4 research outputs found

    PLACE OF LOW-MOLECULAR-WEIGHT HEPARINS IN INTENSIVE THERAPY OF HEPATIC INSUFFICIENCY

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    The practical significance of heparin low-molecular fractions as inhibitors of inflammation and antithrombin IIIΒ consumption reduction were studied. That is most critical in acute hepatic failure. The study was performed using theΒ low-molecular-weight heparin (Nadroparin calcium) in low (prophylactic) doses of 2000 anti-factor Xa units dailyΒ per 1 meter squared in the form of continuous intravenous infusion. The cohort study proved the nadroparin positiveΒ effect on carbohydrate and protein metabolism in children with acute poisoning by hepatotoxic poisons, The significantΒ decrease in the quantitative assessment of disseminated intravascular coagulation relative to the comparison group hasΒ been revealed, and the decrease in 28-day mortality from 42 to 13 % has been found in children receiving nadroparin.Β Conclusions are drawn on the feasibility of introducing low molecular weight heparins into the intensive care regimenΒ of liver failure

    Evaluation of deadspace effects created by heat and moisture exchange filter during artificial lung ventilation in newborns

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    Heat and moisture exchange filters create additional dead space, comparable in volume to physiological, in premature newborns. It makes carbon dioxide remove difficultΡƒ. Reducing the dead space volume by increasing the flow in the ventilator circuit can lead to the hypocapnia.Β Aim of the study was to determine the safety and efficiency of gas flow boost in the ventilator circuit to hypercapnia compensation created by the additional dead space.Β Material and methods. The effect of the additional dead space created by a heat and moisture exchange filter on hemoglobin saturation and partial pressure of carbon dioxide at the end of expiration in premature newborns at flows of 5 and 6 l/min was studied.Β Results and discussion. It has been demonstrated that flows of 5–6 l/min satisfactorily compensate for the effect of additional deadspace without hypocapnia.Β Conclusions. It is possible to recommend the widespread use of heat and moisture exchange filters in newborn weighing at least 1.0 kg during long-term transportation

    Π—Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² Ρ‚Ρ€Π°Π½Π·ΠΈΡ‚ΠΎΡ€Π½ΠΎΠΉ ишСмии ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄Π° ΠΈ гСмодинамичСской ΠΏΠ΅Ρ€Π΅Π³Ρ€ΡƒΠ·ΠΊΠΈ Ρƒ Π½ΠΎΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… Π² критичСском состоянии

