[The effect of the induction of anesthesia on human cardiac activity]. / Vliianie na uvod v anesteziia vurkhu surdechnata deinost u litsa.

The authors studied the effect of intravenous induction with thiopental, myorelaxant and subsequent laryngoscopy and intubation on cardiac rhythm, Q-T interval and cardiac stroke volume in children without accompanying diseases. Cardiac dysrhythmias in adults have been reported in the literature; low fentanil doses have been recommended for their suppression. Thirty five children (20 of them younger than 10 years and 15-10 to 14 years of age) were tested in five stages. Records were taken of ECG, impedance cardiography by the method of Kubicek; the stroke volume, the duration of the Q-T interval and the cardiac rate were estimated. Children younger than 10 had no dysrhythmia during the induction in anesthesia, which made unnecessary prophylactic administration of low fentanil doses. More pronounced were the changes in the Q-T interval and the stroke volume in the age group beyond 10; one child in this group had dysrhythmia as well.

[Subphrenic abscess and suppurative pericarditis as complications in children with perforated appendicitis]. / Kum vuprosa za subfrenichniia abstses i gnoiniia perikardit kato uslozhnenie pri detsa s perforativen apenditsit.

The combination of subphrenic abscess with purulent pericarditis is a rare postoperative complication of perforated appendicitis in children, with severe clinical course, difficult to diagnose and high case fatality rate. A 7-year-old child with this complication, successfully diagnosed and treated is reported. The importance of complex therapy--surgical and intensive and collaboration between pediatric surgeons, anesthesiologists, cardiac surgeons and cardiologists for the favourable outcome is emphasized.

[A case of chemical burns of the tracheobronchial tree in childhood]. / Vurkhu khimicheskite izgarianiia na trakheobronkhialnoto durvo v detskata vuzrast s prinos na edin sluchai.

A rare case of chemical burn of the tracheobronchial tree with powdered NaOH in a child is reported. In the course of the disease there were several periods of acute respiratory failure (ARF), requiring respiratory resuscitation with intubation, mechanical ventilation, aspiration and kinesitherapy. The chemical burn was followed by several hours of imaginary well-being, but subsequently pulmonary edema developed. On the fifth day obstruction of the air passages by secretions and mucosal hyperemia led again to acute respiratory failure. On the 15. day bleeding from the mucosa of the respiratory and gastrointestinal tracts developed, which incited again ARF. Such periodic deteriorations, leading to ARF after chemical burns, have been reported in the literature. They require recurrent respiratory resuscitation of different degree and form. Knowledge of these period in the pathologic process, leading to ARF and the adequate respiratory resuscitation are prerequisite for a favourable outcome of the morbid process.