Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-66-77
A. V. Byndiu, M. Orlov, M. V. Yelieinyk, S. O. Lytvak
Objective ‒ to analyze the effectiveness of intraoperative contact Doppler, repositioning the clip on the aneurysm and pilot clipping of the cervical aneurysm as the main methods of prevention of inadequate clipping of the cervical aneurysm in patients with intraoperative rupture of aneurysms. Materials and methods. Due to the use of intraoperative contact ultrasound Doppler control it was possible to avoid inadequate clipping of cerebral aneurysms in 16 cases, of which in 12 (75.00 %) cases ‒ incomplete clipping of cerebral aneurysms, in 3 (18.75 %) cases ‒ compression of the aneurysm’s artery-carrier, in 1 (6.25 %) case ‒ slipping of the clip with cerebral aneurysm. Perioperative examination of patients, in addition to intraoperative contact ultrasound Doppler control of radical clipping cerebral aneurysms, included clinical and neurological examination, computed tomography of the brain, cerebral angiography, ultrasound duplex scanning of the main vessels of the head and neck. In the analysis of observations of inadequate clipping of cerebral aneurysms (according to contact intraoperative Doppler), the following parameters were considered: size, location of cerebral aneurysm, timing of surgery after subarachnoid hemorrhage, anatomical forms of intracranial hemorrhage. Results. The purpose of the operations was to devascularize saccular aneurysm to prevent its re-rupture, to reduce the mass effect caused by intracerebral hematoma; reduction of intracranial pressure, rehabilitation of basal cisterns of the brain., But in the postoperative period there was a tendency to worsen the results of treatment, the appearance of focal neurological symptoms on the background of cerebral vasospasm with subsequent development of ischemic complications in patients with III‒V degree according to the Hunt‒Hess Scale on admission, in patients with prolonged temporary clipping of the cerebral aneurysm-artery and prolonged mechanical manipulation of the cerebral arteries and cerebral aneurysm. It should be noted that all patients in our sample, with complicated clipping of cerebral saccular aneurysms, had an intraoperative rupture of the MA, which complicated the process of clipping the saccular aneurysm and prolonged the time of surgery and was one of the inducers of postoperative aggravating consequences. There was a tendency to worsen the results of treatment in patients with III–IV degree according to the Hunt‒Hess Scale. Thus, patients with 1 point according to the Glasgow Outcome Scale, there were 2 patients who had II and III degrees according to Hunt–Hess Scale at hospitalization; among discharged patients with 3 point according to Glasgow Outcome Scale was dominated by patients from the second century according to Hunt‒Hess Scale at hospitalization, among patients with 5 point according to Glasgow Outcome Scale dominated patients who had I degree according to the Hunt‒Hess Scale at hospitalization. Conclusions. Inadequate clipping of the cervix cerebral an
{"title":"Prevention of complication in cerebral aneurysm microsurgery, associated with their non-radical clipping","authors":"A. V. Byndiu, M. Orlov, M. V. Yelieinyk, S. O. Lytvak","doi":"10.26683/2304-9359-2020-3(33)-66-77","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-66-77","url":null,"abstract":"Objective ‒ to analyze the effectiveness of intraoperative contact Doppler, repositioning the clip on the aneurysm and pilot clipping of the cervical aneurysm as the main methods of prevention of inadequate clipping of the cervical aneurysm in patients with intraoperative rupture of aneurysms. Materials and methods. Due to the use of intraoperative contact ultrasound Doppler control it was possible to avoid inadequate clipping of cerebral aneurysms in 16 cases, of which in 12 (75.00 %) cases ‒ incomplete clipping of cerebral aneurysms, in 3 (18.75 %) cases ‒ compression of the aneurysm’s artery-carrier, in 1 (6.25 %) case ‒ slipping of the clip with cerebral aneurysm. Perioperative examination of patients, in addition to intraoperative contact ultrasound Doppler control of radical clipping cerebral aneurysms, included clinical and neurological examination, computed tomography of the brain, cerebral angiography, ultrasound