scholarly journals ISSUES OF TREATMENT OF SECONDARY HYPERPARATHYROIDISM WITH THE EYES OF AN ANESTHESIOLOGIST. EXPERIENCE OF PERIOPERATIVE ANESTHESIOLOGICAL SUPPORT AND INTENSIVE THERAPY IN PARATHYROID SURGERY

2021 ◽  
Vol 2 (16) ◽  
pp. 4-16
Author(s):  
A.I. Denysenko ◽  
V.I. Cherniy ◽  
R.P. Tkachenko
Keyword(s):  
Chronic Kidney Disease ◽  
Intensive Care ◽  
Secondary Hyperparathyroidism ◽  
Anesthetic Management ◽  
Intensive Therapy ◽  
Parathyroid Surgery ◽  
Preoperative Preparation ◽  
Careful Monitoring ◽  
The Third ◽  
Hungry Bone

Secondary hyperparathyroidism (SHPT) affects a majority of patients with chronic kidney disease (CKD) in the third and above stages with manifestations of chronic renal failure (CRF), especially in patients undergoing hemodialysis. Despite the temporary effects obtained from taking calcimimetics, there is no significant breakthrough in the treatment of SHPT, and most of the patients require parathyroid surgery (PTS). This review describes the main pathophysiological changes in SHPT, their correction, summarizes the indications for PTS, reflects preoperative preparation, anesthetic management, perioperative intensive care, and possible complications associated with SHPT and CRF. The experience of treating 214 patients with SHPT, 237 PTS (23 in connection with relapse of SHPT), algorithm of examination, preoperative preparation, anesthetic management and perioperative intensive care are presented. In the postoperative period, patients are at risk of severe hypocalcemia and hungry bone syndrome, which require careful monitoring and calcium replenishment.

scholarly journals Preeclampsia. Eclampsia. Anesthesia and intensive care in childbirth and the puerperium. Review

2020 ◽  
pp. 41-52
Author(s):  
Natalia Yu. Pylaeva ◽  
E. M Shifman ◽  
A. V Kulikov ◽  
N. V Artymuk ◽  
T. E Belokrinitskaya ◽  
...  
Keyword(s):  
Intensive Care ◽  
Cesarean Section ◽  
Anesthetic Management ◽  
Intensive Therapy ◽  
Fetal Outcome ◽  
Diagnosis And Treatment ◽  
Evidence Based ◽  
Hypertensive Disorders ◽  
Interdisciplinary Approaches

The review discusses the possibilities of predicting preeclampsia and its complications, modern criteria for the diagnosis of gestational hypertensive disorders and tactics of their intensive therapy. Particular attention was devoted on the anesthetic management for cesarean section in a woman with preeclampsia and its complications. The information proposed in the review makes it possible to define a unified terminology and form unified evidence-based interdisciplinary approaches to the diagnosis and treatment of preeclampsia, which will improve maternal and fetal outcome.

scholarly journals Application of indirect electrochemical oxidation of blood in a complex of intensive therapy in children with urolithiasis complicated with chronic kidney disease

2020 ◽  
pp. 92-93
Author(s):  
T. Ikromov ◽  
A. Abdulaliev
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Electrochemical Oxidation ◽  
Sodium Hypochlorite ◽  
Intensive Therapy ◽  
Venous Blood ◽  
Mixed Venous Blood ◽  
Preoperative Preparation ◽  
Arterial Blood ◽  
Sodium Hypochloride

