scholarly journals Successful treatment of severe calcium channel blocker poisoning: a clinical case

2021 ◽  
Vol 17 (3) ◽  
pp. 71-76
Author(s):  
S.M. Nedashkivskyi ◽  
D.K. Lisnyak ◽  
G.A. Milienko ◽  
Yu.B. Kozlovskyi ◽  
A.D. Doroshenko
Keyword(s):  
Intensive Care ◽  
Clinical Case ◽  
Channel Blocker ◽  
Lethal Dose ◽  
Stable State ◽  
Lung Ventilation ◽  
Cardiotoxic Effect ◽  
Inotropic Drugs ◽  
Artificial Lung Ventilation ◽  
Long Time

The article describes the successful experience of treating a female patient with severe poisoning by a mixture of drugs with a predominant cardiotoxic effect. The number of drugs taken was many times higher than the potentially lethal dose. Hemodynamics has been supported by vasopressors and inotropic drugs for a long time, antidotes, sorbents, detoxification agents were used. Due to inadequate spontaneous ventilation, the patient was on artificial lung ventilation for 24 days. After 26 days in the intensive care unit, she was transferred to the therapeutic department in a stable state and without neurological deficit. We believe that this material will be useful for intensive care physicians when providing emergency care to patients in such situations.

scholarly journals Severe Sepsis – Clinical Manifestations and Pharmaco-Economic Analysis in an Intensive Care Unit in Latvia

2016 ◽  
Vol 70 (4) ◽  
pp. 237-244
Author(s):  
Linda Brīdiņa ◽  
Angelika Krūmiņa ◽  
Oļegs Šuba ◽  
Vinita Cauce ◽  
Indulis Vanags ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Economic Analysis ◽  
Clinical Manifestations ◽  
Lung Ventilation ◽  
Artificial Lung ◽  
University Hospital ◽  
Hospitalised Patients ◽  
Artificial Lung Ventilation

Abstract Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary “Gaiļezers” of the Rīga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients - 34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.

scholarly journals CLINICAL CASE OF THE SUCCESSFUL TREATMENT OF AN ACUTE ETHYLENE GLYCOL POISONING

2020 ◽  
Vol 25 (3) ◽  
pp. 28-34
Author(s):  
Sergei Anatolievich Vasilyev ◽  
◽  
Oleg Anatolievich Kuznetsov ◽  
Pavel Pavlovich Gavrikov ◽  
Milena Andreevna Formozova ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Ethylene Glycol ◽  
Successful Treatment ◽  
Clinical Case ◽  
Lethal Dose ◽  
Clinical Manifestations ◽  
Toxic Encephalopathy ◽  
Toxic Impact ◽  
Ethylene Glycol Poisoning

In clinical case of toxic impact by ethylene glycol with severe development of acute kidney damage, respiratory failure and toxic encephalopathy, dynamic of clinical manifestations against the background of intensive care with a positive expected result of treatment in a patient who took a dose of ethylene glycol exceeding the lethal dose by 5 times is reflected.

scholarly journals Analysis of the Etiological Structure and Profile of Drug Resistance of Causative Agents of Nosocomial Pneumonia in Young Children Who Were on Mechanical Ventilation

2019 ◽  
pp. 16-19
Author(s):  
V.V. Danilova ◽  
S.I. Bevz ◽  
S.S. Ovcharenko ◽  
O.S. Shevchenko ◽  
L.D. Todoriko
Keyword(s):  
Antibiotic Resistance ◽  
Intensive Care ◽  
Young Children ◽  
Antibiotic Therapy ◽  
Nosocomial Pneumonia ◽  
Lung Ventilation ◽  
Artificial Lung ◽  
Aim Analysis ◽  
Gram Negative ◽  
Artificial Lung Ventilation

Background. The results of the treatment of young children who are on artificial lung ventilation in the departments of anesthesiology and intensive care (DAIC) depend directly on the antibiotic therapy policy used in the department. Aim. Analysis of the etiological structure and the level of antibiotic resistance of pathogens of nosocomial pneumonia (NP) in young children in the conditions of the DAIC of the Regional Children’s Clinical Hospital № 1 in Kharkov for the period 2000-2018. Materials and methods. 89 children with nosocomial pneumonia who were undergoinig artificial lung ventilation in the anesthesiology and intensive care unit up to 3 year-olds. Results. Gram-negative microorganisms (MOs) were isolated in 84.3% (n=75), gram-positive MOs – in 12.35% (n=11), micosis of different species in 3.37% (n=3). The study of antibiotic resistance of strains of microorganisms isolated from endotracheal aspirate in infants with nosocomial pneumonia, significantly indicates the predominance in the structure of pathogens of gram-negative microorganisms having multiple or panresistant microorganisms Conclusions. Carrying out regular monitoring of antibiotic sensitivity will allow more flexible implementation of antibiotic therapy policy in the DAIC, which, in turn, will increase the effectiveness of treatment, will reduce the economic costs and mortality of this contingent of patients.