duplex scanning of the main vessels of the head and neck. In the analysis of observations of inadequate clipping of cerebral aneurysms (according to contact intraoperative Doppler), the following parameters were considered: size, location of cerebral aneurysm, timing of surgery after subarachnoid hemorrhage, anatomical forms of intracranial hemorrhage. Results. The purpose of the operations was to devascularize saccular aneurysm to prevent its re-rupture, to reduce the mass effect caused by intracerebral hematoma; reduction of intracranial pressure, rehabilitation of basal cisterns of the brain., But in the postoperative period there was a tendency to worsen the results of treatment, the appearance of focal neurological symptoms on the background of cerebral vasospasm with subsequent development of ischemic complications in patients with III‒V degree according to the Hunt‒Hess Scale on admission, in patients with prolonged temporary clipping of the cerebral aneurysm-artery and prolonged mechanical manipulation of the cerebral arteries and cerebral aneurysm. It should be noted that all patients in our sample, with complicated clipping of cerebral saccular aneurysms, had an intraoperative rupture of the MA, which complicated the process of clipping the saccular aneurysm and prolonged the time of surgery and was one of the inducers of postoperative aggravating consequences. There was a tendency to worsen the results of treatment in patients with III–IV degree according to the Hunt‒Hess Scale. Thus, patients with 1 point according to the Glasgow Outcome Scale, there were 2 patients who had II and III degrees according to Hunt–Hess Scale at hospitalization; among discharged patients with 3 point according to Glasgow Outcome Scale was dominated by patients from the second century according to Hunt‒Hess Scale at hospitalization, among patients with 5 point according to Glasgow Outcome Scale dominated patients who had I degree according to the Hunt‒Hess Scale at hospitalization. Conclusions. Inadequate clipping of the cervix cerebral an","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45593801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-83-93
E. Pedachenko, V. Moroz, V. Yatsyk, U. I. Malyar, L. Liubich, D. Egorova
Stroke is a global medical and socio-economic problem and a great demand for alternative therapies, the leading one being stem cell (SC) therapy. Pathogenetic processes in ischemic stroke (II) trigger the mechanisms of necrotic and apoptotic death of neurons with the formation of the central infarct zone («core of ischemia») and the ischemic «penumbra» zone; the severity and reversibility of the injury directly depends on the duration of ischemia. In parallel with pathogenetic processes, endogenous neurogenesis occurs – the proliferation of neurogenic stem and progenitor cells (NSC/NPC) and their migration into the ischemic focus; however, most NSCs and newly formed neurons undergo apoptosis and recovery of lost functions does not occur. Significant efforts are being made to find ways to control neurogenesis, in particular through the transplantation of exogenous SCs. The main factors preventing the use of SCs in humans are moral, ethical, religious and legal aspects related to the source and method of obtaining cells, as well as possible immunocompromised complications due to incompatibility of donor cells with the recipient of the main histocompatibility complex antigens. The safest is the use of autologous SCs (the patient’s own cells), as it does not require the use of immunosuppressive protocols. Due to the relative safety and ease of production, the most common are multipotent mesenchymal stem cells (MSCs), namely MSCs of the bone marrow (BM). Numerous preclinical studies in experimental animals with modeled II, as well as clinical trials conducted over the past 15 years, have shown the safety and feasibility of transplantation of autologous MSCs in patients with severe neurological deficits after II. Two different approaches to the use of MSCs are discussed: neuroprotection in the acute phase and neurorestoration in the chronic phase II. Proposals are currently being developed for phase II/III clinical trials in acute and chronic stroke using BM MSCs, the results of which will form the basis for certified standardized II treatment protocols.
