scholarly journals Expediency of abdominal drainage after operative delivery in severe preeclampsia

2020 ◽  
Vol 4 (3) ◽  
pp. 01-02
Author(s):  
V. A. Kramarsky ◽  
Protopopova N. V.
Keyword(s):  
Perfusion Pressure ◽  
Subsequent Development ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Severe Preeclampsia ◽  
Abdominal Pressure ◽  
Operative Delivery ◽  
Abdominal Drainage ◽  
Intraperitoneal Pressure ◽  
Abdominal Organs

One of the leading mechanisms for the development of severe preeclampsia in pregnant women is a decrease in perfusion pressure in the life-supporting organs, followed by the development of multiple organ failure. In recent years, there have been studies indicating the influence of intraperitoneal hypertension on the perfusion pressure of the pelvic and abdominal organs with the subsequent development of obstetric complications [ 4,2] according to the classification of JAN(2006), pregnancy is included in the list of conditions accompanied by an increase in intraperitoneal pressure. Thus, the prevention and treatment of increased intra-abdominal pressure in pathology accompanied by multiple organ dysfunction and insufficiency, which is observed in preeclampsia, is one of the important problems of modern medicine. The purpose of our study was to determine the feasibility of abdominal drainage during operative delivery for severe preeclampsia.

scholarly journals Prediction of kidney damage in the syndrome of intra-abdominal hypertension

2018 ◽  
Vol 22 (4) ◽  
pp. 669-673
Author(s):  
A.I. Suchodolia ◽  
K.Yu. Krenov ◽  
I.V. Loboda ◽  
V.M. Monastyrskiy
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Perfusion Pressure ◽  
Blood Pressure Measurement ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
Intraabdominal Pressure ◽  
Abdominal Pressure ◽  
Abdominal Hypertension ◽  
Abdominal Compartment

The syndrome of intra-abdominal hypertension and abdominal compartment syndrome can complicate the course of many surgical abdominal diseases and lead to the development and progression of multiple organ failure. In particular, impaired renal blood flow is an early and significant pathogenetic link of thanatogenesis in such patients. Mortality at an abdominal compartment syndrome reaches very significant figures — 42–68% and without treatment approaches 100%. The purpose of the work is to predict renal failure in patients with intra-abdominal hypertension syndrome and abdominal compartment syndrome. A survey of 40 patients with acute surgical abdominal pathology and signs of intra-abdominal hypertension was performed. Blood pressure measurement was performed according to the recommendations of the conciliation commission on the problem of intra-abdominal hypertension syndrome (SIGA) from 2004. Also, the calculation of perfusion pressure of the abdominal cavity was performed, which is the difference between mean arterial pressure and intraabdominal pressure. The level of perfusion pressure is less than 60 mm Hg. Art. correlates with survival of patients. Determination of cystatin C was performed in the first 48 hours after hospitalization of patients in VAIT. The calculation of the results was carried out according to the standard t-criterion calculation formulas in the Exel tables. It was found that of 40 patients died — 13, and survived — 27. The reliable difference between the indicators of intra-abdominal pressure in surviving and deceased patients was acquired only at the end of the third day of observation, whereas the abdominal perfusion pressure indices significantly differed already in the first day. In the analysis of cytatine C in surviving patients, the biomarker values were 1,299±0.827, whereas in those who died 1,882±0.828, the statistical deviation was significant at p≤0.05. Thus: the cytosine C score, in combination with the dynamics of abdominal perfusion tick, can be considered as a marker that may predict the development of renal insufficiency in patients with SIGA-AKS.

Clinical case of periostitis in pregnant women complicated by sepsis

2020 ◽  
pp. 61-63
Author(s):  
S. Sh. Kakvaeva ◽  
M. A. Magomedova ◽  
A. N. Dzhalilova
Keyword(s):  
Pregnant Woman ◽  
Multiple Organ Failure ◽  
Pregnant Women ◽  
Organ Failure ◽  
Clinical Case ◽  
Clinical Observation ◽  
Infectious Agent ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Number Of Patients

One of the most serious problems of modern medicine is sepsis. The number of patients undergoing this complication is 20–30 million (WHO) annually and has no tendency to decrease. Sepsis is characterized by severe multiple organ failure due to a violation of the response of the macroorganism to an infectious agent. Moreover, it is dangerous with high mortality. Sepsis often develops in patients with immunodeficiency conditions, which primarily include pregnant women. The article presents a clinical observation of a case of periostitis in a pregnant woman complicated by a septic state.

