RESUMEN
This work aimed to reveal the statistically reliable clinical and laboratory markers, which are associated with fatal outcomes in patients with hemorrhagic shock of the III degree on the stage of hospital treatment. It was stated that decrease of body temperature (till 35,9 °C), pH of venous blood (till 7,19) and content of ionized calcium (till 0,32 mmole/l) in venous blood and increase of lactate content (up to 4,1 mmole/l) in venous blood and rise of activated partial thromboplastin time (up to 59 sec) are connected with fatal outcomes.
Asunto(s)
Sustitutos Sanguíneos/administración & dosificación , Hemorragia Gastrointestinal , Úlcera Péptica Hemorrágica , Choque Hemorrágico , Adulto , Temperatura Corporal , Calcio/análisis , Femenino , Hemorragia Gastrointestinal/complicaciones , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/terapia , Humanos , Concentración de Iones de Hidrógeno , Masculino , Gravedad del Paciente , Úlcera Péptica Hemorrágica/complicaciones , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/terapia , Valor Predictivo de las Pruebas , Choque Hemorrágico/diagnóstico , Choque Hemorrágico/etiología , Choque Hemorrágico/mortalidad , Choque Hemorrágico/prevención & control , Resultado del TratamientoRESUMEN
The article deals with a case report of successful treatment of patient with massive blood loss and shock. The observation showed that use of balanced crystalloid solution and modified gelatin 4% in the program of infusion therapy effectively corrects systemic haemodynamics and effect on haemostasis, electrolyte and acid-base balance.
Asunto(s)
Hemorragia/terapia , Traumatismos del Cuello/cirugía , Choque/terapia , Heridas Punzantes/cirugía , Adulto , Transfusión Sanguínea , Volumen Sanguíneo/fisiología , Hemorragia/diagnóstico , Hemorragia/etiología , Humanos , Masculino , Monitoreo Fisiológico , Traumatismos del Cuello/complicaciones , Traumatismos del Cuello/diagnóstico , Choque/diagnóstico , Choque/etiología , Resultado del Tratamiento , Heridas Punzantes/complicaciones , Heridas Punzantes/diagnósticoRESUMEN
UNLABELLED: Endothelial dysfunction is a universal mechanism of pathogenesis of many critical conditions. Goal of the study was to assess a relation of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. MATERIALS AND METHODS: 17 patients with hemorrhagic shock 3 were involved in the study. All patients received infusion therapy, artificial lung ventilation after tracheal intubation and symptomatic treatment in prehospital period. Common volume of blood loose was 2900 +/- 200 mL. The patients received infusion, transfusion, inotrope, antibacterial, respiratory and symptomatic therapy in ICU after surgical treatment. Cardio-vascular system parameters were assessed by Tischenko method of integral reography. Number of red cells, hemoglobin, lactate, endotelin-1 and Wb-factor of venous blood were studied before surgery, in 12 and in 24 hours after. Morphological study of the omentumbiopsy was carried out. RESULTS: Performed correlation analysis showed statistically significant relations of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. Endothelial dysfunction occurs in patients with hemorrhagic shock 3. The endothelial dysfunction correlates with parameters of cardio-vascular system and tissue perfusion.
Asunto(s)
Sistema Cardiovascular/fisiopatología , Endotelio Vascular/fisiopatología , Hemodinámica/fisiología , Choque Hemorrágico/fisiopatología , Choque Hemorrágico/terapia , Adolescente , Adulto , Volumen Sanguíneo/fisiología , Sistema Cardiovascular/patología , Endotelio Vascular/patología , Eritrocitos/citología , Hemoglobinas/análisis , Humanos , Epiplón/irrigación sanguínea , Pletismografía de Impedancia , Índice de Severidad de la Enfermedad , Choque Hemorrágico/sangre , Choque Hemorrágico/patología , Volumen Sistólico/fisiología , Resistencia Vascular/fisiología , Adulto JovenRESUMEN
This work presents the results of treatment of 60 patients with 2nd degree hemorrhagic shock at pre-hospital and hospital stages by different variations of infusion therapy. It is established that balanced infusion therapy in patients with 2nd degree hemorrhagic shock helps to stabilize the system hemodynamic and improve the general condition. The balanced infusion therapy does not lead to unfavorable changes in acid-alkaline and electrolyte balance.
Asunto(s)
Fluidoterapia/métodos , Soluciones para Rehidratación/administración & dosificación , Choque Hemorrágico/terapia , Adulto , Soluciones Cristaloides , Gelatina/administración & dosificación , Hemodinámica/fisiología , Humanos , Soluciones Isotónicas/administración & dosificación , Sustitutos del Plasma/administración & dosificación , Índice de Severidad de la Enfermedad , Choque Hemorrágico/sangre , Choque Hemorrágico/fisiopatología , Succinatos/administración & dosificación , Resultado del Tratamiento , Equilibrio Hidroelectrolítico/fisiologíaRESUMEN
The comparative analysis of different protocols of infusion therapy of the hemorrhagic shock stage III was performed. The infusion of the colloid solution of hydroxiethylstarch 200/0.5 and non-balanced crystalloid 0.9% solution of natrium chloride leads to the development of negative changes in homeostasis. Whereas infusion of the 4% solution of the modified gelatin and balanced crystalloid solition (sterofundin) allows to avoid the registered changes in electrolyte and alkaline balance.