{"title":"Autologous cell using for the restoration of functional defects in patients with ischemic cerebrovascular accident","authors":"E. Pedachenko, V. Moroz, V. Yatsyk, U. I. Malyar, L. Liubich, D. Egorova","doi":"10.26683/2304-9359-2020-3(33)-83-93","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-83-93","url":null,"abstract":"Stroke is a global medical and socio-economic problem and a great demand for alternative therapies, the leading one being stem cell (SC) therapy. Pathogenetic processes in ischemic stroke (II) trigger the mechanisms of necrotic and apoptotic death of neurons with the formation of the central infarct zone («core of ischemia») and the ischemic «penumbra» zone; the severity and reversibility of the injury directly depends on the duration of ischemia. In parallel with pathogenetic processes, endogenous neurogenesis occurs – the proliferation of neurogenic stem and progenitor cells (NSC/NPC) and their migration into the ischemic focus; however, most NSCs and newly formed neurons undergo apoptosis and recovery of lost functions does not occur. Significant efforts are being made to find ways to control neurogenesis, in particular through the transplantation of exogenous SCs. The main factors preventing the use of SCs in humans are moral, ethical, religious and legal aspects related to the source and method of obtaining cells, as well as possible immunocompromised complications due to incompatibility of donor cells with the recipient of the main histocompatibility complex antigens. The safest is the use of autologous SCs (the patient’s own cells), as it does not require the use of immunosuppressive protocols. Due to the relative safety and ease of production, the most common are multipotent mesenchymal stem cells (MSCs), namely MSCs of the bone marrow (BM). Numerous preclinical studies in experimental animals with modeled II, as well as clinical trials conducted over the past 15 years, have shown the safety and feasibility of transplantation of autologous MSCs in patients with severe neurological deficits after II. Two different approaches to the use of MSCs are discussed: neuroprotection in the acute phase and neurorestoration in the chronic phase II. Proposals are currently being developed for phase II/III clinical trials in acute and chronic stroke using BM MSCs, the results of which will form the basis for certified standardized II treatment protocols.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43139157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-29-38
Y. Cherednichenko, L. Dzyak, E. S. Tsurkalenko
Objective ‒ to evaluate the possibility of endovascular embolization using non-adhesion of liquid embolic agents as monotherapy for the treatment of cerebral arteriovenous malformations (AVM), its reliability and safety.Materials and methods. examination and gradual endovascular treatment of 64 patients (120 sessions) using non-adhesive liquid embolic agents. Patients were divided into two groups: with ruptured AVM (n = 43) and with unruptured (n = 21). In all cases of unruptured AVM, signs indicating an increased risk of rupture of the AVM were verified.Results. the average decrease in volume after embolization was 79.5 % (up to 50 % ‒ in 7 cases, 50‒75 % ‒ in 14, 75‒99 % ‒ in 29). Complete exclusion of AVM was achieved in 14 (22 %) patients. On average, 2–3 feeders were embolized on the AVM to achieve such results. It was found that the number of feeders was directly proportional to the number of sessions required. Malformations of small size (up to 3 cm) often managed to close in one session. Clinically significant deficiency (2 on the modified Rankin scale) after embolization was found in 2 (3 %) patients. The deficit regressed within 7 days. The angiographic frequency of complete obliteration of AVM at the end of all embolization procedures was 22 % (14 AVM).Conclusions. knowledge of the angioarchitectural characteristics of AVM, which are suitable for the treatment with liquid embolic agents, and their careful selection allow to achieve a high frequency of occlusion with a low frequency of complications. The use of superselective intranidal or perinidal positions of the catheter, slow controlled injections that protect the draining veins, the gradual embolization make the therapy safer.
