scholarly journals Perioperative infusion therapy

2021 ◽  
Author(s):  
Evgeny Skobelev ◽  
Igor Pasechnik
Keyword(s):  
Perioperative Period ◽  
Fine Tuning ◽  
Surgical Patients ◽  
Critical Conditions ◽  
Infusion Therapy ◽  
Invasive Monitoring ◽  
Colloidal Solutions ◽  
Salt Solutions ◽  
Treatment Regimens ◽  
The Subject

Perioperative infusion support of surgical patients is the main and non-alternative element of treatment. At the same time, the tactics of infusion therapy continues to be the subject of study. Ideas about the optimal quantitative and qualitative composition of the fluid transfused to patients are being revised as ideas about the pathogenesis of critical conditions evolve. The basis of pathogenetic analysis of compensatory hemodynamic capabilities, as a point of application of infusion treatment, previously consisted mainly of invasive monitoring techniques, replaced in recent years by the control of routine parameters with proven high correlation with invasive ones. In current studies devoted to the problems of infusion correction of hemodynamic abnormalities, the most discussed issues are the applicability of isotonic and balanced polyionic crystalloids, less often colloidal solutions in various clinical situations, and the results of such studies do not always allow to unambiguously determine the choice of infusion media, and sometimes simply incomparable. Some researchers advocate the use of isotonic crystalloids, some works prove the best effectiveness of balanced salt solutions. With the volumes of treatment corresponding to the perioperative period, in most studies there are no differences in the effectiveness of the main composite groups of crystalloids at all. We see the reason for this in the peculiarities of randomization methods, when statistical limitations do not allow us to avoid discrete data analysis: their comparative grouping occurs according to the principle of selecting a target parameter, and all the others are classified as auxiliary or secondary. It seems to us that the involvement of arrays of data obtained in real clinical practice as a result of a combination of local theoretical and empirical ideas about corrective treatment regimens correlated with their effectiveness could smooth out the inconsistency of the results of such studies, especially since clinicians have a sample with a volemic load at their disposal, allowing them to predict the hemodynamic reaction of the patient's body to infusion and a set of routine parameters for more fine-tuning of therapy.

scholarly journals Infusion and transfusion therapy: main aspects

2021 ◽  
Vol 17 (3) ◽  
pp. 25-29
Author(s):  
V.V. Nikonov ◽  
K.I. Lyzohub ◽  
M.V. Lyzohub
Keyword(s):  
Perioperative Period ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Evidence Based ◽  
Consensus Guidelines ◽  
Successful Management ◽  
Transfusion Therapy ◽  
Vital Functions ◽  
Crystalloid Solutions ◽  
Based Medicine

The adequate choice of strategy for infusion therapy is an essential component of successful management of critically ill patients. Infusion therapy is one of the main methods of maintai-ning vital functions of patients in the perioperative period. In the practice of a doctor, there are reasonable doubts about the feasibility and safety of various solutions for infusion therapy. Both are fundamental principles of infusion therapy, and the changes that have taken place, of course, need to be understood from the standpoint of evidence-based medicine. Balanced crystalloid solutions were safe and clinically effective, their use is provided by the Bri-tish Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients.

scholarly journals Correction of stress hyperglycemia in surgical patients with metabolic syndrome

2020 ◽  
pp. 26-30
Author(s):  
I.G. Kryvorchuk ◽  
◽  
I.M. Leshchishin ◽  
◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Metabolic Syndrome ◽  
Intensive Care ◽  
Postoperative Period ◽  
Perioperative Period ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Control Group ◽  
Stress Hyperglycemia ◽  
Patients With Diabetes