Nanoantioxidant/Antioxidant therapy in 2019-nCoV: A new approach to reactive oxygen species mechanisms

2021 ◽  
Vol 16 ◽  
Author(s):  
Ali Fathijouzdani ◽  
Rezvan Heidarimoghadam ◽  
Maryam Hazhirkamal ◽  
Akram Ranjbar
Keyword(s):  
Reactive Oxygen Species ◽  
High Performance ◽  
Membrane Lipids ◽  
Reactive Oxygen ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Antioxidant Therapy ◽  
Oxygen Species ◽  
Medicinal Uses ◽  
Organ Failures

: The COVID-19 pandemic has caused serious concerns for people around the world. The COVID-19 is associated with respiratory failure, generation of reactive oxygen species (ROS), and the lack of antioxidants among patients. Specified ROS levels have an essential role as an adjuster of immunological responses and virus cleaners. Still, excessive ROS will oxidize membrane lipids and cellular proteins and quickly destroy virus-infected cells. It can also adversely damage normal cells in the lungs and even the heart, resulting in multiple organ failures. Given the above, a highly potent antioxidant therapy can be offered to reduce cardiac loss due to COVID-19. In modern medicine, nanoparticles containing antioxidants can be used as a high-performance therapy in reducing oxidative stress in the prevention and treatment of infectious diseases. It can provide a free and interactive tool to determine whether antioxidants & nanoantioxidants can be administered for COVID-19. More research and studies are needed to investigate and make definitive opinions about their medicinal uses.

The development of complications of community-acquired pneumonia of a severe course against the background of parenteral poisoning with a mixture of narcotic substances

2020 ◽  
Vol 22 (4) ◽  
pp. 59-66
Author(s):  
I. N. Gayvoronskiy ◽  
Yu. Sh Khalimov ◽  
S. V. Gayduk ◽  
T. V. Lyanginen ◽  
A. S. Partsernyak ◽  
...  
Keyword(s):  
Young Patient ◽  
Severe Pneumonia ◽  
Modern Medicine ◽  
Multiple Organ ◽  
Community Acquired Pneumonia ◽  
High Tech ◽  
Antibacterial Drug ◽  
Toxic Substances ◽  
Military Medical Academy ◽  
Vital Functions

Doctors of the clinic of military field therapy of the Military Medical Academy named after S.M. Kirov, the experience of successful treatment of community-acquired pneumonia of a severe course with the development of complications against the background of parenteral poisoning with a mixture of narcotic substances in a young patient was obtained. An important feature in the treatment tactics of this patient was the impossibility of antidote therapy with naloxone (a competitive opioid receptor antagonist) due to the presence of signs of respiratory failure, hypoxic and tissue hypoxia. As a result of the systemic treatment in the young patient, it was possible to arrest a significant septic process and multiple organ disorders of vital functions that arose due to severe endotoxic damage. An important factor in ensuring the survival of patients with severe pneumonia against a background of immune depression due to the use of toxic substances is the rational selection of an antibacterial drug or combinations of antibiotic therapy, constant monitoring of vital functions with prompt correction of emerging disorders, as well as the need to use modern high-tech treatment methods. This example clearly shows the need for urgent, systematic and complex intensive care in a number of manipulations performed in people with complications of community-acquired pneumonia, suffering from drug addiction. In addition, it is important to minimize the time from the detection of a poisoned person to the start of emergency measures, as well as their further evacuation to the stage of providing qualified and specialized medical care. Thus, modern medicine continues to face an extremely urgent problem of drug use by the population. A significant number of people with drug dependence syndrome do not seek medical help for various reasons, continuing to use illegal drugs.

scholarly journals The body water compartments in women with preeclampsia in the peripartum period

2021 ◽  
Vol 17 (7) ◽  
pp. 20-23
Author(s):  
O.M. Klygunenko ◽  
O.О. Marzan
Keyword(s):  
Pregnant Women ◽  
Extracellular Fluid ◽  
Subsequent Development ◽  
Bioelectrical Impedance ◽  
Body Water ◽  
Fluid Volume ◽  
The Body ◽  
Severe Preeclampsia ◽  
Water Compartments ◽  
Total Fluid