{"title":"Experience of intracranial arteriovenous malformations endovascular treatment with advanced techniques and non-adhesive liquid embolic agents using","authors":"Y. Cherednichenko, L. Dzyak, E. S. Tsurkalenko","doi":"10.26683/2304-9359-2020-3(33)-29-38","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-29-38","url":null,"abstract":"Objective ‒ to evaluate the possibility of endovascular embolization using non-adhesion of liquid embolic agents as monotherapy for the treatment of cerebral arteriovenous malformations (AVM), its reliability and safety.Materials and methods. examination and gradual endovascular treatment of 64 patients (120 sessions) using non-adhesive liquid embolic agents. Patients were divided into two groups: with ruptured AVM (n = 43) and with unruptured (n = 21). In all cases of unruptured AVM, signs indicating an increased risk of rupture of the AVM were verified.Results. the average decrease in volume after embolization was 79.5 % (up to 50 % ‒ in 7 cases, 50‒75 % ‒ in 14, 75‒99 % ‒ in 29). Complete exclusion of AVM was achieved in 14 (22 %) patients. On average, 2–3 feeders were embolized on the AVM to achieve such results. It was found that the number of feeders was directly proportional to the number of sessions required. Malformations of small size (up to 3 cm) often managed to close in one session. Clinically significant deficiency (2 on the modified Rankin scale) after embolization was found in 2 (3 %) patients. The deficit regressed within 7 days. The angiographic frequency of complete obliteration of AVM at the end of all embolization procedures was 22 % (14 AVM).Conclusions. knowledge of the angioarchitectural characteristics of AVM, which are suitable for the treatment with liquid embolic agents, and their careful selection allow to achieve a high frequency of occlusion with a low frequency of complications. The use of superselective intranidal or perinidal positions of the catheter, slow controlled injections that protect the draining veins, the gradual embolization make the therapy safer.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41875389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-4(34)-82-94
N. Turchina, T. Cherenko, V. Chernyak, L. Bondar
Objective ‒ to mark the quantity of herpes and flu infection detection of the none-stabil and stabil atherosclerotic (AS) plaques in patients with ischemic stroke (IS)/TIA and with the progressing AS and in the anamnesis after carotid endarterectomy.Materials and methods. 103 patients with IS/TIA after carotid endarterectomy were examined: 67 males 42‒82 years old (average age ‒ 66,1±1,4 years), 36 females 44‒81 years old (average age ‒ 63,0±1,3 years). Average age ‒ 65,1± 0,9 year. We examined the width of intima-media complex, presence of AS plaques, their constitution.Results. Among all viruses investigated with transfection and polymerase chain reaction in AS plaques and blood after carotid endarterectomy (HSV1,2, ЕВV, CMV, HHV6), the most prefer are with CMV and associated CMV + HSV1, CMV + HSV2, where patients, hwo have HHV6 and associated HSV1 + HHV6, HHV6 + HSV1 + HSV2.Conclusions. Presentation of CMV and associated CMV + HSV1, CMV + HSV2 increases the risk of development of the hypoechoic none-stabil AS plaques of internal carotid artery (ICA). Presentation of HHV6 and associated HSV1 + HHV6, HSV1 + HSV2 + HHV6 in AS plaques of ICA increases the relative risk of development of severe stenosis in the patients with symptomatic stenosis. The investigation confirms the necessary of periodical administration at exclusion of the stenosis of ICA.