Asunto(s)
Gelatina , Homeostasis/efectos de los fármacos , Derivados de Hidroxietil Almidón , Soluciones Isotónicas , Choque Hemorrágico , Cloruro de Sodio , Adulto , Volumen Sanguíneo/efectos de los fármacos , Soluciones Cristaloides , Servicios Médicos de Urgencia/métodos , Femenino , Fluidoterapia/métodos , Fluidoterapia/normas , Gelatina/administración & dosificación , Gelatina/efectos adversos , Hemorragia/complicaciones , Hemorragia/tratamiento farmacológico , Hemorragia/metabolismo , Hemorragia/fisiopatología , Humanos , Derivados de Hidroxietil Almidón/administración & dosificación , Derivados de Hidroxietil Almidón/efectos adversos , Hipovolemia/tratamiento farmacológico , Hipovolemia/etiología , Hipovolemia/fisiopatología , Infusiones Intravenosas , Soluciones Isotónicas/administración & dosificación , Soluciones Isotónicas/efectos adversos , Masculino , Sustitutos del Plasma/administración & dosificación , Sustitutos del Plasma/efectos adversos , Índice de Severidad de la Enfermedad , Choque Hemorrágico/tratamiento farmacológico , Choque Hemorrágico/etiología , Choque Hemorrágico/metabolismo , Choque Hemorrágico/fisiopatología , Cloruro de Sodio/administración & dosificación , Cloruro de Sodio/efectos adversos , Resultado del Tratamiento , Desequilibrio Hidroelectrolítico/tratamiento farmacológico , Desequilibrio Hidroelectrolítico/etiología , Desequilibrio Hidroelectrolítico/metabolismo , Desequilibrio Hidroelectrolítico/fisiopatologíaRESUMEN
The clinical significance of the parameters of a systemic inflammatory response, leukocytic intoxication index, and procalcitonin test were studied in 63 patients with pyodestructive pyelonephritis of pregnant women. The blood concentration of procalcitonin was measured in 15 patients, by using the semiquantitative analysis. The authors revealed the high sensitivity and specificity of the method and the high prognostic value of positive results and the low frequency of false-positive results for procalcitonin and the leukocytic index of intoxication.
Asunto(s)
Calcitonina/sangre , Leucocitos/citología , Complicaciones Infecciosas del Embarazo/diagnóstico , Precursores de Proteínas/sangre , Pielonefritis/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Adolescente , Adulto , Péptido Relacionado con Gen de Calcitonina , Femenino , Humanos , Recuento de Leucocitos , Valor Predictivo de las Pruebas , Embarazo , Complicaciones Infecciosas del Embarazo/sangre , Complicaciones Infecciosas del Embarazo/patología , Pielonefritis/sangre , Pielonefritis/patología , Índice de Severidad de la Enfermedad , Supuración , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Síndrome de Respuesta Inflamatoria Sistémica/patologíaRESUMEN
Studies on white mongrel rats addressed the reorganization of the synaptoarchitectonics of layer I of the cerebral cortex in diffuse-focal injuries. The experiments used models of acute arrest of the systemic circulation (clinical death) resulting from exposure to mechanical asphyxia for 6 min, clamping of the common carotid arteries for 20 min (ischemia), and imposition of sublethal rotatory trauma by the Noble-Collip method (craniocerebral trauma). Electron microscopy and morphometric analysis showed that reductions in the total number density of synapses were accompanied by changes in the relative and absolute contents of the major types of synaptic apparatuses. There were increases in the numbers of large simple and perforated contacts and synapses with invaginated synaptic membranes, mitochondria, and spine apparatuses. These changes were interpreted as the structural basis for the mechanisms of synaptic plasticity in diffuse-focal brain injuries.
Asunto(s)
Lesiones Encefálicas/patología , Neocórtex/ultraestructura , Plasticidad Neuronal , Daño por Reperfusión/patología , Sinapsis/ultraestructura , Animales , Lesiones Encefálicas/fisiopatología , Masculino , Neocórtex/irrigación sanguínea , Neocórtex/fisiopatología , Ratas , Ratas Endogámicas , Sinapsis/patologíaRESUMEN
In an experiment conducted using mature albino rats, the regularities of reorganization of synaptic architectonics of cortical layer I of the brain were studied in the areas of diffuse-focal injuries. The models of acute break of systemic circulation (clinical death) as a result of 6-minute-long mechanical asphyxia, compression of common carotid arteries for 20 min (ischemia) and rotatory sublethal injury according to Noble-Collip method (cranial trauma), were used. Using the methods of electron microscopy and morphometric analysis, it was shown that a reduction in a general numerical density of synapses was accompanied by the changes in relative and absolute numbers of major variants of synaptic organization. The content of large simple and perforated contacts was increased, as well as of synapses with invaginated synaptic membranes, containing mitochonria and spine apparatus. The changes detected are considered as a structural basis for realization of the mechanisms of synaptic plasticity in diffuse-focal injuries of the brain.