scholarly journals Correction of electrolyte balance in surgical patients with urgent surgical interventions

2021 ◽  
Vol 25 (4) ◽  
pp. 620-622
Author(s):  
P. I. Bignyak
Keyword(s):  
Acute Appendicitis ◽  
Postoperative Period ◽  
Oral Rehydration Therapy ◽  
Electrolyte Imbalance ◽  
Surgical Patients ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Oral Rehydration ◽  
Postoperative Therapy

Annotation. Acute appendicitis is one of the most common acute pathologies of the abdominal cavity, which requires immediate surgical intervention and can lead to water-electrolyte imbalance. The aim of the study was to investigate the clinical significance of electrolyte imbalance in patients operated on for acute appendicitis and their correction. We examined 20 urgent surgical patients who were part of the control group and received “traditional” postoperative therapy and 23 patients of the study group who received oral rehydration therapy in the postoperative period to correct water-electrolyte disorders. To analyze the results of the study, profile analysis was used as a modification of multidimensional covariance analysis with repeated measurements. As can be seen from the results of testing the hypothesis of normalization of homeostasis due to the use of oral rehydration therapy schemes, the hypothesis was confirmed with a threshold significance of p=0.0642. The only significant effect of the rate of normalization of potassium concentration in blood plasma is the appointment of oral rehydration therapy with p=0.045. Also, the appointment of oral rehydration therapy is a significant effect of the rate of normalization of sodium and glucose in plasma (normalization of plasma glucose is significantly better in the dynamics of younger patients (p=0.045)). Thus, normalization of potassium and glucose, which correlates with the patient's age, was better in patients receiving oral rehydration mixture in the postoperative period than in patients receiving “traditional” postoperative therapy. Oral rehydration therapy is an acceptable alternative to infusion therapy in patients undergoing surgery for acute appendicitis in the postoperative period.

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.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals Non-Conservative Therapy in the Prevention of Subepithelial Fibroplasia after LASEK Hypermetropia Correction

2018 ◽  
Vol 15 (2) ◽  
pp. 200-206
Author(s):  
S. A. Korotkikh ◽  
A. E. Bogachev ◽  
A. S. Shamkin
Keyword(s):  
Dry Eye ◽  
Postoperative Period ◽  
Sodium Hyaluronate ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Dry Eye Syndrome ◽  
Control Group ◽  
Study Group ◽  
Postoperative Therapy ◽  
Significant Difference

The results of observation of patients who underwent vision eximerlaser correction by the LASEK method regarding medium degree of hyperopia were analyzed.Purpose:to investigate the severity of the «dry eye» syndrome and corneal subepithelial fibroplasia in patients after laser correction of  hyperopia by the LASEK method, and their prevention by reducing  the preservative action on the eye surface.Patients and methods.The study included 40 patients (76 eyes), aged 21–46 years (32.98 ± 1.79) who underwent LASEK surgery for  moderate hyperopia (4.03 ± 0.38 D). Patients were divided into two  groups: 1) control group (20 patients, 37 eyes) — postoperative  therapy included the corneoprotector “Stilavit®” and the preparation  of hyaluronic acid “Oksial®”, containing preservatives;  2) the study group (20 patients, 39 eyes) — postoperative therapy  included the corneoprotector “Hilozar-comod®” and the artificial tear  preparation “Hilo-comod®”, which did not contain reservatives. Ophthalmic examination included, in addition to standard diagnostic  methods, the Norn test, the Schirmer test, the staining of the eye  surface with lissamine green. In addition, a questionnaire was  conducted on a modified OSDI questionnaire; there a section  characterizing the quality of vision (section B) was removed.Results.The analysis of the obtained data showed that in the study group there was less pronounced “dry eye” syndrome at 3,6,12  months after the operation. The maximum difference in the  indicators of the “dry eye” syndrome between the groups was at 3  and 6 months of the postoperative period. When evaluating corneal  subepithelial fibroplasia, maximum attention was paid to the  frequency and the intensity index. It was shown a significant  difference in the intensity of the haze between the study group and the control group by 26.1 % at 3 months, by 62.2 % at 6  months and by 65.3 % 12 months after the operation. Conclusion.Nonconservative therapy with sodium hyaluronate and  dexapanthenol in the early postoperative period and only sodium  hydrolurate allows to reduce the severity of the dry eye syndrome  after laser correction of hypermetropia and, as a result, to reduce  the intensity of haze development by 65.3 %, and its frequency on 11,5 %.