{"title":"Virus persistence in atherosclerotic plaques in patients after carotid endarterectomy","authors":"N. Turchina, T. Cherenko, V. Chernyak, L. Bondar","doi":"10.26683/2304-9359-2020-4(34)-82-94","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-4(34)-82-94","url":null,"abstract":"Objective ‒ to mark the quantity of herpes and flu infection detection of the none-stabil and stabil atherosclerotic (AS) plaques in patients with ischemic stroke (IS)/TIA and with the progressing AS and in the anamnesis after carotid endarterectomy.Materials and methods. 103 patients with IS/TIA after carotid endarterectomy were examined: 67 males 42‒82 years old (average age ‒ 66,1±1,4 years), 36 females 44‒81 years old (average age ‒ 63,0±1,3 years). Average age ‒ 65,1± 0,9 year. We examined the width of intima-media complex, presence of AS plaques, their constitution.Results. Among all viruses investigated with transfection and polymerase chain reaction in AS plaques and blood after carotid endarterectomy (HSV1,2, ЕВV, CMV, HHV6), the most prefer are with CMV and associated CMV + HSV1, CMV + HSV2, where patients, hwo have HHV6 and associated HSV1 + HHV6, HHV6 + HSV1 + HSV2.Conclusions. Presentation of CMV and associated CMV + HSV1, CMV + HSV2 increases the risk of development of the hypoechoic none-stabil AS plaques of internal carotid artery (ICA). Presentation of HHV6 and associated HSV1 + HHV6, HSV1 + HSV2 + HHV6 in AS plaques of ICA increases the relative risk of development of severe stenosis in the patients with symptomatic stenosis. The investigation confirms the necessary of periodical administration at exclusion of the stenosis of ICA.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42720262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-56-65
L. V. Havrylova
Objective ‒ to maintain the adequate sedation and analgesia without respiratory depression in children up to 4 years old with spinal cord pathology in early postoperative period (first 3 days) in inpatient department; to decrease digestive system motor function depression; to exclude aspiration possibility; to start early children’s natural feeding in postoperative period.Materials and methods. From October 2019 to January 2020 dexmedetomidine sedation was performed by the prolonged infusion administration to 10 children (6 children aged 6 month to 1 year and 4 children up to 4 years) with spinal cord and vertebral pathology (spina bifida, meningomyelocele, myelocele, teratoma, lipoma of lumbar spine) in early postoperative period at intensive observation ward of neurosurgical department. During the first three days after the surgery and dexmedetomidine prescription the vital functions monitoring was being performed for 24 hours. Arterial blood pressure, heart rate, blood saturation have been scheduled by one of the parents. The immediate access to oxygen and parent’s permission for using this sedation method were the obligatory requirements.Results. The appropriate sedation target was achieved after the dexmedetomidine prescription for the children with the spinal cord and vertebral pathology in early postoperative period at intensive observation ward of neurosurgical department; the dosage of opioid analgesics was successfully decreased by 50 %. The respiratory depression was not observed. The blood pressure and bradycardia were not haemodynamically significant. Swallowing reflex was saved, which led to early physiological nutrition and excluded aspiration risk. The following transfer of patients after the surgery to the neurosurgical department bypassing ICU reduced the financial expenditure of the hospital.Conclusions. Dexmedetomidine provides with the adequate sedation in early postoperative period and can be recommended for the usage in children with the spinal cord and vertebral pathology as the safest medication due to minimal cardio-respiratory complications during moderately prolonged prescribed period.
{"title":"Experience with the dexmedetomidine for sedation in pediatric neurosurgery in the early postoperative period","authors":"L. V. Havrylova","doi":"10.26683/2304-9359-2020-3(33)-56-65","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-56-65","url":null,"abstract":"Objective ‒ to maintain the adequate sedation and analgesia without respiratory depression in children up to 4 years old with spinal cord pathology in early postoperative period (first 3 days) in inpatient department; to decrease digestive system motor function depression; to exclude aspiration possibility; to start early children’s natural feeding in postoperative period.Materials and methods. From October 2019 to January 2020 dexmedetomidine sedation was performed by the prolonged infusion administration to 10 children (6 children aged 6 month to 1 year and 4 children up to 4 years) with spinal cord and vertebral pathology (spina bifida, meningomyelocele, myelocele, teratoma, lipoma of lumbar spine) in early postoperative period at intensive observation ward of neurosurgical department. During the first three days after the surgery and dexmedetomidine prescription the vital functions monitoring was being performed for 24 hours. Arterial blood pressure, heart rate, blood saturation have been scheduled