Background. Preeclampsia in pregnant women is a threatening condition that causes significant water imbalance, particularly hyperhydration of the extracellular fluid compartment. The condition is the result of the main pathogenetic processes — endothelial dysfunction and the subsequent development of hypoproteinemia. The changes can be detected by measuring body water compartments. Objective: to investigate the effect of a standard intensive care on the body water compartment indicators in women with moderate to severe preeclampsia. Materials and methods. Ninety patients divided into three groups were examined: non-pregnant healthy women, pregnant women with healthy pregnancy, and women whose pregnancy was complicated by moderate to severe preeclampsia. Body water compartments were measured by non-invasive bioelectrical impedance analysis. Results. Pregnancy complicated by preeclampsia is accompanied by an increase in total fluid volume at 34–40 weeks due to an increase in both the extracellular and intracellular water compartments, but with a predominance of the extracellular compartment. By the 7th day of the postpartum period, there is a tendency to decrease the total fluid volume, however, interstitial and intracellular edema can be still observed. Conclusions. The results of the bioelectrical impe-dance analysis of the body water compartments show that additional methods of treatment are needed to correct the body water compartments in women with preeclampsia.

scholarly journals Intra-abdominal pressure monitoring in postoperative period in patients with diffuse peritonitis

2015 ◽  
Vol 96 (2) ◽  
pp. 214-219 ◽  
Author(s):  
E K Salakhov ◽  
K K Salakhov
Keyword(s):  
Organ Failure ◽  
Organ Dysfunction ◽  
Dynamic Assessment ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Abdominal Pressure ◽  
Diffuse Peritonitis ◽  
Pressure Monitoring ◽  
Systemic Complications ◽  
Functional Changes

Epidemiology, etiology, pathologic and morphologic changes associated with increased intra-abdominal pressure are described. The most common ways of its measuring and monitoring are presented. Intra-abdominal pressure is increased by more than 15 mm Hg in patients with diffuse peritonitis. Increased intra-abdominal pressure is associated with the disease severity: the higher the intra-abdominal pressure, the more severe is the disease. If intra-abdominal pressure is increased over 20 mm Hg, treatment strategy depends on the signs of organ failure. In the absence of organ failure, intra-abdominal pressure should be monitored every 4 hours as long as the patient is in critical condition. Intra-abdominal pressure monitoring in case of peritonitis must be attributed to the mandatory manipulation, as pressure changes precede the clinical manifestations of intra-abdominal complications. Measurement of intra-abdominal pressure allows to detect the early signs of multiple organ failure, which is essential for the correction of systemic complications in pancreatogenic peritonitis. In this case, monitoring of intra-abdominal pressure in diffuse postoperative peritonitis should be considered only as a screening test for assessing of the organ dysfunction severity, as the development of multiple organ dysfunction syndrome involves complex pathophysiological mechanisms. Predictions that are more accurate can be made using such integrated indicators as APACHE II (Acute Physiology And Chronic Health Evaluation scale, which is used for assessing various acute and chronic diseases), SAPS (Simplified Acute Physiology Score - a simplified scale for acute functional changes assessment), SOFA (Sepsis-related Organ Failure Assessments Score - scale for dynamic assessment of organ failure in sepsis), MPI (Mannheim Peritonitis Index) scales.

scholarly journals Results Of Treatment Of Acute Diffuse Purulent Peritonitis Using Laparostomy

2020 ◽  
Vol 02 (11) ◽  
pp. 66-71
Author(s):  
S. A. Ruziboev ◽  
◽  
A. A. Avazov ◽  
Sh. Kh. Sattarov ◽  
A. N. Elmuradov ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
The Body ◽  
Abdominal Pressure ◽  
Results Of Treatment ◽  
Abdominal Hypertension ◽  
Purulent Peritonitis ◽  
Intractable Problems ◽  
Cause Of Deaths

