RESUMEN
Acid-base balance and lactate concentration in the arterial blood and spinal liquor have been studied in 32 patients after air embolism of the brain vessels developed during cardiopulmonary bypass surgery. It has been shown that an increase of lactate concentration in the spinal liquor over 3.5 mmol/l after air embolism of the brain vessels is indicative of severe hypoxic brain damage, in which the prospect of stable consciousness recovery is doubtful. In lactate concentration 4.5-5 mmol/l and higher as well as in metabolic acidosis of liquor (sodium hydrocarbonate concentration less than 20 mmol/l) the intensive care procedures used were not effective. It is believed that these parameters are of prognostic value in the condition under study.
Asunto(s)
Equilibrio Ácido-Base , Embolia Aérea/diagnóstico , Embolia y Trombosis Intracraneal/diagnóstico , Lactatos/sangre , Lactatos/líquido cefalorraquídeo , Puente Cardiopulmonar/efectos adversos , Embolia Aérea/sangre , Embolia Aérea/líquido cefalorraquídeo , Humanos , Embolia y Trombosis Intracraneal/sangre , Embolia y Trombosis Intracraneal/líquido cefalorraquídeo , PronósticoRESUMEN
Concentrations of the ingredients have been analysed in a nonstandard cardioplegia solution (CS) and CS from St. Thomas Hospital at the outset before CS introduction into the coronary vessels of patients under cardioplegia. It has been shown that the use of nonstandard CS was accompanied by undesirable variability in ingredient concentration, which to some extent may be accounted for by the use of incompletely unfrozen CS. The use of CS from St. Thomas Hospital could be accompanied by moderate hypermagnesiumemia, which did not lead to the onset of vascular insufficiency. It is stressed that plasma magnesium content should be controlled when this CS is used.
Asunto(s)
Calcio/análisis , Soluciones Cardiopléjicas/análisis , Magnesio/análisis , HumanosRESUMEN
New criteria of the arterial blood oxygen transport function suggested by O. Siggaard-Andersen et al. are reviewed. The examples from clinical practice show the possibility to evaluate the capacity of the arterial blood to transport O2 during general anesthesia and intensive care.
Asunto(s)
Oxígeno/sangre , Trasplante de Corazón , Humanos , Hipercapnia/sangre , Tetralogía de Fallot/sangre , Infección de Heridas/sangreRESUMEN
Intraoperative and early postoperative parameters of the central hemodynamics, oxygen transport function and acid-base status of the blood, and blood lactic and pyruvic acid levels in patients under general anesthesia with dalargin were compared to those under traditional neuroleptic analgesia. The comparative evaluation allowed for a conclusion that general anaesthesia with dalargin provides for a reliable anesthesiological defence and exerts a lower deteriorating effect on the vessels of pulmonary circulation than traditional neuroleptic analgesia.
Asunto(s)
Analgésicos , Anestesia General , Leucina Encefalina-2-Alanina/análogos & derivados , Encefalina Leucina/análogos & derivados , Pulmón/cirugía , Neuroleptanalgesia , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The paper presents results of application of the Soviet synthetic neuropeptide Dalargin as a major agent of anesthesiologic protection in the correction of a secondary atrial septal defect under general artificial circulation. From the findings obtained from examinations of central and peripheral hemodynamic parameters and blood oxygen transport function it was concluded that the anesthesiological protection was adequate at all the stages of an operation. The authors also give data on the optimization of the afterload of the right ventricle and preload of the left ventricle under anesthesia in which dalargin was used by directly affecting the elasticity of pulmonary vessels. The nature of changes in the ventilation-perfusion relationships, in the postoperative period, in particular, also enables the author to recommend the preferable employment of the described method for anesthesia while correcting this type of heart disease.