Taking into account that stress and diabetic hyperglycemia is an independent risk factor for increased mortality in surgical patients with metabolic syndrome, an increase in the time spent by patients in intensive care units and the cost of treatment, it is important to carry out treatment, in particular, infusion therapy with the appointment of drugs that do not increase glucose levels and help to reduce the need for insulin in patients with diabetes mellitus in the postoperative period. Aim is to assess the effectiveness of the drug Xylat as an integral component of intensive care for patients with metabolic syndrome in perioperative period. Materials and methods. The study was conducted in 21 women with metabolic syndrome who underwent urgent surgical intervention for tumors in pelvic area. All patients received Xylat (Yuria-Pharm) – 5-6 ml/kg/day, 50-70 drops/min for 3 days in the postoperative period. The control group consisted of 15 women with metabolic syndrome, who underwent surgical treatment in the regional clinical hospital for ovarian tumors, but received alternative infusion therapy during the postoperative period (according to archived case histories). Results. The data of our study showed that the drug Xylatum (Yuria-Pharm) helps to reduce the risk of the severity of stress hyperglycemia, suppresses the risk of lactacidemia, provides energy support for postoperative patients with diabetes mellitus with an insulin+independent metabolism, and stimulates the production of endogenous insulin in critically ill patients. Conclusions. With the use of Xylate, the tolerance to carbohydrates increases. It has a very low glycemic index, antiketogenic properties, does not adversely affect the central nervous system, the exchange of hormones and neurotransmitters. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: surgical patients, diabetes mellitus, hyperglycemia, infusion therapy, metabolic syndrome, Xylatum.

FUNCTIONING OF THE MENTAL DEFENSES IN THE CONDUCT OF INTERROGATION WITHIN THE CRIMINAL PROCESS

2018 ◽  
Vol 28 (6) ◽  
pp. 2161-2165
Author(s):  
Hristo Ivanov Popnikolov
Keyword(s):  
Objective Assessment ◽  
Critical Conditions ◽  
Criminal Process ◽  
External Influences ◽  
Administration Of Justice ◽  
Individual Protection ◽  
The Subject ◽  
The Individual ◽  
The Cost ◽  
Subjective Side

From the subject presented in the report it is evident that the pre-trial and the court bodies may, to some extent, be influenced both by the person of the accused and by his competence to participate in the criminal process. In this regard as an expert, the psychologist can offer invaluable assistance. Each expertise would assist all actors involved in the administration of justice on their objective assessment of the offenders, the understanding of their individual protection and the inherent self-justification during procedural actions. The involvement of psychologists in the criminal process is key to establishing the truth in the investigation, because every crime as an act has a subjective side, expressed in the psychic attitude of the perpetrator to the committed act. Establishing these psychological motives is a key point in the criminal process with a view to establishing the truth.Psychological protection stabilizes the personality in the critical conditions of counteraction, related to the elimination of the experiences of tension, anxiety, stress and frustration, leading to maximum mobilization of its resources and at the same time to their overpayment. Thus, the individual who is the subject of the process action is protected against the adverse external influences, but at the cost of a lot of effort and enormous loss of nervous-mental energy, which increases his own vulnerability instead of contributing to its reduction. The appearance and functioning of psychological protection can be significantly impeded by the interaction of the investigator with the accused. Even more complicated is the situation when it breaks the communication contact that may arise in the psychological alienation and self-isolation of the accused due to the desire to protect himself.Protective psychological dominance is a real psychic activity that investigators, investigators, investigators and judges need to take into account in order to effectively deal with their task and to overcome the resistance of the investigated persons and in a time to prove in a lawful and moral way their guilt and participation in the commitment of the crimes.

scholarly journals Invasive, minimally invasive and non-invasive hemodynamic monitoring in perioperative medicine

2020 ◽  
Vol 12 (1) ◽  
pp. 7-19
Author(s):  
Guerrero Gutiérrez Manuel Alberto ◽  
Pérez Nieto Orlando Rubén ◽  
Eder Iván Zamarrón López ◽  
Jesús Salvador Sánchez Díaz ◽  
Escarramán Martínez Diego ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pulmonary Artery ◽  
Minimally Invasive ◽  
Hemodynamic Monitoring ◽  
Perioperative Period ◽  
Invasive Monitoring ◽  
Less Invasive ◽  
Non Invasive ◽  
Fundamental Part ◽  
Invasive Hemodynamic Monitoring

The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient's bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which is being replaced by ultrasound and less invasive monitoring techniques, in this article we will review from the beginning of the monitoring to the most used less invasive monitors currently.