scholarly journals MARKERS FOR PREDICTING THE DEVELOPMENT OF CRITICAL CONDITION IN CHILDREN WITH RESPIRATORY DISEASES UNDER INTENSIVE THERAPY

2020 ◽  
Vol 20 (1) ◽  
pp. 119-125
Author(s):  
M.Ye. Fesenko ◽  
V.I. Pokhylko ◽  
S.M. Tsvirenko ◽  
L.S. Ziuzina ◽  
O.O. Kaliuzhka
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Critical Condition ◽  
Respiratory Diseases ◽  
Clinical Course ◽  
Lung Ventilation ◽  
Artificial Lung Ventilation ◽  
Ischemic Encephalopathy

Introduction. The clinical course of respiratory diseases is often accompanied with the impairment of the nervous system, it makes up a large proportion in the clinical picture of diseases, and often leads to long-term adverse effects. The purpose of the study is to elaborate the diagnostic algorithm for predicting the course of diseases in children with respiratory pathology during the intensive care based on the thorough study of clinical and anamnestic predictors. Subjects and methodology. The study included 132 children aged from 1 day to 1 year with various pathologies during intensive care. The children were divided into 6 groups: I group included 87 patients with acute respiratory viral infection (ARVI), pneumonia; II group included 21 children with ARVI, stenosis of II-III degree, III group involved 10 children with hypoxic-ischemic encephalopathy. There was a group of children supported with artificial lung ventilation (14), who make up IV group; 20 children died. The control group consisted of 25 healthy children aged under 1 year old. We carried out clinical, bacteriological, immunological examination and statistical processing of findings obtained. Results. When assessing the cases of the clinical course in children up to 1 year, who needed intensive care to mitigate the symptoms of acute respiratory failure of II-III degree, we have found out that except of aggravating factors in the ante-, intra- and postnatal period, there are the number of  pathological change detected by neurosonography, which are of unfavourable predictive value: 29.5% of children had subependymal haemorrhages; 10.3%, of children had intraventricular haemorrhages, 9% of children had periventricular haemorrhages. Infants with acute respiratory failure III degree who needed artificial lung ventilation (50% of them were premature) were born to mothers with a pathologic pregnancy and childbirth. Among children who were in the intensive care unit, the general mortality was 15.2%. The causes of death of newborns included asphyxia (80%), respiratory disorder syndrome III degree (10%), hypoxic-ischemic encephalopathy (10%). In the long-term period, the main cause of death was pneumonia, complicated by acute respiratory failure III degree, brain oedema. Conclusion. Applying of the markers to prevent and reverse the development of infants’ critical condition promotes to the reduction of morbidity, disability and mortality of children.

scholarly journals The use of extracorporeal membrane oxygenation in severe closed chest injury

2019 ◽  
Vol 178 (2) ◽  
pp. 65-68
Author(s):  
D. A. Zaitsev ◽  
A. V. Kochetkov ◽  
D. A. Shelukhin ◽  
V. V. Lishenko ◽  
V. I. Popov ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Clinical Case ◽  
Lung Ventilation ◽  
Chest Injury ◽  
Closed Chest ◽  
Membrane Oxygenation ◽  
Life Saving ◽  
Artificial Lung Ventilation ◽  
Life Threatening ◽  
Closed Chest Injury

The clinical case of successful cure of the victim with severe closed chest injury is presented, as a result of which the life-threatening acute respiratory failure could not be compensated by artificial lung ventilation and, in connection with which the use of extracorporeal membrane oxygenation as a «life-saving technology» was required.