Postoperative pain scores and opioid consumption in opioid-dependent patients with cancer after intraoperative remifentanil analgesia: A prospective case-controlled study

2017 ◽  
Vol 13 (4) ◽  
pp. 221
Author(s):  
Cyrus Motamed, MD ◽  
Juliette Audibert, MD ◽  
Aline Albi-Feldzer, MD ◽  
Gaelle Bouroche, MD ◽  
Christian Jayr, MD, PhD
Keyword(s):  
Heart Rate ◽  
Postoperative Period ◽  
Opioid Therapy ◽  
Surgical Patients ◽  
Controlled Study ◽  
Control Group ◽  
Baseline Heart Rate ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Postoperative Morphine

Background: Opioid dependency is becoming increasingly common among surgical patients with cancer, and can lead to inadequate pain relief during the initial postoperative period. No guidelines are currently available for the management of perioperative and postoperative morphine administration in these patients. As a first approach, the authors assessed the opioid requirements of these patients during the early postoperative period.Methods: A group of 35 consecutive surgical patients with cancer on opioid therapy (opioid-dependent group) for cancer pain were compared to a matched group of 44 surgical opioid-naive patients (control group). All patients underwent major head and neck or abdominal surgery. The following parameters were recorded and compared: preoperative and postoperative morphine consumption, patient-controlled analgesia records and Visual Analog Scale scores, intraoperative remifentanil and desflurane consumption, Bispectral Index monitoring values, heart rate, and blood pressure.Results: Remifentanil requirements were significantly higher (1.4-fold) in the opioid-dependent group compared to the control group (p < 0.05). On postoperative day 1, morphine requirements were significantly higher in the opioid-dependent group (2.3-fold) compared to the control group (p < 0.05). Baseline heart rate was significantly higher in the opioid-dependent group and this difference remained significant during surgery, no significant difference in blood pressure was observed between the two groups.Conclusion: This study shows a 40 percent increase of intraoperative remifentanil requirements in opioid-dependent patients during cancer surgery. Morphine requirements during the postoperative period were increased by up to 140 percent.

scholarly journals A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

2021 ◽  
Vol 102 (3) ◽  
pp. 362-372
Author(s):  
I S Simutis ◽  
G A Boyarinov ◽  
M Yu Yuriev ◽  
D S Petrovsky ◽  
A I Kovalenko ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gas Exchange ◽  
Sodium Succinate ◽  
Intensive Therapy ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Study Group ◽  
Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

scholarly journals Comparative analysis of the results of computerized phonoenterography in patients with acute destructive appendicitis before surgery and in the postoperative period

2017 ◽  
Vol 25 (3) ◽  
pp. 469-475
Author(s):  
K. V. Philippova ◽  
O. V. Zaitsev
Keyword(s):  
Abdominal Pain ◽  
Comparative Analysis ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Spectral Power ◽  
Abdominal Cavity ◽  
Pain Syndrome ◽  
Acoustic Signals ◽  
Early Postoperative Period ◽  
Control Group

Using the method of computerized phonoenterography we made an analysis of motor-evacuation function of the gastrointestinal tract in 35 patients with acute destructive appendicitis before surgery and in the postoperative period and in 30 patients without abdominal pain syndrome and concomitant pathology of the organs of the abdominal cavity. The obtained results of computerized phonoenterography different in the group of patients with acute appendicitis before appendectomy in comparison with group of patients without acute abdominal pathology (control group). For patients after appendectomy statistically significant differences with the control group in the vast majority of bands wasn’t obtained. Given the fact that the densities of the spectral power of acoustic signals of the abdominal cavity to assess the motor-evacuation function of the intestine in these groups of patients, we showed a reduction of motor-evacuation function of the intestine in patients with acute destructive appendicitis before surgery in comparison with patients of control group and recover in the postoperative period. Thus, the method of computerized phonoenterography is advisable to apply for the diagnosis of lower motor function of the intestine in patients with acute appendicitis, and in the early postoperative period in patients with acute destructive appendicitis for monitoring recovery of intestinal motility.