Objective. To study the efficacy of sodium hypochlorite in children with urolithiasis complicated by chronic kidney disease (CKD). Materials and methods. The results of the use of sodium hypochlorite 0.03-0.06 % in the pre- and postoperative period in 20 patients with urolithiasis complicated by stage IV CKD were analyzed. The indices of endogenous intoxication in venous cubital blood (VСK), mixed venous blood (MVB) flowing to the lungs and arterial blood (AB) flowing from the lungs were studied. Indirect electrochemical oxidation of blood (IEOB) was carried out in 20 patients with stage. For children under 12 years old, we used 0.03 %, and for the older age group from 12 to 18 years old ‒ 0.06 %, the volume of the injected solution did not exceed 1/10 of the patient’s CBV per infusion, at a rate of 40-60 drops/min. We have studied the use of sodium hypochloride (NaCIO) as a component of complex intensive care (CIC) in preoperative preparation in children with urolithiasis complicated by CKD and the effect of sodium hypochloride on detoxification lung function (DLF). Results. There was a significant increase in low molecular weight toxic substances (creatinine, calurea), average mass molecules (AMM), lipid peroxidized products, oligopeptides of a high necrotic body mass (NB), circulating immune complex (CIC), integral indicators of toxicity leukocyte index of intoxication and index of intoxication, as well as a decrease in antioxidant protection, more pronounced at sub- and decompensated stages of DLF impairment in the examined group of patients before treatment in the basin of VKK, VCK and AB. In 7 (35.0 %) patients ‒ 1b compensated, in 13 (65.0 %) ‒ subcompensated stage of impairment. Conclusions. CIC with the use of IEOB in the preoperative preparation by infusion of sodium hypochlorite in this subgroup of patients significantly improved DLF in relation to NB, CIC and high-weight oligopeptides. The use of NaCIO leads to inactivation of the entire spectrum of AMM and large toxic molecular compounds fixed on the membranes of blood corpuscles, and also, ensures the transformation of hydrophobic metabolites into hydrophilic ones, which are actively excreted by excretory organs.

Limitation and withdrawal of intensive therapy at the end of life: Practices in intensive care units in Mumbai, India*

2005 ◽  
Vol 33 (6) ◽  
pp. 1272-1275 ◽  
Author(s):  
Farhad Kapadia ◽  
Manoj Singh ◽  
Jigeeshu Divatia ◽  
Priya Vaidyanathan ◽  
Farokh E. Udwadia ◽  
...  
Keyword(s):  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Intensive Therapy

scholarly journals Development of a Prognostic Model to Predict Mortality after Traumatic Brain Injury in Intensive Care Setting in a Developing Country

2021 ◽  
Vol 12 (02) ◽  
pp. 368-375
Author(s):  
Mini Jayan ◽  
Dhaval Shukla ◽  
Bhagavatula Indira Devi ◽  
Dhananjaya I. Bhat ◽  
Subhas K. Konar
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Prognostic Model ◽  
Third Ventricle ◽  
The Third ◽  
Scan Data ◽  
Gcs Score ◽  
Basal Cisterns

Abstract Objectives We aimed to develop a prognostic model for the prediction of in-hospital mortality in patients with traumatic brain injury (TBI) admitted to the neurosurgery intensive care unit (ICU) of our institute. Materials and Methods The clinical and computed tomography scan data of consecutive patients admitted after a diagnosis TBI in ICU were reviewed. Construction of the model was done by using all the variables of Corticosteroid Randomization after Significant Head Injury and International Mission on Prognosis and Analysis of Clinical Trials in TBI models. The endpoint was in-hospital mortality. Results A total of 243 patients with TBI were admitted to ICU during the study period. The in-hospital mortality was 15.3%. On multivariate analysis, the Glasgow coma scale (GCS) at admission, hypoxia, hypotension, and obliteration of the third ventricle/basal cisterns were significantly associated with mortality. Patients with hypoxia had eight times, with hypotensions 22 times, and with obliteration of the third ventricle/basal cisterns three times more chance of death. The TBI score was developed as a sum of individual points assigned as follows: GCS score 3 to 4 (+2 points), 5 to 12 (+1), hypoxia (+1), hypotension (+1), and obliteration third ventricle/basal cistern (+1). The mortality was 0% for a score of “0” and 85% for a score of “4.” Conclusion The outcome of patients treated in ICU was based on common admission variables. A simple clinical grading score allows risk stratification of patients with TBI admitted in ICU.

Effect of parathyroidectomy on bone tissue biomarkers and body composition in patients with chronic kidney disease and secondary hyperparathyroidism

2021 ◽  
Author(s):  
Flavia Ramos de Siqueira ◽  
Karin Carneiro de Oliveira ◽  
Wagner Vasques Dominguez ◽  
César Augusto Madid Truyts ◽  
Rosa Maria Affonso Moysés ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Bone Tissue ◽  
Tissue Biomarkers

scholarly journals POS-470 CARDIAC BIOMARKERS AS A PREDICTOR OF MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS IN THE INTENSIVE CARE UNIT

2021 ◽  
Vol 6 (4) ◽  
pp. S204
Author(s):  
M.R. BEHERA ◽  
N. Prasad ◽  
A. Bhawane ◽  
A. Kaul ◽  
D. Bhadauria ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Kidney Disease ◽  
Cardiac Biomarkers
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