ABSTRACT
Research results of the central hemodynamics, microcirculation and of oxygen status are described for 48 children (aged 8 months to 14 years) as observed during surgeries aggravated by massive hemorrhage in the routine infusion-transfusion therapy plus a 6% solution of INFUKOL GEK. Solution dosages of 6% were approved; the drug's positive effect on the central-hemodynamics condition, microcirculation and on the oxygen regime, as observed in the process of the infusion therapy made to compensate for a massive blood loss, was demonstrated; besides, the related shrinking of the infusion therapy total volume and the possibility to give up totally or to significantly reduce the blood-drug preparations, administered intraoperatively, were shown.
Subject(s)
Blood Loss, Surgical/prevention & control , Burns/surgery , Dextrans/administration & dosage , Erythrocyte Transfusion , Plasma Exchange/methods , Plasma Substitutes/administration & dosage , Adolescent , Child , Child, Preschool , Hemodynamics/physiology , Humans , Infant , Infusions, Intravenous , Intraoperative Care , Microcirculation/physiologyABSTRACT
Effects of nondepolarizing myorelaxants pancuronium, arduan, and tracrium were studied during surgery in 347 children with thermal injuries aged from several months to 15 years. Nondepolarizing myorelaxants are drugs of choice for providing myoplegia in children operated on for thermal injuries. The optimal initial dose of these agents in children with burns is 30-50% higher than the recommended dose and depends on the size of the lesion. For controllable myoplegia, the doses of subsequent injections are to be 1.-5-2 times lowered in comparison with the initial dose. The effects of pancuronium and arduan depend on the hepatorenal function. Tracrium ensures sufficient controllable myorelaxation in children with burns even in cases with hepatorenal dysfunction.