scholarly journals Feasibility and Safely of Oral Rehydration Therapy before Upper Gastrointestinal Endoscopic Submucosal Dissection

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Yasutoshi Shiratori ◽  
Takashi Ikeya ◽  
Kenji Nakamura ◽  
Katsuyuki Fukuda
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Hospital Stay ◽  
Fluid Intake ◽  
Oral Rehydration Therapy ◽  
Control Group ◽  
Upper Gastrointestinal Endoscopy ◽  
Procedure Time ◽  
Oral Rehydration ◽  
Submucosal Dissection ◽  
Upper Gastrointestinal

Background/Aims. Preoperative oral rehydration therapy (PORT), often used before surgery, is rarely performed before endoscopy. Only a few reports of PORT before upper gastrointestinal endoscopy are available. This study is aimed at evaluating the safety and feasibility of PORT before upper gastrointestinal endoscopic submucosal dissection (ESD). Methods. We used alginade water (125 mL, Nestle Co., Kobe, Japan) for PORT. Alginade water is a flavored sports drink, which is palatable and promotes wound healing due to a high concentration of alginate. We conducted a single-center single-arm prospective feasibility study of PORT in 244 patients who underwent upper gastrointestinal ESD. The group wherein PORT was administered up to two hours before ESD (n=120) was compared with the historical control group (non-PORT group, n=120). We investigated the total fluid intake, hematocrit change, complications due to PORT, complications during ESD, ESD procedure time, and length of hospital stay in each group. Results. The average fluid intake in the PORT group was 462.6 mL. No complications were observed due to PORT and ESD, and significant differences in the ESD procedure time or hospital stay was not noted. Conclusion. PORT up to two hours before upper gastrointestinal ESD is feasible.

scholarly journals Effectiveness of the Use of Acupressure Wristband at Neiguan Point (P6) Towards Postoperative Nausea Vomiting (PONV) in Orthopedic Surgical Patients

2021 ◽  
Vol 8 (1) ◽  
pp. 31-38
Author(s):  
Putu Wira Kusuma Putra ◽  
I Kadek Agus Widiantara ◽  
AA Nara Kusuma
Keyword(s):  
Postoperative Nausea ◽  
Healing Process ◽  
Nausea And Vomiting ◽  
Wilcoxon Test ◽  
Electrolyte Imbalance ◽  
Surgical Patients ◽  
Control Group ◽  
Wound Healing Process ◽  
Research Subjects ◽  
Moderate Nausea

Postoperative nausea and vomiting (PONV) is one of the most common causes of patient discomfort after undergoing surgery. The emergence of PONV allows the emergence of various complications including dehydration, electrolyte imbalance, slowing the wound healing process, the emergence of problems related to nutritional fulfillment to pneumonia aspiration. Pharmacological treatment has been done but it has not been effective and there are side effects of drugs used so that we need a complementary therapy that works synergistically with antiemetic therapy, namely acupressure. This study aimed at determine the effectiveness of the use of acupressure wristband at neiguan point (p6) towards postoperative nausea vomiting (ponv) in orthopedic surgical patients at BIMC Hospital Kuta. The study design was a pre-experimental with non-randomized uncontrolled trial with pretest-posttest without control group design, with a total of 19 research subjects included in the inclusion criteria. The research instrument consisted of two questionnaires namely the patient information form and the RINVR questionnaire (Rhodes Index of Nausea Vomiting and Retching). The results showed that the incidence of PONV before being given an intervention was obtained by 12 people (63.2%) had mild nausea and vomiting 7 people (36, 8%) experience moderate nausea and vomiting. Whereas after being given the intervention obtained as many as 6 people (31.6%) did not experience nausea, vomiting, 12 people (63.2%) experienced mild nausea, and 1 (5.3%) experienced moderate nausea and vomiting. Wilcoxon test results showed there is the effect of the use of acupressure wristband at neiguan point (p6) towards postoperative nausea vomiting (PONV) in orthopedic surgical patients at BIMC Hospital Kuta

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