ABSTRACT
The clinical estimation of the state of patient is one of the basic components of the checking of the state of patient, but more precise and more objective indices today become necessary. The arterial blood gases analysis helps to select the optimum regime of mechanical ventilation. The medical evacuation of the critically ill patients frequently requires the correction of the parameters of respiratory support. The conducted investigations showed that the prognostics of unfavorable outcome within the first three days from the moment of the medical evacuation are hypercapnia, which exists during the process of evacuation in spite of the correction of the parameters of mechanical ventilation, reduction in the saturation of the arterial blood. The forecast of the medical evacuation is located as well in the direct correlation with the manifestation of acidosis, and at the moment of the completion of the transfer of the patient the greatest prognostic significance they possess the low level of the partial tension of oxygen in the artery. The application of a portable express- analyzer of blood gases permits implementation of correction parameters of respiratory support and to increase quality and safety of the medical evacuation of patients.
Subject(s)
Blood Gas Analysis , Critical Illness , Respiration, Artificial , Humans , Oxygen , PrognosisABSTRACT
The use of point-of-care diagnostics can prevent a number of complications and leading to improved health outcomes for patients in critical condition. Research have shown that elongation of the preanalytic stage leading of errors of studies and changes the results of a number of laboratory parameters. The article presents the key problems associated with the elongation of the preanalytic stage and possible solutions to address the shortcomings of existing diagnostics.
Subject(s)
Clinical Laboratory Techniques , Disaster Medicine , Point-of-Care Testing , Pre-Analytical Phase , Critical Care , Humans , LaboratoriesABSTRACT
The syndrome "of the curse of Undina" or the innate central hypoventilation syndrome with the second disorder of cen- tral nervous system is the result of the disrupted vegetative control of the respiration in the absence of neuromuscular diseases and disturbances of the mechanics of respiration. In the clinical practice diagnostics of this state is complex, frequently the cases remain not diagnosed. Taking into account clinical manifestations and depending on the degree of their intensity, early diagnostics, which warns the undesirable consequences ofthe episodes ofhypoxia and hypercapnia, that ensures the proper checking of the episodes of asphyxia, determines not only the forecast of disease, but also life of patient. The purpose ofthis work is the idea of the clinical case of this rarely meeting illness.
Subject(s)
Pregnancy Complications/diagnosis , Sleep Apnea, Central/diagnosis , Adult , Brain/diagnostic imaging , Early Diagnosis , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications/diagnostic imaging , Pregnancy Complications/therapy , Pulmonary Gas Exchange , Respiration, Artificial , Sleep Apnea, Central/diagnostic imaging , Sleep Apnea, Central/therapy , Treatment OutcomeABSTRACT
The closed injury of chest with the breaks of edges is the vital problem of traumatology, anesthesiology and resuscitation For the change to conservative treatment with the aid of mechanical ventilation of lungs today come the methods of surgical fixation with the closed injury of chest. The conducted investigation showed the clinical and economic expediency of introducing the method of active surgical tactics.
Subject(s)
Critical Care/methods , Respiration, Artificial , Resuscitation/methods , Rib Fractures/surgery , Wounds, Nonpenetrating/surgery , Adult , Cost-Benefit Analysis , Critical Care/economics , Female , Humans , Male , Radiography , Respiration, Artificial/economics , Resuscitation/economics , Rib Fractures/diagnostic imaging , Rib Fractures/economics , Rib Fractures/mortality , Trauma Severity Indices , Treatment Outcome , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Nonpenetrating/economics , Wounds, Nonpenetrating/mortalityABSTRACT
The article deals with a multicenter study that demonstrates the possibility and feasibility of noninvasive ventilation in patients with skeletal trauma complicated wiith fat embolism syndrome. The authors found additional criteria for the severity of the condition of patients with trauma. Important criteria for the choose a type of ventilation (non-invasive and invasive) is the lack of consciousness, desynchronization of a patient with ventilator and the need for a specialized regimes or miorelaxation to synchronize with the respirator.
Subject(s)
Bone and Bones/injuries , Critical Care/methods , Embolism, Fat/therapy , Health Care Costs , Multiple Trauma/therapy , Noninvasive Ventilation/methods , Respiratory Distress Syndrome/therapy , Adolescent , Adult , Critical Care/economics , Embolism, Fat/diagnosis , Embolism, Fat/etiology , Embolism, Fat/mortality , Humans , Middle Aged , Multiple Trauma/complications , Multiple Trauma/diagnosis , Multiple Trauma/mortality , Noninvasive Ventilation/economics , Prospective Studies , Respiratory Distress Syndrome/diagnosis , Respiratory Distress Syndrome/etiology , Respiratory Distress Syndrome/mortality , Retrospective Studies , Trauma Severity Indices , Young AdultSubject(s)
Critical Illness/therapy , Enteral Nutrition/methods , Gastrointestinal Agents/therapeutic use , Intestinal Diseases/prevention & control , Adolescent , Child , Child, Preschool , Gastrointestinal Agents/administration & dosage , Gastrointestinal Motility/drug effects , Gastrointestinal Motility/physiology , Hemodynamics/drug effects , Hemodynamics/physiology , Humans , Intestinal Diseases/etiology , Intestinal Diseases/immunology , Intestinal Diseases/metabolism , Intestinal Diseases/physiopathology , Oxidative Stress/drug effects , SyndromeABSTRACT
The study deals with infusion therapies in children with thermal injury and with its impact of its qualitative composition at the local (tissue) and systemic levels. The investigations have indicated that the best qualities' in replenishing the volume of circulating blood and in eliminating hypovolemia are shown by hydroxyethylated starch (the study used voluvene) that offers advantages in the rate of correction of blood concentrations and in the maintenance of a volumic effects and that increases oxygen delivery, resulting in a rapider emergency from shock and improving the trophism of a burn wound.