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1.
Antibiot Khimioter ; 42(2): 33-7, 1997.
Article in Russian | MEDLINE | ID: mdl-9124991

ABSTRACT

Fifteen patients with severe bacterial infection (12 with pneumonia) that developed in the resuscitation unit were subjected to the empirical monotherapy with piperacillin/tazobactam (P/T) or tazocin under an open randomized controlled experiment. P/T was administered intravenously in a dose of 4.5 g every 8 hours for 5 to 12 days (9.3 days on the average). When the monotherapy was not sufficiently efficient the patients were additionally treated with amikacin administered intravenously in a dose of 0.5 g every 8-12 hours. The favourable effect was observed in 14 patients (93 per cent). 7 of them were treated with P/T alone and 7 were treated with P/T in combination with amikacin. The primary pathogens were eradicated in 8 (73 per cent) out of the 11 patients treated with P/T alone. Before the treatment 34 microbial strains were isolated from the patients. 77 per cent of them were susceptible to P/T. The treatment with P/T resulted in eradication of 27 bacterial strains (79 per cent) including 67 per cent of gram-positive organisms and 86 per cent of gram-negative organisms. The adverse effects were recorded in 1 patient on the 6th day of the treatment: skin eruption and pruritus that required the treatment discontinuation. The results showed that the use of P/T in the initial empirical monotherapy of infections in patients under resuscitation conditions could be efficient.


Subject(s)
Bacterial Infections/drug therapy , Drug Therapy, Combination/therapeutic use , Resuscitation , Adult , Drug Therapy, Combination/adverse effects , Female , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Hospital Departments , Humans , Male , Penicillanic Acid/adverse effects , Penicillanic Acid/analogs & derivatives , Penicillanic Acid/therapeutic use , Piperacillin/adverse effects , Piperacillin/therapeutic use , Piperacillin, Tazobactam Drug Combination , Treatment Outcome
2.
Anesteziol Reanimatol ; (1): 43-8, 1996.
Article in Russian | MEDLINE | ID: mdl-8686942

ABSTRACT

Clinical and physiological effects of pressure-regulated ventilation of the lungs using the inverse rate of inhalation to exhalation (PCV-IR) were studied in two groups of patients. No appreciable advantages of this mode of pulmonary ventilation in comparison with common ("volumic") method were observed in group 1 patients (following open-heart surgery) with moderately expressed respiratory disorders (PaO2/FIO2 = 340c13 and index of lung comprometation 0.7c0.04). At the same time, the level of the peak inhalation pressure in the airways at PCV-IR was reliably lower than during common artificial ventilation of the lungs (AVL). In patients with grave respiratory disturbances (PaO2/FIO2 = 93c10 and index of lung comprometation 6.88c0.56) application of this scheme brought about an improvement of pulmonary biomechanics and gas exchange, but the hemodynamics was virtually the same. It is noteworthy that the process of PCV-IR adaptation required a thorough preliminary "adjustment" of the ventilation parameters and took rather a long time in the majority of patients. Positive effects of PCV-IR may be due to several mechanisms: a slowing down (ramp-like) flow, limitation of the upper pressure during inhalation, prolongation of exhalation in comparison with inhalation, and a regulated level of internal positive end expiratory pressure. PCV-IR is recommended as a variant of respiratory support in the treatment of patients with severe involvement of the lungs, when the potentialities of common AVL are exhausted.


Subject(s)
Positive-Pressure Respiration/methods , Adolescent , Adult , Analysis of Variance , Cardiac Surgical Procedures , Critical Care , Hemodynamics , Humans , Infant, Newborn , Lung/physiopathology , Middle Aged , Positive-Pressure Respiration/statistics & numerical data , Postoperative Care , Postoperative Complications/physiopathology , Postoperative Complications/therapy , Respiratory Distress Syndrome, Newborn/physiopathology , Respiratory Distress Syndrome, Newborn/therapy , Respiratory Function Tests/statistics & numerical data
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