Feed Abdominal Surgery Patients to Improve Outcomes

2021 ◽  
Vol 66 (6) ◽  
pp. 158-160
Author(s):  
Laura Bolton
Keyword(s):  
Abdominal Surgery ◽  
Clinical Outcomes ◽  
Postoperative Morbidity ◽  
Oral Feeding ◽  
The Other ◽  
Surgical Patients ◽  
Electrolyte Balance ◽  
Considerable Research ◽  
Balance Energy ◽  
The Subject

Malnourishment of surgical patients has long been recognized as contributing to postoperative morbidity and mortality.1,2 Early protocols calling for lengthy perioperative patient fasting have been replaced by interventions aimed at diagnosing and addressing each patient’s nutritional and metabolic needs; maintaining fluid and electrolyte balance, energy, and protein stores; and preserving muscle strength and gut microbiome by restoring oral feeding as soon as possible postoperatively.3 Interventions to achieve this physiologic balance have been the subject of considerable research, yet neither comprehensive preoperative programs4 nor early postoperative oral feeding5 have been reported to result in consistently improved clinical outcomes following abdominal surgery. This installment of Evidence Corner explores 2 systematic reviews, one of which presents clinical outcomes of early resumption of enteral food intake within 24 hours after gastrointestinal (GI) surgery,6 and the other presents clinical outcomes of perioperatively enhanced nutrition for those undergoing radical cystectomy (RC) for bladder cancer.7

New options for surgeons to improve malnutrition in the outpatient setting

2021 ◽  
Vol 100 (2) ◽  
Keyword(s):  
Health Insurance ◽  
Nutritional Status ◽  
Perioperative Period ◽  
Outpatient Setting ◽  
Surgical Patients ◽  
Insurance Companies ◽  
Negative Factor ◽  
Health Insurance Companies ◽  
Limited Period

Malnutrition is a significant negative factor for surgical patients in the entire perioperative period. However, this factor can be controlled and is easy to detect in the outpatient setting. Starting from May 1, 2020, surgeons have the possibility to prescribe sipping under certain conditions for a limited period of 4 weeks. Thereby they have become able to strongly impact any altered nutritional status both preoperatively and postoperatively. The authors describe scoring questionnaires used for the detection of malnutrition and required by health insurance companies. Additionally, prescribing conditions and potential mistakes in the outpatient setting are analysed.

Deliberate Increase of Oxygen Delivery in the Perioperative Period

2018 ◽  
pp. 34-38
Keyword(s):  
Oxygen Consumption ◽  
High Risk ◽  
Cardiac Index ◽  
Oxygen Delivery ◽  
Myocardial Oxygen Consumption ◽  
Perioperative Period ◽  
Surgical Patients ◽  
Controlled Study ◽  
Surgical Patient ◽  
Mortality And Morbidity

This case focuses on increasing the amount of oxygen delivered to the surgical patient during the perioperative period by asking the question: Does the deliberate increase in oxygen delivery with the use of perioperative dopexamine reduce mortality and morbidity in high-risk surgical patients? Dopexamine is a dopamine analogue that produces peripheral vasodilation and an increase in cardiac index without significant increases in myocardial oxygen consumption. High-risk surgical patients were randomized to control or protocol limbs of the study. This randomized controlled study demonstrated a significant reduction in mortality and morbidity when dopexamine was used to increase oxygen delivery during the perioperative period in high-risk surgical patients.

Sign in / Sign up

Export Citation Format

Share Document