[Department of Anesthesiology and Resuscitation of the Military Medical Academy--45 years].
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Biomedical subjects
Publications and source records attributed to A I Levshankov.
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Prospects of the development of ambulatory anesthesiology are greatly dependent on understanding its problems caused by the specific character of work of the ambulatory polyclinical institutions. The most important of them is responsibility for safety of the patients during general anesthesia and after it as well as comfort feelings of the patients in the nearest postoperative period. The solution of these problems is related not only with qualification of anesthesiologists but also with the adequate, corresponding to the present-day level of the material technical supply of their work. Of special importance are the "postnarcosis" wards, ability of the personnel to evaluate the psychophysiological state of the patients and correspondence of their life conditions to the requirements of ambulatory anesthesiology.
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The article analyses the experience of reanimatological care to medical patients in Afghanistan. These patients comprised 3% of all the contingency from anaesthesia/reanimation/intensive care unit. The experience obtained in these researches made it possible to reevaluate some principles concerning the improvement of work in this unit, as far as professional qualities of its specialists, organic structure and material support are concerned.
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On the basis of the latest achievements in anesthesia and reanimation, as well as the results of special military medical exercises and documents which depict the experience of local wars, the article shows the basic features of a conception about field anesthesia and reanimation. Taking into account the experience gained in Afghanistan the author determines the principles of its organization and approaches towards the solution of important tasks assigned to anesthesiological and reanimation service in combat conditions.
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Experiments on 11 dogs under hypoventilation hypoxia (a decrease in the respiratory minute volume by 40-50%) were made to study the efficacy of membrane oxygenation using a membrane Sever-OMP oxygenator of the blood under the conditions of minor perfusion (14-17% of the minute volume of circulation). The animals of the main series (7 dogs) with a veno-venous connection of the membrane oxygenator (MO) tolerated hypoxia quite well for 2 hours. The control animals died. The conclusion is made that membrane oxygenation with small volumes of perfusion (with the MO connected according to Seldinger) can be used in conjunction with artificial ventilation where the latter one is not effective enough.
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