Currently, despite significant achievements in the field of surgery, anesthesiology and resuscitation, the results of treatment of patients with advanced purulent peritonitis remain one of the most intractable problems, almost every sixth patient with acute surgical diseases and injuries of the abdominal cavity is admitted to medical institutions with peritonitis [1,3] Common peritonitis in 17-29% complicates the course of most acute surgical diseases and is the main cause of deaths in surgical hospitals [3,7]. Lethality in advanced peritonitis remains extremely high and reaches 20-39% [1,2,4,5]. In recent decades, great importance has been attached to recording intra-abdominal pressure in purulent pathology of the abdominal cavity. It was found that intra-abdominal hypertension occurs in every third patient with acute surgical pathology and negatively affects the functioning of all organs and systems of the body [1,6,8]. Pathological changes that occur with acute and excessive increase in intra-abdominal pressure (IAP) are manifestations of abdominal compartment syndrome (ACS) with disorders of the cardiovascular system; urinary disorders, disorders of perfusion of internal organs and the development of intestinal ischemia, which contributes to bacterial translocation and endogenous infection [2,7,8]. Ischemic blood flow disorders of the splanchnic zone are fraught with the development of bacterial translocation and the development of systemic inflammatory response syndrome and multiple organ failure (PON). Unsatisfactoriness with such results gave rise to a fundamentally different approach to the surgical treatment of common forms of peritonitis-the introduction of an open abdominal management method based on the ideas of I. Mikulich (1881), Jean-Louis Faure (1928), N. S. Makoch (1984) and D. Steinberg (1979).

scholarly journals Intracoelomic pressure and coelomic perfusion pressure in healthy tegus (Salvator merianae)

2018 ◽  
Vol 48 (2) ◽  
Author(s):  
André Nicolai Elias da Silva ◽  
Thais Feres Bressan ◽  
Adriano Bonfim Carregaro
Keyword(s):  
Water Column ◽  
Pressure Transducer ◽  
Perfusion Pressure ◽  
Pressure Method ◽  
Column System ◽  
Column Method ◽  
Abdominal Organs ◽  
Significant Difference ◽  
Consequent Reduction ◽  
The Mean

ABSTRACT: The evaluation of intracoelomic pressure is very important, as many diseases can culminate with an increase in intracoelomic pressure and a consequent reduction in perfusion of the abdominal organs. The aim of this study was to measure the intracoelomic pressure and coelomic perfusion pressure in tegus (Salvator merianae). Twelve healthy tegus without sexual distinctions, weighing 1.64±0.39kg, were enrolled in this study. Intracoelomic pressure was measured using two methods: a handmade water column system and a pressure transducer connected to a multiparameter monitor. Coelomic perfusion pressure was determined by subtracting the intracoelomic pressure from the mean arterial pressure, which was measured using an oscillometric method. Intracoelomic pressure was 0mmHg (range, 0 - 0.5) according to the water column method and 2mmHg (range, 0 - 2.0) according to the pressure transducer. Coelomic perfusion pressure was 76mmHg (range, 62 - 105) according to the water column system and 82mmHg (range, 57 - 93) according to the pressure transducer. No significant difference was observed between the values obtained by the different measurement methods. Intracoelomic pressure value reported in this study might be useful in tegus, but the coelomic perfusion pressure should be used with caution, considering the blood pressure method that was used.

Preformed Silastic Silos in the Management of Necrotizing Enterocolitis

2009 ◽  
Vol 75 (2) ◽  
pp. 172-174
Author(s):  
Amy B. Moore ◽  
Don K. Nakayama
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Necrotizing Enterocolitis ◽  
Clinical Status ◽  
Intestinal Resection ◽  
Multiple Organ ◽  
Clinical Syndrome ◽  
Abdominal Pressure ◽  
Definitive Surgery ◽  
Abdominal Compartment

Necrotizing enterocolitis (NEC) is sometimes complicated by abdominal compartment syndrome, a clinical syndrome characterized by multiple organ dysfunction that arises as a consequence of increased intra-abdominal pressure. The evolving clinical picture of NEC sometimes requires “second-look” operations done after initial abdominal exploration to more accurately gauge the optimal extent of surgery. Placing intestines in a preformed, spring-loaded, transparent Silastic silo, traditionally used in the staged treatment of gastroschisis, addresses both situations: decompression of the abdomen and allowing periodic inspection of the intestines. Standard silos were used in three infants with advanced (Bell Class 3) NEC without perforation before definitive surgery. Clinical indices and laboratory values were recorded during the patients’ hospital courses. All three infants had extensive areas of intestinal ischemia and necrosis. FiO2, acidosis, and urinary output remained stable or improved in two patients. Silo placement corrected abdominal compartment syndrome in the third patient. Intestinal resection was required in all infants, each achieving surgical resolution of NEC. Two patients ultimately died from respiratory and neurologic complications. Application of a silo addresses abdominal compartment syndrome as a complication of NEC and allows continual inspection of the intestines. Physiological indices may improve the patient's overall clinical status.

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