RESUMO
The retrospective study was undertaken to examine the impact of anemia developing during abdominal operations on oxygen transport and consumption. The concomitance of anemia and low reserves of the blood circulatory system was shown to be accompanied by obvious cardiovascular system tension. This appeared as the greater magnitude of tachycardia, metabolic disorders and is attended by high oxygen extraction. The paper shows it necessary to decide whether hemotransfusion should be made, by taking into account the compensatory capacities of the cardiovascular system, and not just hemoglobin levels.
Assuntos
Anemia/sangue , Oxigênio/sangue , Doença Aguda , Adaptação Fisiológica , Anemia/fisiopatologia , Anemia/terapia , Circulação Sanguínea/fisiologia , Transfusão de Sangue , Frequência Cardíaca/fisiologia , Hemoglobinas/análise , Humanos , Contração Miocárdica/fisiologia , Período Pós-Operatório , Estudos Retrospectivos , Volume Sistólico/fisiologiaRESUMO
Contemporary state and trends in further improvement of equipment for anesthesiological and resuscitation monitoring are considered on the bases of multiyear experience in the use and upgrade of this equipment in military hospitals of the USSR and RF. The developed and implemented policy and concept of technological engineering support of military anesthesiology and resuscitation allowed the priority directions to be determined and a number of its mane applications to be realized in military hospitals. Analysis of technological engineering support of anesthesiology and resuscitation equipment carried out in 2002-2003 revealed a trend toward improvement in supply of equipment for inhalation narcosis, artificial lung ventilation, and control diagnostic devices. On the other hand, certain disadvantages were found and their causes were analyzed. The main directions in improvement of monitoring support of military medical organizations were determined taking into account modern requirements for anesthesiological and resuscitation service.
Assuntos
Anestesia , Engenharia Biomédica/tendências , Hospitais Militares , Ressuscitação , Desenho de Equipamento , Humanos , Monitorização Fisiológica/instrumentação , Monitorização Fisiológica/tendências , Federação Russa , U.R.S.S.RESUMO
Diagnostic algorithm developed on the basis of multifactorial regression analysis is suggested for more objective diagnosis of acute pancreatitis after operations on the hepatopancreatoduodenal organs. This algorithm helps differentiate the strategy of intensive care in patients with pancreatitis, pancreatic disease, and uneventful postoperative period. It is impossible to single out the specific (pathognomonic) clinical signs of this complication during the immediate postoperative period. Hyperamylasemia and changes in other enzymes are important but not absolute markers of unfavorable course of disease.
Assuntos
Pancreatite , Complicações Pós-Operatórias , Doença Aguda , Adulto , Algoritmos , Amilases/sangue , Ensaios Enzimáticos Clínicos , Cuidados Críticos , Procedimentos Cirúrgicos do Sistema Digestório , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Pancreatite/diagnóstico , Pancreatite/terapia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/terapia , Análise de Regressão , Fatores de TempoRESUMO
Equations for accurate prediction of the course of postoperative pancreatitis are developed by multifactorial regression analysis for purposeful prevention of this condition. An injury to the pancreas and the "readiness" of hepatoduodenal organs to a degenerative destructive process are significant for the development of pancreatitis. A differentiated strategy is developed for preventing this complication during the post- and intraoperative period by protease inhibitors, cytostatics, and other nonspecific methods.
