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Biomedical subjects

E V Nedashkovskiĭ

Publications and source records attributed to E V Nedashkovskiĭ.

At least 19 recordsLinked to original sources
PubMedDate not supplied

[Effects of basic therapy of ischemic heart disease on vascular-platelet hemostasis during myocardial revascularization].

Effects of preoperative therapy of coronary diseases with calcium antagonists and aspirin on vascular platelet hemostasis during aortocoronary shunting (ACS) have been studied in order to evaluate the role of hemostasis disorders in the pathogenesis of perioperative hemorrhagic complications. Therapy of coronary disease with these drugs during preparation to ACS can involve changes in platelet functional activity, depending on the individual sensitivity of patients. Drug-induced thrombocytopathy can induce pathological hemorrhages in the perioperative period of ACS.

Adult↗
PubMedDate not supplied

[Monitoring of extravascular lung water in patients with severe sepsis].

The key objective of the case study was the possibility to monitor the extravascular lung water (EVLW) in severe cases. Twelve mechanically ventilated patients with severe sepsis complicated by septic shock and by an acute lung injury (ALI) were involved in the prospective study. The measurements, performed on days 1 and 3 after the onset of sepsis, comprised hemodynamics, EVLW as assessed by Pulsion PiCCO method, blood gases and severity scores. The EVLW correlated significantly with lung injury score (r = 0.46), oxygenation (r = -0.46) and with pulmonary compliance (r = -0.58) versus the central venous pressure. The EVLW and lung injury scores were found to be essentially higher in non-survivors on day 3. The clinical situations, described in the present article, are indicative of a potential EVLW value applicable to sepsis treatment. Finally, the monitoring of EVLW is a useful tool in the purpose-oriented therapy of sepsis-induced ALI; moreover, the method has an important prognostic value.

Blood Volume↗
PubMedDate not supplied

[Optimization of intensive care of acute disseminated intravascular syndrome].

The discrete plasmapheresis and Fraxiparin were used to optimize the intensive care scheme in acute disseminated intravascular syndrome (DIS). A total of 394 patients underwent the clinical and laboratory examinations to assess the method's efficiency. A lower degree thrombinemia was registered after the therapy versus the original values.

Adult↗
PubMedDate not supplied

[Volumetric monitoring based on transpulmonary thermodilution in anesthesiology and intensive care].

The review elucidates the technique of transpulmonary thermodilution in volumetric monitoring of critically ill patients. The experimental and clinical studies, now underway, are indicative of a great value of the discussed method for practical medicine. The key parameters of volumetric monitoring comprise Intrathoracic Blood Volume and Extravascular Lung Water as well as a wide range of other derived variables and indices. The approach is highly effective in the mechanical ventilation and inotope/vasopressor support of patients with a high risk of non-cardiogenic or cardiogenic pulmonary edema. The evaluation of volumetric parameters and of invasive monitoring of hemodynamics provide for an excellent guidance in fluid resuscitation in an overwhelming majority of ICU patients. The PiCCO technology of continuous cardiac output (CO) measurements or, the so-called "pulse contour CO" is also under discussion.

Anesthesia↗
PubMedDate not supplied

[The systems analysis of anesthesiological activities in a general hospital].

Using an information mathematical model of anesthesiological service suggested, the authors have performed system analysis of anesthesia management in a multi-profile hospital in Arkhangelsk. Changes in the scope and structure of anesthesia, indexes of anesthesiological activity, frequency of procedures, asepsis, incidence of complications have been analysed. The analysis performed demonstrates the possibility of the control and management of anesthesiological service and forms the necessary prerequisites for its further development on the basis of economic parameters and criteria.

Anesthesia↗
PubMedDate not supplied

[Nasogastric intubation of the small intestine in relation to the anesthesiologist and the resuscitation specialist].

The experience of the use of single and prolonged nasogastric intubation of the small intestine in 286 urgent patients in Arkhangelsk clinical hospital No. I has been reviewed and the peculiarities and drawbacks of the technique have been assessed from the point of view of the anesthesiologist and intensive care specialist. A special technique of respiratory airway protection during intestinal intubation is described and recommendations on intensive care as well as control over tubing location and patency in the postoperative period that can adequately prevent potential complications are outlined.

Anesthesia↗
PubMedDate not supplied

[Comparison of various types of epidural analgesia after abdominal operations].

The authors compare three types of epidural analgesia using a mixture of 0.125% bupivacaine solution and morphine in 102 patients after abdominal surgery. Patient-controlled analgesia was applied in Group 1; the mixture was injected as a bolus in Group 2; continuous epidural infusion was used in Group 3. The findings have indicated that patient-controlled epidural analgesia can yield an adequate analgesia with smaller doses of local anesthetics and morphine reliably and in a shorter space of time and reduce the frequency of side effects associated with the opioid.

Abdominal Cavity↗
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[Technical difficulties of puncture and the functional anatomy of the subclavian vein].

The difficulties occurring during puncture subclavian catheterization (PSC) are discussed. The results of 4559 PSC in 4007 patients are analysed. The results of ultrasonic examination (198 patients) and postmortem X-ray studies (34 cases) of the subclavian vein anatomy are presented. A great variability in the subclavian vein anatomy has been observed, this is associated with a likelihood of technical difficulties, failures and complications in standard PSC technique. An ultrasonic examination prior to PSC is recommended.

Adult↗
PubMedDate not supplied

[Systems analysis of activities of the intensive care and resuscitation department at a multidisciplinary hospital. I. Development of structure and function].

Using the suggested information mathematical model of reanimation activity, realized in an administrative computer program, the authors carry out a total system analysis of the activity of the intensive care and reanimation unit of a multi-discipline hospital in the town of Arkhangelsk. They discuss the problems of present-day equipment and modernization, formation of the patient populations, improvement of the resuscitation methods, and the policy of reanimation bed use. They recommend that along with the traditional activities, such department should take part in the prevention of grave states in inpatients of all departments of the hospital.

Hospital Administration↗
PubMedDate not supplied

[Systems analysis of activities of the intensive care and resuscitation department at a multidisciplinary hospital. II. Intensity of work and quality indicators].

The second part of the research is devoted to problems of the personnel labor load, to maintenance of reanimation asepsis, to analysis of the complications of intensive care, the causes and outcomes of these complications. A total system approach allows, as the authors believe, an objective assessment of the prerequisites of complications in expert evaluations.

Asepsis↗