ABSTRACT
Nondepolarizing shortly acting myorelaxant trakrium (0.5 mg/kg) during surgical interventions in children makes it possible to perform tracheal intubation 1.5 min later and to maintain optimal myoplegia at various stages of the operation by bolus injections in doses making up 1/2-1/3 of the initial one or by non-stop infusion at a rate of 0.008 mg/kg per min. Trakrium may be used along with arduan administered at the end of the operation. Trakrium administration is accompanied by the recovery of adequate respiration 25-30 min after discontinuation of administration. Trakrium has no unfavourable effect on hemodynamics and ensures retention of the myocardial reserve capacities.
Subject(s)
Atracurium/administration & dosage , Surgical Procedures, Operative , Adolescent , Child , Child, Preschool , Humans , Infant , Infusions, IntravenousABSTRACT
It has been observed that controlled lung ventilation during surgery in children is accompanied by an increase in intrapulmonary blood shunting, which averages 7.3% in urological surgery, 12% in abdominal surgery and 16.8% in thoracic surgery. The shunting is caused by ventilation-perfusion disturbances. The use of high-frequency jet ventilation, i.e. application of 16.7 Hertz oscillatory modulations together with conventional controlled lung ventilation enables one to decrease intrapulmonary shunting, reduce the signs of circulatory hyperdynamia and the load on the heart ventricles and leads to normalization of pulmonary flow in thoracic surgery.
Subject(s)
Intraoperative Complications/physiopathology , Pulmonary Circulation , Surgical Procedures, Operative , Adolescent , Child , Child, Preschool , Hemodynamics , High-Frequency Ventilation , Hirschsprung Disease/physiopathology , Hirschsprung Disease/surgery , Humans , Intraoperative Complications/prevention & control , Pneumonectomy , Respiration, Artificial , Urologic Diseases/physiopathology , Urologic Diseases/surgery , Ventilation-Perfusion RatioSubject(s)
Bronchial Diseases/physiopathology , Hemodynamics , Lung Diseases/physiopathology , Pulmonary Gas Exchange , Adolescent , Bronchial Diseases/surgery , Child , Child, Preschool , Chronic Disease , Humans , Lung Diseases/surgery , Monitoring, Intraoperative , Postoperative Period , Preanesthetic MedicationABSTRACT
The effect of infusion hemodilution on hemodynamic parameters and oxygen-transport homeostasis was studied during elective chest surgery in 18 children with chronic bronchopulmonary diseases. The data obtained have evidenced the expediency of using the method of infusion hemodilution in children for the operative hemorrhage therapy, ensuring the adequate hemodynamics and oxygen-transport supply at all the operation stages and in the early postoperative period.
