ABSTRACT
The authors analysed the results of balloon angioplasty using paclitaxel-coated balloons (IN.PACT Admiral, Medtronic Inc., USA) in patients with occlusive and stenotic lesions of arteries of the femoropopliteal segment. The Study Group was composed of 30 patients subjected to angioplasty with drug-coated balloons and the Control Group consisted of 32 patients undergoing balloon angioplasty with uncoated balloons. Primary patency of the angioplasty zone within the terms up to 30 months after the intervention using drug-coated balloons amounted to 70% and in the Control Group to 37.5%, with the limb-salvage rate equalling 96.7% and 87.5%, respectively. It was shown that angioplasty using drug-coated balloons in treatment of occlusive and stenotic lesions of femoropopliteal arteries considerably improves the results of treatment at the expense of preventing restenosis of the angioplasty zone both in the short- and long-term periods of follow up.
Subject(s)
Angioplasty, Balloon , Arterial Occlusive Diseases/therapy , Femoral Artery/pathology , Ischemia , Paclitaxel/therapeutic use , Popliteal Artery/pathology , Adult , Aged , Aged, 80 and over , Angiography/methods , Angioplasty, Balloon/instrumentation , Angioplasty, Balloon/methods , Antineoplastic Agents, Phytogenic/therapeutic use , Arterial Occlusive Diseases/complications , Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/etiology , Arterial Occlusive Diseases/mortality , Equipment Design/methods , Female , Follow-Up Studies , Humans , Ischemia/etiology , Ischemia/physiopathology , Kaplan-Meier Estimate , Male , Middle Aged , Russia , Severity of Illness Index , Treatment Outcome , Vascular PatencyABSTRACT
A retrospective analysis of 100 case histories of patients with diffuse peritonitis was made in order to evaluate the prognostic significance of the Mannheim Peritonitis Index (MPI). The patients were divided into 3 groups according to the amount of scores: in the first group (12-20 scores) there were no lethal issues, in the second group (21-29 scores) 42% of the patients died, 100% lethality was noted in the third group when MPI was 30 scores or more. MPI allows not only to make a retrospective evaluation of results of treatment of peritonitis and compare outcomes of different surgical accesses, it may be one of criteria for programmed relaparotomy or for using laparostomy in patients of the 2nd and 3rd groups.
Subject(s)
Peritonitis/diagnosis , Severity of Illness Index , Evaluation Studies as Topic , Female , Humans , Male , Middle Aged , Peritonitis/etiology , Peritonitis/mortality , Peritonitis/surgery , Prognosis , Retrospective StudiesABSTRACT
Nine patients with adult respiratory distress syndrome, stage III, secondary to diffuse peritonitis have been examined. The patients were subject to pulmonary artery and aorta catheterization. Cardiac output, extravascular water in the lungs, the extent of pulmonary shunting were determined; pulmonary artery and aortic pressure were measured. O2 transport parameters, pulmonary capillary pressure (Pc), pressure gradient (Pc-COP) were calculated and arterial and venous blood gases as well as colloid-osmotic pressure (COP) were analysed. Selective hypotension in the pulmonary circulation was performed using an infusion of nitroglycerin solution. Despite differences in the response of patients with ARDS to nitroglycerin, when the drug was injected with optimal positive end-expiratory pressure, it promoted an increase in O2 delivery, normalization of pulmonary hemodynamics and a decrease in extravascular pulmonary water.
Subject(s)
Extravascular Lung Water/drug effects , Hemodynamics/drug effects , Nitroglycerin/therapeutic use , Pulmonary Gas Exchange/drug effects , Respiratory Distress Syndrome/drug therapy , Extravascular Lung Water/physiology , Hemodynamics/physiology , Humans , Infusions, Parenteral , Nitroglycerin/administration & dosage , Pulmonary Gas Exchange/physiology , Respiratory Distress Syndrome/physiopathologyABSTRACT
In 48 patients operated on for peritonitis of different etiology the postoperative period was complicated by the onset of adult respiratory distress syndrome. A considerable increase in the blood level of biologically active compounds (adrenalin, noradrenalin, histamine, serotonin) and the activation of kinin system have been observed. Marked humoral shifts trigger a sequence of reactions manifested in microcirculation disturbances and the onset of tissue hypoxia, thus inducing the damage of metabolic lung functions and the development of adult respiratory distress syndrome.
Subject(s)
Lung/metabolism , Peritonitis/surgery , Postoperative Complications , Respiratory Distress Syndrome/etiology , Humans , Respiratory Distress Syndrome/bloodABSTRACT
Adult respiratory distress syndrome (ARDS) is accompanied by disseminated intravascular coagulation syndrome (DICS), its development causing progressing signs of the shock lung. The loss of the so far high pulmonary fibrinolytic activity promotes the onset of DICS in mixed venous and arterial blood. This metabolic pulmonary function is retained in patients with ARDS, stage I, is slightly damaged in patients with ARDS, stage II and is completely impaired in patients with ARDS, stages III and IV.
Subject(s)
Fibrinolysis/physiology , Lung/physiopathology , Peritonitis/complications , Respiratory Distress Syndrome/etiology , Disseminated Intravascular Coagulation/etiology , Disseminated Intravascular Coagulation/physiopathology , Humans , Peritonitis/physiopathology , Respiratory Distress Syndrome/physiopathologyABSTRACT
39 patients after surgery for generalized peritonitis with adult respiratory distress syndrome (ARDS) in the postoperative period have been examined. It is suggested that platelets play a certain role in the pathogenesis of ARDS and may serve as one of the mechanisms triggering disturbances in the function of both pulmonary vessels and respiratory airways. The degree of changes in platelet number and aggregation "below" and "above" the lungs may predict the severity of ARDS.