Progressive Early Rehabilitation Program Applied to Patients with Acute Cerebrovascular Accident

2020 ◽  
Vol 25 (3) ◽  
pp. 17-25 ◽  
Author(s):  
G. R. Ramazanov ◽  
L. B. Zavaliy ◽  
L. L. Semenov ◽  
S. A. Abudeev ◽  
A. O. Ptitsyn ◽  
...  
Keyword(s):  
Cerebrovascular Accident ◽  
Lung Ventilation ◽  
Rehabilitation Program ◽  
Artificial Lung ◽  
Early Rehabilitation ◽  
Gravity Gradient ◽  
Acute Cerebrovascular Accident ◽  
Artificial Lung Ventilation ◽  
Bed Days ◽  
Severity Of The Disease

Abstract. Early rehabilitation (ER) of patients with acute cerebrovascular accident (ACA) is one of the priority tasks of the vascular centers; the issue of increasing the volume of rehabilitation measures in the resuscitation and intensive care units (ICU) is relevant. Objective. To evaluate the safety and effectiveness of the progressive ER program in patients with ACA. Material and research methods. The study included 129 patients with ACA in ICU. Each patient of the main group (MGr, n = 61) underwent progressive ER: at least 4–5 vertical adjustments per day, passive mode Kinesiotherapy 49 ± 9.3 minutes, a double load of physiotherapy exercises, preventive physiotherapy; the total time of classes reached 240 minutes per day. In the comparison group (СGr, n = 68), standard ER was performed no more than 120 minutes per day. The groups are comparable by sex, age, severity of the disease and comorbidity. The severity of ACA, the gravity gradient, patient mobility, functional status, degree of dependence, and the presence of complications were evaluated. Results. During a month of work with the MGr, 102 ICU bed-days, 94 days of the artificial lung ventilation use, p < 0.05 were saved. Mortality in MGr decreased -— 8 patients (13.1%) versus 14 (20.6%) in CGr (p < 0.05). In patients within CGr, pulmonary thromboembolism developed in 8.8%, in MGr – in 3.3%. The severity of the apoplectic attack decreased ( by 28% in MGr, and by 20% in CGr ), mobility increased. Comparing the modalities of post resuscitationsyndrome in MGr, it was noted that the score decreased by 2 times from 6 [5; 6] to 3 [2.3; 3.3], but it has not changed in the CGr. Patients in the MGr were 2-–3 days earlier adapted to the vertical adjustment. Conclusions. The progressive ER program in ICU is safe, effective, realisable, and allows reducing the number of bed-days in ICU, the number of days of the artificial lung ventilation use, complications, and mortality in comparison with standard medical care.

TECHNICAL AND ECONOMIC EVALUATION OF THE DEVELOPMENT OF A DEVICE FOR THE PREVENTION OF APNEA DURING PHYSIOLOGICAL SLEEP IN HUMANS

2020 ◽  
pp. 198-210
Author(s):  
Сергей Борисович Казаков ◽  
Дмитрий Михайлович Шишов ◽  
Антон Игоревич Ларин ◽  
Александр Петрович Николаев ◽  
Аза Валерьевна Писарева
Keyword(s):  
Sleep Apnea ◽  
Humidity Sensor ◽  
Lung Ventilation ◽  
High Price ◽  
Device Structure ◽  
Artificial Lung Ventilation ◽  
Exact Moment ◽  
The Cost ◽  
Technical Solutions ◽  
Physiological Sleep

В статье представлен обзор существующих технических решений в сфере мониторинга и предотвращения апноэ во сне. Произведён анализ существующих аппаратов для предотвращения апноэ, который показал, что на рынке присутствует большое количество импортных моделей, однако они имеют довольно высокую цену. Разработанный нами Российский аналог проектируемого аппарата, при схожих характеристиках, будет иметь более привлекательную цену, чем у импортных приборов. Интегрирование датчика влажности в персональную маску пациента даёт возможность отслеживать остановки дыхания пациента во время сна, и тем самым включать процесс принудительной подачи дыхательной смеси именно в тот момент, когда она необходима для устранения патологии. Целью научной работы является разработка конструкции прибора и создание алгоритма программы для управления аппарата искусственной вентиляции лёгких для предотвращения апноэ во сне. Показана разработка структуры устройства аппарата. Подобран компрессор и датчик влажности с обоснованными характеристиками для создания аппарата, а также основные элементы. Разработана конструкция корпуса аппарата и разработана компоновка. Выполнено технико-экономическое обоснование разработки аппаратно-программного комплекса для предотвращения апноэ во сне. Показано, что себестоимость готового изделия достаточно конкурентна The article presents an overview of existing technical solutions in the field of monitoring and prevention of sleep apnea. An analysis of existing devices for preventing apnea was made, which showed that there are a large number of imported models on the market, but they have a fairly high price. The Russian analog of the designed device developed by us, with similar characteristics, will have a more attractive price than that of imported devices. The integration of the humidity sensor into the patient's personal mask makes it possible to monitor the patient's breathing stops during sleep, and thus enable the process of forced delivery of the respiratory mixture at the exact moment when it is necessary to eliminate the pathology. The purpose of the research is to develop the device design and create a program algorithm for controlling the artificial lung ventilation device to prevent sleep apnea. The development of the device structure is shown. The compressor and humidity sensor with reasonable characteristics for creating the device, as well as the main elements are selected. The design of the device body and its layout were developed. A feasibility study for the development of a hardware and software system for preventing sleep apnea has been completed. It is shown that the cost of the finished product is quite competitive

