[Xenon and sevoflurane anti stress activity comparative assessment during elective anaesthesia in pediatric patients].

UNLABELLED: Research objective was to compare Xenon and Sevoflurane anti stress activities during elective anaesthesia in Pediatric patients. MATERIAL AND METHODS: The results of anaesthesia in 42 patients in age from 1 to 18 years were analyzed. The clinical sings, BIS-index, Somatotropinum hormone and Cortisol levels in patient's blood were studied. RESULTS: Xenon and Sevoflurane provide sufficient level of sedation, analgesia and do not cause Somatotropinum hormone and Cortisol levels increase. CONCLUSION: Xenon and Sevoflurane have the same high anti stress activity However Xenon anaesthesia is characterized by more stable haemodynamics.

[Medical care provision to the victim children of Haiti].

Treatment and diagnostic measures, including anesthesia during catastrophes and natural disasters are a world known problem. The paper presents the experience of anesthetic care provision during specialized surgical care to the victim children of the earthquake in Haiti. The materials of analysis were 529 anesthesias conducted to 72 children, who were in the treatment for crush syndrome, skeletal and concomitant injury. The peculiarities of anesthesia during the treatment of wound process depending on the stage of surgery are brought into view. During the preparatory phase the optimal type of anesthesia is inhalation and intravenous anesthesia, whereas for the defect closure (main stage) all types of anesthesia, including balanced endotracheal and combined anesthesia were used.

[Procedure for determining the initiation of tube feeding in children in an intensive care unit].

A procedure is proposed to determine the timing of tube feeding in children treated in an intensive care unit, which records the hypertonia of the pyloric sphincter and consists in the determination the time of gastric administration of distilled water before its evacuation into the duodenal lumen (water evacuation test) visualized in the real-time mode through abdominal ultrasonography. The proposed procedure was successfully applied to 42 children aged 3 months to 14 years who had severe brain injury, appendicular peritonitis, polytrauma, and polysegmental pneumonias. This determining procedure makes it possible to exclude radiation exposure in patients treated in intensive care units and to improve the outcomes of treatment, by prescribing the artificial feeding, that is adequate to the patients' status, in the periods optimal for each specific clinical case.

[The enteral feeding during the treatment of appendicular peritonitis in children]. / Enteral'noe pitanie pri lechenii peritonita appendikuliarnogo proiskhozhdeniia u detei.

A total of 65 patients, aged 3 to 14, with different forms of appendicular peritonitis, in whom the intestinal insufficiency syndrome (IIS), stage 2, was diagnosed, were investigated. 35 patients were in the main group, and 30 patients were in the control group; the subjects of the latter group had a similar form of peritonitis, i.e. IIS, stage 2, it was confirmed clinically and by ultrasound examinations. The laparoscopic operations were carried out in all patients. The patients of both groups received postoperatively a similar therapy, i.e. the antibacterial, metabolic and infusive ones, as well as vitamins and parenteral feeding (daily caloric values--50-120 kcal/kg, protein--2-3 g/kg/day) according to a child's age and a clinical course of peritonitis. All children of the main group received postoperatively an early enteral therapy (EET), which involved 4 stages. Stage 1: introduction of the salt solution with added glutamine through the naso-gastric probe by increasing volumes and with respect to an individual tolerability of a patient; stage 2: introduction of semi-element mixtures; stage 3: introduction of 10% solutions of polymer balanced mixture; stage 4: introduction of 20% solutions of polymer mixtures. Ultrasound scanning and clinical methods were used to assess the efficiency of the recovery of intestinal peristalsis. The conducted investigations showed that the mean duration of the gastric-type EET amounted to 3-4 days, and the IIS was, on the average, arrested by days 6 or 7. The duration of infusive therapy and parenteral feeding went down, in the main group, by 2 days. A trend towards an increase of the erythrocyte level was noted in these patients. No differences were registered in the values of concentrations of total protein and albumin in the blood serum of patients in both groups from the 1st to 7th postoperative days, however, the infusions of plasma and albumin were made by 2 times more often in the main group as compared to the control one. The EET technique preserved the gastric mucous tunic intact, which cut the postoperative complications 2-fold, and consequently, it reduced the stay of patients in hospital on the average by 8 days. A conclusion was made, on the basis of the conducted study, that EET is a pathophysiologically substantiated treatment method for IIS, stage 2, in children with appendicular peritonitis; EET ensures a rapid recovery of gastric-tract functions, it reduces the frequency rate of postoperative complications and cuts the length of both the infusive therapy and of the patients' stay in hospital.