ABSTRACT
In 90 patients, to whom blood transfusion was done while the thoracic operation conduction, the blood hemoglobin (Hb) content was analysed. In the patients, to whom intraoperatively the blood preparations transfusion was done, Hb concentration in the blood was lower than in patients with similar blood loss, but who was not blood transfused. While the own blood transfusion conduction, which was reinfused from the pleural cavity, the Hb level lowering was not observed. In 1998, comparing with 1984, the blood transfusion rate had lowered from 14.7 to 4.1% while the intraoperative complications rate lowering. The anastomosis sutures insufficiency occurrence rate had reduced also after reconstructive operations on trachea from 7.6% (in 1978-1987) down to 1.8% (in 1988-1998).
Subject(s)
Blood Transfusion/methods , Monitoring, Intraoperative , Thoracic Surgical Procedures/methods , Wounds, Penetrating/surgery , Adult , Humans , Male , Retrospective StudiesABSTRACT
In 100 patients the highly-frequential (HF) artificial pulmonary ventilation (APV) was applied while conduction of reconstructive operation on trachea and its bifurcation. While application of two-pulmonary ventilation or single-pulmonary and part of another pulmonary ventilation using HF APV an adequate pulmonary gas exchange was guaranteed, but using of HF APV of one pulmonary more than in 30% of observations severe hypercapnia and/or hypoxemia had occurred. In comparison with conventional methods of APV the improved conditions of surgeon's work appeared, the frequency of intraoperative complications--severe hypoxemia and hypercapnia--had reduced. The main fault of the HF APV method is the embarrassed monitoring of respiration efficacy.
Subject(s)
High-Frequency Ventilation/methods , Lung/surgery , Respiration, Artificial , Trachea/surgery , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Plastic Surgery Procedures , Ventilators, MechanicalABSTRACT
The results of treatment of 590 patients are analyzed, to whom the operations on trachea were conducted. In 91 patient 99 complications have occurred, 35 (6.4%) patients died. But due to the operation method refinement, new approaches elaboration, improvement of the measures of tracheoplasty complications prophylaxis and treatment, 2 (1.4%) patients died of 142 operated on during last years.
Subject(s)
Postoperative Complications/prevention & control , Trachea/surgery , Antibiotic Prophylaxis , Humans , Postoperative Complications/mortality , Postoperative Complications/therapy , Time Factors , TracheotomyABSTRACT
The analgesic effect of intrapleural administration of local anesthetics (lidocaine, trimecaine, azocaine) has been studied in 180 patients after thoracic surgery and with chest trauma. The effect was assessed on the basis of subjective (visual analogue 10-score scale) and objective findings (hemodynamic parameters, spirograms, ECG). In control patients analgesia was performed by intramuscular promedol administration. It has been shown that fractionated intrapleural administration of local anesthetics is an effective and safe analgesic technique after thoracic surgery and in chest trauma.
Subject(s)
Anesthetics, Local/administration & dosage , Thoracic Injuries , Thoracic Surgery , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Humans , Middle Aged , PleuraABSTRACT
Clinical data are presented on prolonged (3 to 63 days) nasotracheal intubation in 159 patients performed for controlled lung ventilation and for maintenance of upper respiratory ways patency in spontaneous respiration. The advantages and disadvantages of nasotracheal intubation as compared to tracheostomy and orotracheal intubation are analysed. The indications for delayed tracheostomy, ways of prevention of complications of prolonged nasotracheal intubation and a method for maintenance of intubation tube patency are suggested.
Subject(s)
Intubation, Intratracheal , Adolescent , Adult , Aged , Child , Humans , Middle Aged , Time FactorsSubject(s)
Shock, Traumatic/diagnosis , Thoracic Injuries/diagnosis , Emergencies , Hemorrhage/diagnosis , Hemorrhage/mortality , Hemorrhage/therapy , Humans , Shock, Hemorrhagic/diagnosis , Shock, Hemorrhagic/mortality , Shock, Hemorrhagic/therapy , Shock, Traumatic/mortality , Shock, Traumatic/therapy , Thoracic Injuries/mortality , Thoracic Injuries/therapyABSTRACT
Infectious complications developing in patients with chest traumas under prolonged artificial ventilation of lungs are described in the article, such as infection of respiration pathways, pneumonia, empyema of the pleura and sepsis. New methods for the treatment and prevention of such complications are presented.
