ABSTRACT
OBJECTIVE: To determine the optimal postponement period for elective surgery in patients with SARS-COV-2 infection. MATERIAL AND METHODS: A multiple-center regional prospective cohort research included patients who underwent elective surgeries in November, 2020. We compared the outcomes in patients with preoperative COVID-19 and those without infection. The primary endpoint was 30-day mortality rate. This parameter was stratified depending on period after COVID-19 diagnosis using logistic regression. RESULTS: Preoperative COVID-19 was diagnosed in 32 (4.6%) out of 682 patients. Thirty-day mortality rate in patients without infection was 1.5%. Preoperative coronavirus infection increased mortality rate (odds ratio 20%, 25%, 18.1% and 8.3% for surgery within 0-2, 3-4, 5-6 and 7-8 weeks after infection, respectively). Surgeries after 7-8 weeks ensured the same result as in patients without infection (odds ratio 1.5%). After 7-8-week postponement of elective surgery, patients with COVID-19 and active symptoms had higher mortality rate compared to those without or resolved symptoms (50 vs. 13 vs 6.5%, respectively). CONCLUSION: If possible, elective surgery should be delayed for at least 7-8 weeks after COVID-19 diagnosis. In patients with active symptoms in 7-8 weeks after diagnosis of infection, further postponement of surgery is recommended.
Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19 Testing , Elective Surgical Procedures , Humans , Prospective StudiesABSTRACT
Efficacy of application of oxygen-transporting preparations in the treatment of obturation jaundice was studied. In experimental conditions while modelling obturation jaundice in animals there were revealed signs of failure of the oxygen delivery to hepatic cells, shown by significant lowering of the oxygen pressure (pO2) in hepatic tissue. To compensate such revealed disorders it is expedient to apply preparations, which owe oxygen-transporting function, such as perftoran or ozonized isotonic solution of sodium chloride. Incorporating perftoran and ozonized isotonic solution of sodium chloride in conventionally accepted complex impedes the tissue hypoxia occurrence, which starts after biliary system decompression, it promotes restoration of hepatic cells functional state in more early terms.
Subject(s)
Decompression, Surgical/methods , Disease Models, Animal , Jaundice, Obstructive/surgery , Liver/surgery , Oxygen Consumption , Animals , Female , Fluorocarbons/administration & dosage , Isotonic Solutions , Jaundice, Obstructive/metabolism , Liver/metabolism , Male , Oxygen/analysis , RabbitsABSTRACT
More earlier break off of the disease clinical symptoms, laboratory indexes normalization, the shortening of the patients stationary treatment duration were promoted by trental and thiotriazolin inclusion in the acute pancreatitis complex of treatment.
Subject(s)
Enzyme Inhibitors/therapeutic use , Pancreatitis/drug therapy , Pentoxifylline/therapeutic use , Triazoles/therapeutic use , Acute Disease , Drug Therapy, Combination , Humans , Treatment OutcomeABSTRACT
The lowering of activity of succinate dehydrogenase (SDH), alpha-glycerophosphate dehydrogenase (alpha GPDH), glucose-6-phosphate dehydrogenase (G-6-PDH), the raising of activity of lactate dehydrogenase (LDH) was noted in neutrophil granulocytes in an acute experimental pancreatitis. The prophylaxis of SDH, alpha GPDH, G-6-PDH activity lowering and LDH activity raising was promoted by trental and thiotriazoline injection.
Subject(s)
Neutrophils/enzymology , Oxidoreductases/blood , Pancreatitis/drug therapy , Pentoxifylline/therapeutic use , Triazoles/therapeutic use , Vasodilator Agents/therapeutic use , Acute Disease , Animals , Dogs , Neutrophils/drug effects , Oxidoreductases/drug effects , Pancreatitis/enzymology , Pentoxifylline/pharmacology , Triazoles/pharmacology , Vasodilator Agents/pharmacologyABSTRACT
It was established while experiments on dogs that in an acute pancreatitis the vessels reactivity is changing, the tissue blood flow and oxygen pressure (pO2) are lowering in pancreatic tissue. Infusion of trental and thiotriazolinum didn't impede the tissue blood flow lowering but reduced significantly the oxygen consumption by pancreatic tissue.