scholarly journals Physiological and Psychological Effects of Watching Videos of Different Durations Showing Urban Bamboo Forests with Varied Structures

2020 ◽  
Vol 17 (10) ◽  
pp. 3434
Author(s):  
Yuqian Wang ◽  
Mingyan Jiang ◽  
Yinshu Huang ◽  
Zhiyi Sheng ◽  
Xiao Huang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Skin Conductance ◽  
Human Body ◽  
Stable State ◽  
Mean Value ◽  
Psychological Effects ◽  
Physiological Indicators ◽  
Psychological Indicators ◽  
Before And After ◽  
Long Time

This study illustrated the physiological and psychological effects of watching videos of different durations showing bamboo forests with varied structures. Physiological indicators, including EEG (electroencephalogram), blood pressure, skin conductance, and pulse, were monitored in 180 Chinese university students (mean age: 20.72 ± 2.56 years) while they were watching bamboo videos. Before and after watching the videos, their psychological indicators, including positive and negative moods, were measured using the Profile of Mood States questionnaire. After watching the bamboo videos of different durations, all of the physiological indicators responded to the stimulation after only 1 min. The indicators showed different trends at 1, 3 and 5 min. EEG decreased and then was maintained at a stable level after 1 min, and the high β, low β, and α waves had no significant differences between 1, 3 and 5 min. Blood pressure dropped to a stable state after 3 min, and the decline was significantly different greater after 3 min than after 1 min. Skin conductance increased for 1 to 5 min, and it did not stabilize after a long time (5 min). Pulse decreased after 1 min but increased after 5 min. After watching the videos with bamboo of varying structures, the physiological and psychological indicators showed significantly different changes. Skin conductance significantly increased (mean value: 6.78%), and the amount of sweat was more effectively reduced, thereby reducing tension, when the students viewed videos of sympodial bamboo forests compared with monopodial bamboo forests. Bamboo forests with a higher canopy density (0.83–0.85) could significantly decrease α waves (mean value: 1.50 Hz), relaxing the human body. High β and low β waves showed greater decreases, with tension reduced more effectively, when bamboo forests with a low tilt ratio (< 1.5%) were viewed. Bamboo forests with neat undergrowth could have more beneficial physiological and psychological effects on the human body.

MECHANICAL VENTILATION OF THE LUNGS WITH A TARGETED TIDAL VOLUME IN NEWBORNS AND INFANTS WITH VARIOUS LUNG DISEASES

2021 ◽  
Vol 100 (5) ◽  
pp. 76-82
Author(s):  
A.V. Mostovoy ◽  
◽  
S.S. Mezhinsky ◽  
A.L. Karpova ◽  
A.N. Nikolishin ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Lung Diseases ◽  
Lung Ventilation ◽  
First Year ◽  
Lung Pathology ◽  
Pathological Conditions ◽  
Artificial Lung Ventilation ◽  
First Year Of Life ◽  
Ventilation Of The Lungs ◽  
Selection Of

The review presents and systematizes the current provisions on artificial lung ventilation (ALV) with a guaranteed or target tidal volume as the most effective and safe mode of ALV in neonatal practice. The application of this method of respiratory support is described. The authors present the main provisions on the optimal selection of the target tidal volume in various pathological conditions. The use of various modes of ALV in combination with a guaranteed tidal volume makes it possible to prevent or reduce the harmful impact of ALV in patients with acute and chronic lung pathology, in newborns and children in the first year of life.

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