ABSTRACT
The article deals with a case report of successful treatment of patient with massive blood loss and shock. The observation showed that use of balanced crystalloid solution and modified gelatin 4% in the program of infusion therapy effectively corrects systemic haemodynamics and effect on haemostasis, electrolyte and acid-base balance.
Subject(s)
Hemorrhage/therapy , Neck Injuries/surgery , Shock/therapy , Wounds, Stab/surgery , Adult , Blood Transfusion , Blood Volume/physiology , Hemorrhage/diagnosis , Hemorrhage/etiology , Humans , Male , Monitoring, Physiologic , Neck Injuries/complications , Neck Injuries/diagnosis , Shock/diagnosis , Shock/etiology , Treatment Outcome , Wounds, Stab/complications , Wounds, Stab/diagnosisABSTRACT
The article deals with a case of successful acute lung injure syndrome treatment. Patient received enteral nutritive treatment with balanced polysubstrate mixture--immune liquid additionally to antibacterial, infusion, respiratory and symptomatic therapy. The case shows that immune liquid corrects hypermetabolic syndrome and effects on decreasing of organs dysfunctions especially lung dysfunction.
Subject(s)
Acute Lung Injury/therapy , Critical Care/methods , Enteral Nutrition/methods , Food, Formulated , Respiratory Distress Syndrome/prevention & control , Acute Lung Injury/diagnosis , Acute Lung Injury/immunology , Energy Metabolism , Humans , Immunomodulation , Lymphocyte Count , Male , Middle Aged , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/immunology , Treatment OutcomeABSTRACT
UNLABELLED: Endothelial dysfunction is a universal mechanism of pathogenesis of many critical conditions. Goal of the study was to assess a relation of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. MATERIALS AND METHODS: 17 patients with hemorrhagic shock 3 were involved in the study. All patients received infusion therapy, artificial lung ventilation after tracheal intubation and symptomatic treatment in prehospital period. Common volume of blood loose was 2900 +/- 200 mL. The patients received infusion, transfusion, inotrope, antibacterial, respiratory and symptomatic therapy in ICU after surgical treatment. Cardio-vascular system parameters were assessed by Tischenko method of integral reography. Number of red cells, hemoglobin, lactate, endotelin-1 and Wb-factor of venous blood were studied before surgery, in 12 and in 24 hours after. Morphological study of the omentumbiopsy was carried out. RESULTS: Performed correlation analysis showed statistically significant relations of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. Endothelial dysfunction occurs in patients with hemorrhagic shock 3. The endothelial dysfunction correlates with parameters of cardio-vascular system and tissue perfusion.
Subject(s)
Cardiovascular System/physiopathology , Endothelium, Vascular/physiopathology , Hemodynamics/physiology , Shock, Hemorrhagic/physiopathology , Shock, Hemorrhagic/therapy , Adolescent , Adult , Blood Volume/physiology , Cardiovascular System/pathology , Endothelium, Vascular/pathology , Erythrocytes/cytology , Hemoglobins/analysis , Humans , Omentum/blood supply , Plethysmography, Impedance , Severity of Illness Index , Shock, Hemorrhagic/blood , Shock, Hemorrhagic/pathology , Stroke Volume/physiology , Vascular Resistance/physiology , Young AdultABSTRACT
This work presents the results of treatment of 60 patients with 2nd degree hemorrhagic shock at pre-hospital and hospital stages by different variations of infusion therapy. It is established that balanced infusion therapy in patients with 2nd degree hemorrhagic shock helps to stabilize the system hemodynamic and improve the general condition. The balanced infusion therapy does not lead to unfavorable changes in acid-alkaline and electrolyte balance.
Subject(s)
Fluid Therapy/methods , Rehydration Solutions/administration & dosage , Shock, Hemorrhagic/therapy , Adult , Crystalloid Solutions , Gelatin/administration & dosage , Hemodynamics/physiology , Humans , Isotonic Solutions/administration & dosage , Plasma Substitutes/administration & dosage , Severity of Illness Index , Shock, Hemorrhagic/blood , Shock, Hemorrhagic/physiopathology , Succinates/administration & dosage , Treatment Outcome , Water-Electrolyte Balance/physiologyABSTRACT
The aim of the current research was to measure the clinical efficacy of 3rd generation fat emulsion in the program of complete parenteral nutrition of patients with severe sepsis. The work demonstrates the results of treatment of 25 patients with severe sepsis divided into 2 groups depending on the way of parenteral nutrition. In the 1st group (13 patients) the parenteral nutrition was carried out by 20% glucose, 15% solution of crystallic aminoacids and 20% of 2nd generation fat emulsion. In the 2nd group (12 patients) parenteral nutrition was carried out by 20% glucose, 15% solution of crystallic aminoacids and 20% of 3rd generation fat emulsion. The parenteral nutrition of Ist and 2nd group contributed to the correction of hypermetabolism syndrome and stabilization of the nutritive status parameters. It was observed that the parenteral nutrition used in the 2nd group showed statistically higher positive effect on the parameters of systemic inflammation and cellular part of immunity, rather than parenteral nutrition used in the 1st group. It is revealed that, the used methods of complete parenteral nutrition in patients with severe sepsis effectively eliminate the hypermetabolism syndrome. Parenteral nutrition of patients with severe sepsis by 3rd generation fat emulsion has a positive effect of parapeters of systemic inflammation.
Subject(s)
Fat Emulsions, Intravenous/therapeutic use , Parenteral Nutrition, Total/methods , Sepsis/therapy , Adult , Combined Modality Therapy , Energy Metabolism , Fat Emulsions, Intravenous/administration & dosage , Humans , Nutritive Value , Peritonitis/complications , Peritonitis/metabolism , Peritonitis/surgery , Postoperative Care , Sepsis/etiology , Sepsis/metabolism , Sepsis/surgery , Severity of Illness Index , Treatment OutcomeABSTRACT
The comparative analysis of different protocols of infusion therapy of the hemorrhagic shock stage III was performed. The infusion of the colloid solution of hydroxiethylstarch 200/0.5 and non-balanced crystalloid 0.9% solution of natrium chloride leads to the development of negative changes in homeostasis. Whereas infusion of the 4% solution of the modified gelatin and balanced crystalloid solition (sterofundin) allows to avoid the registered changes in electrolyte and alkaline balance.
