient, reflecting a correlation of glucose concentration in blood at the end of the first hour of ГТТ and Га!ТТ, makes it possible to raise diagnostic value of tolerance tests

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Change in function of thl - and th2-lymphocytes and cytokine profile at chronic intoxication of ethanol

Year: 2010, volume 6 Issue: №2 Pages: 307-309
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: A.A. Svistunov, P.F. Zabrodsky V.G. Lim, V.A. Grishin
Organization: Saratov State Medical University
Summary:

It has been established during the experiments carried on noninbred rats that chronic intoxication of ethanol (30 days, total dose - 6,0 LD50) essentially reduces concentration of cytokines (IFNy, IL-2, IL-4, IL-6,IL-10) in blood, reduces interrelation of IFNy/IL-4 in comparison with the control, suppresses immune reactions, indicating the greater lesion of Th1-cells in comparison with Th2-lymphocytes

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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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Use Exercise Testing for an Estimation of a Oxygen-Power Exchange at Patients of High Anesthesiology-Operational Risk

Year: 2009, volume 5 Issue: №3 Pages: 333-336
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: M.V. Prigorodov, DM. Sadchikov
Organization: Saratov Military Medical Institute, Saratov State Medical University
Summary:

It is lead randomized prospective research with the double "blind" control over 228 patients of high risk (ASA>III), undergone long and traumatic to operations on bodies of a breast and a stomach. Have excluded from research 133 patients. The staying 95 patients have divided into groups without complications and with complications (accordingly 51 and 44 patients) which one day prior to operation have carried out exercise testing. Investigated: ADP, CPRV, SI, a arterio-ve-nous difference on oxygen, delivery of oxygen to fabrics, consumption of oxygen in fabrics, factor extraction oxygen in tissue, a power exchange. In reply to exercise testing in both groups growth of SI is marked due to a tachycardia and falling CPRV which in group of complication remained above norm. In group without complications it was normalized FEO, 6-v the difference on О became higher than norm, in other group — FEO and б-v a difference on 02 began to exceed norm, and consumption of oxygen has grown almost in 2 times. After exercise testing б-v a difference on 02 and consumption of oxygen were essentially higher in group with complications. The total of complications made — 53, respiratory — 16, inflammatory — 23 and purulent — septic complications — 14. Clinically important connection (p=0,06939) perioperative complications with growth a-v differences on oxygen and a power exchange is received

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MANAGEMENT OF INTENSIVE THERAPY OF GENERAL PERITONITIS IN CHILDREN

Year: 2007, volume 3 Issue: №2 Pages: 14-17
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: V.V. Berlinskiy, M.A. Antonov, A.O. Kogshevnikov, S.G. Areshchenco, V.V. Mushkin, I.V. Turishchev, A.A. Markelov
Organization: Saratov State Medical University
Summary:

In the presented work the results of treatment of 161 children at the age from 6

Keywords: peritonitis
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ANESTHESIA FOR UROLOGICAL AND GYNECOLOGICAL OPERATIONS

Year: 2008, volume 4 Issue: №4 Pages: 35-37
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: I.G. Zhdanov, S.A. Matveev
Organization: Saratov State Medical University
Summary:

The studies of free radical blood activity in surgical patients of urological and gynecological profile, operated under regional anesthesia (RA) or total intravenous anesthesia (TIVA) have demonstrated that biochemical blood parameters, characteristics of stress reaction during anesthesia and early postoperative period, underwent less marked changes and normalized quicker during regional anesthesia. Early postoperative period in regional anesthesia coursed better than in TIVA.

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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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Analysis of Anaesthetic and Reanimation Aid Rendered to Patients with Reproductive System Tumours who Died from Pulmonary Artery Thromboembolism

Year: 2009, volume 5 Issue: №2 Pages: 180-184
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: D.V. Sadchikov, A.V. Lushnikov
Organization: Saratov State Medical University
Summary:

Research goal: to identify defects of rendering anaesthetic and reanimation aid, resulting in the development of tromboembolism of pulmonary artery (ТЕРА) and subsequent death of patients with tumours of reproductive system. The development of thromboembolic complications in the post-operative period of gynaecological patients is the result of medical aid defects at all the stages of the post-operative period. The identified defects call for the revision of significance of various factors of ТЕРА risk. Prophylaxis of thromboembolic complications has demonstrated the ungrounded concentration in plasma and thrombocyte part of haemostas without due attention to significance of vascular wall condition. The dose calculation of injected anti-coagulators based on a patient’s weight only neglecting such factors as original haemostas condition, activated partial thrombin time (APTT) control or finding out endogenous heparin titre can not be considered rational.

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Postoperative Pain Management in Urologic Patients

Year: 2009, volume 5 Issue: №2 Pages: 177-179
Heading: Anaesthesiology and Reanimatology Article type: Original article
Authors: S.A. Matveev, I.G. Zhdanov, V.V. Schukovskiy, Yu.I. Kondrakova, M.A. Gulyaeva
Organization: Saratov State Medical University
Summary:

The quality of postoperative anesthesia in urologic patients has been analyzed. Correlation between pain intensity and postoperative complications has been revealed. Nonsteroid antiinflammatory and narcotic drugs don’t provide high-quality anesthesia after urological operations. Continued postoperative pain is the cause of development of pathological reactions and complications. An important role of prevention and treatment of postoperative pain comes to prolonged epidural analgesia composed of multimodal pain management. Usage of similar tactics significantly decreases the risk of negative reactions for organs and systems in response to operative stress, excludes the necessity of narcotic drugs, prevents the development of complications during the early postoperative period and provides comfortable conditions for patients.

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