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    Monitoring of cardiospecific markers is significant during intensive care.The objective: to compare the diagnostic and prognostic significance of cardiac markers in newborns with somatic and surgical pathology.Subjects and Methods. The study included 76 newborns aged 1 to 14 days with somatic or surgical disorders. The changes in the concentration of cardiomarkers in newborns and their relationship with echocardiography data and non-invasive hemodynamic parameters are presented, their prognostic ability is assessed.Results. Rigidity of non-invasive hemodynamic parameters, and echocardiography data was revealed. In the somatic group, regression of NT-proBNP from 8,307 ng/ml (3,600; 9,000) to 1,717 ng/ml (1,041; 5,011) was regarded as a marker of resolution of hypervolemia against the background of cardiovascular maladaptation. The increase in NT-proBNP from 4,710 ng/ml (3,400; 6,989) to 7,987 ng/ml (3,397; 9,000) in the postoperative period requires a revision of the infusion therapy program with the priority of volume restriction.Conclusions. Stabilization of the condition of patients in the groups is accompanied by a decrease in the concentration of markers of myocardial tension (MB-fraction of creatine phosphokinase, troponin T).Measurement of NT-proBNP concentration allows assessment of fluid overload in critically ill neonates.ΠœΠΎΠ½ΠΈΡ‚ΠΎΡ€ΠΈΠ½Π³ кардиоспСцифичСских ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² Π·Π½Π°Ρ‡ΠΈΠΌ ΠΏΡ€ΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ.ЦСль: ΡΡ€Π°Π²Π½ΠΈΡ‚ΡŒ Π΄ΠΈΠ°Π³Π½ΠΎΡΡ‚ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ ΠΈ ΠΏΡ€ΠΎΠ³Π½ΠΎΡΡ‚ΠΈΡ‡Π΅ΡΠΊΡƒΡŽ Π·Π½Π°Ρ‡ΠΈΠΌΠΎΡΡ‚ΡŒ ΠΊΠ°Ρ€Π΄ΠΈΠΎΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² Ρƒ Π½ΠΎΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… с соматичСской ΠΈ хирургичСской ΠΏΠ°Ρ‚ΠΎΠ»ΠΎΠ³ΠΈΠ΅ΠΉ.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. Π’ исслСдованиС Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ 76 Π½ΠΎΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… соматичСского ΠΈΠ»ΠΈ хирургичСского профиля Π² возрастС ΠΎΡ‚ 1 Π΄ΠΎ 14 суток. ΠŸΡ€Π΅Π΄ΡΡ‚Π°Π²Π»Π΅Π½Ρ‹ Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ ΠΊΠ°Ρ€Π΄ΠΈΠΎΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² Ρƒ Π½ΠΎΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… ΠΈ ΠΈΡ… взаимосвязь с Π΄Π°Π½Π½Ρ‹ΠΌΠΈ эхокардиографии, Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Ρ‹ΠΌΠΈ показатСлями Π³Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ, ΠΎΡ†Π΅Π½Π΅Π½Π° ΠΈΡ… прогностичСская ΡΠΏΠΎΡΠΎΠ±Π½ΠΎΡΡ‚ΡŒ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ВыявлСна Ρ€ΠΈΠ³ΠΈΠ΄Π½ΠΎΡΡ‚ΡŒ Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ½Π°ΠΌΠΈΠΊΠΈ, Π΄Π°Π½Π½Ρ‹Ρ… эхокардиографии. Π’ соматичСской Π³Ρ€ΡƒΠΏΠΏΠ΅ рСгрСсс NT-ΠΏΡ€ΠΎΠœΠΠ£ΠŸ ΠΎΡ‚ 8 307 Π½Π³/ΠΌΠ» (3 600; 9 000) Π΄ΠΎ 1 717 Π½Π³/ΠΌΠ» (1 041; 5 011) расцСнСн ΠΊΠ°ΠΊ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ Ρ€Π°Π·Ρ€Π΅ΡˆΠ΅Π½ΠΈΡ Π³ΠΈΠΏΠ΅Ρ€Π²ΠΎΠ»Π΅ΠΌΠΈΠΈ Π½Π° Ρ„ΠΎΠ½Π΅ сСрдСчно-сосудистой Π΄Π΅Π·Π°Π΄Π°ΠΏΡ‚Π°Ρ†ΠΈΠΈ. Рост ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ NT-ΠΏΡ€ΠΎΠœΠΠ£ΠŸ ΠΎΡ‚ 4 710 Π½Π³/ΠΌΠ» (3 400; 6 989) Π΄ΠΎ 7 987 Π½Π³/ΠΌΠ» (3 397; 9 000) Π² послСопСрационном ΠΏΠ΅Ρ€ΠΈΠΎΠ΄Π΅ Ρ‚Ρ€Π΅Π±ΡƒΠ΅Ρ‚ пСрСсмотра ΠΏΡ€ΠΎΠ³Ρ€Π°ΠΌΠΌΡ‹ ΠΈΠ½Ρ„ΡƒΠ·ΠΈΠΎΠ½Π½ΠΎΠΉ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ с ΠΏΡ€ΠΈΠΎΡ€ΠΈΡ‚Π΅Ρ‚ΠΎΠΌ рСстрикции объСма.Π’Ρ‹Π²ΠΎΠ΄Ρ‹. Бтабилизация состояния ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² Π² Π³Ρ€ΡƒΠΏΠΏΠ°Ρ… сопровоТдаСтся сниТСниСм ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ ΠΌΠ°Ρ€ΠΊΠ΅Ρ€ΠΎΠ² ΠΌΠΈΠΎΠΊΠ°Ρ€Π΄ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ напряТСнности (ΠœΠ’-фракция крСатинфосфокиназы, Ρ‚Ρ€ΠΎΠΏΠΎΠ½ΠΈΠ½ Π’). Π˜Π·ΠΌΠ΅Ρ€Π΅Π½ΠΈΠ΅ ΠΊΠΎΠ½Ρ†Π΅Π½Ρ‚Ρ€Π°Ρ†ΠΈΠΈ NT-ΠΏΡ€ΠΎΠœΠΠ£ΠŸ позволяСт ΠΎΡ†Π΅Π½ΠΈΠ²Π°Ρ‚ΡŒ ΠΏΠ΅Ρ€Π΅Π³Ρ€ΡƒΠ·ΠΊΡƒ ΠΆΠΈΠ΄ΠΊΠΎΡΡ‚ΡŒΡŽ Ρƒ Π½ΠΎΠ²ΠΎΡ€ΠΎΠΆΠ΄Π΅Π½Π½Ρ‹Ρ… Π² критичСском состоянии

    CUMULATIVE FLUID BALANCE OF INFUSION THERAPY OF NEWBORNS WITH NECROTIZING ENTEROCOLITIS

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    The aim of the research is to study the connection between the five-day cumulative fluid balance and the outcome of a critical condition in the surgical group of newborns. Material and methods. The study involved 30 newborns with necrotizing enterocolitis in stage IIIB according to Walsh - Kliegman. Groups were formed by the criterion of outcome. Analyzed parameters were age and body weight of participants, hematocrit number; the cumulative five-day fluid balance expressed as a percentage of the initial body weight. The data were carried out by nonparametric statistics. Results and discussion. The only independent factor determining the probability of death from necrotizing enterocolitis of newborns is the gestational age and the body weight as its derivative. The likelihood of an unfavorable outcome in necrotizing enterocolitis of the newborn doesn’t depend on the five-day cumulative fluid balance
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