by one of the parents. The immediate access to oxygen and parent’s permission for using this sedation method were the obligatory requirements.Results. The appropriate sedation target was achieved after the dexmedetomidine prescription for the children with the spinal cord and vertebral pathology in early postoperative period at intensive observation ward of neurosurgical department; the dosage of opioid analgesics was successfully decreased by 50 %. The respiratory depression was not observed. The blood pressure and bradycardia were not haemodynamically significant. Swallowing reflex was saved, which led to early physiological nutrition and excluded aspiration risk. The following transfer of patients after the surgery to the neurosurgical department bypassing ICU reduced the financial expenditure of the hospital.Conclusions. Dexmedetomidine provides with the adequate sedation in early postoperative period and can be recommended for the usage in children with the spinal cord and vertebral pathology as the safest medication due to minimal cardio-respiratory complications during moderately prolonged prescribed period.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49572405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-19-28
S.V. Chebanyuk, O. E. Svyrydyuk, O.F. Sydorenko, M. Mamonova
Objective ‒ to determine the features of the functioning of the circulatory system in patients with arteriovenous malformations (AVM) of the brain after endovascular operations with long-term observation.Materials and methods. 479 patients with cerebral AVM were examined and treated, of which 377 (78.7 %) were men and 102 (21.3 %) were women. The average age of patients was (27.5±3.5) years. Patients aged 18‒30 years predominated (75.4 %). A dynamic observation of 347 patients after endovascular treatment after 3, 6, 12 and 24 months and more was carried out. Patients underwent cerebral angiography, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, echocardiography, Doppler cardiography, electrocardiography, duplex scanning of cerebral vessels.Results. The study shows the effect of arteriovenous shunting on cerebral and systemic hemodynamics in general. Switching off AVM from the cerebral blood flow improved cerebral hemodynamics already in the early postoperative period, the changes were more significant after 3‒6 months of observation and in some cases reached values in healthy individuals 2 years after the operation. In 52.8 % of patients with AVM, systemic circulation disorders occurred due to an increase in heart rate, minute and stroke blood volumes, left ventricular ejection fraction with an increase in mechanical load on the heart, which led to changes in systolic contraction and diastolic relaxation of the left ventricle of the heart with the development of heart failure. Switching off the AVM from the cerebral blood flow did not cause significant changes in heart functions in the early postoperative period; positive changes occurred over a long period. Dynamic observation showed a positive restructuring of the functioning of the circulatory system in patients after endovascular exclusion of the malformation.Conclusions. Arteriovenous malformations are hemodynamically active systems that lead to hemodynamic-perfusion changes, both at the local and at the general hemodynamic level. The exclusion of the malformation from the bloodstream contributes to the regression of disorders of cerebral and intracardiac blood flow caused by the anatomical and functional characteristics of the malformation itself and its clinical course.
{"title":"Cerebral arteriovenous malformations: features of the functioning of the blood circulation system after endovascular treatment with long-term monitoring","authors":"S.V. Chebanyuk, O. E. Svyrydyuk, O.F. Sydorenko, M. Mamonova","doi":"10.26683/2304-9359-2020-3(33)-19-28","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-19-28","url":null,"abstract":"Objective ‒ to determine the features of the functioning of the circulatory system in patients with arteriovenous malformations (AVM) of the brain after endovascular operations with long-term observation.Materials and methods. 479 patients with cerebral AVM were examined and treated, of which 377 (78.7 %) were men and 102 (21.3 %) were women. The average age of patients was (27.5±3.5) years. Patients aged 18‒30 years predominated (75.4 %). A dynamic observation of 347 patients after endovascular treatment after 3, 6, 12 and 24 months and more was carried out. Patients underwent cerebral angiography, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, echocardiography, Doppler cardiography, electrocardiography, duplex scanning of cerebral vessels.Results. The study shows the effect of arteriovenous shunting on cerebral and systemic hemodynamics in general. Switching off AVM from the cerebral blood flow improved cerebral hemodynamics already in the early postoperative period, the changes were more significant after 3‒6 months of observation and in some cases reached values in healthy individuals 2 years after the operation. In 52.8 % of patients with AVM, systemic circulation disorders occurred due to an increase in heart rate, minute and stroke blood volumes, left ventricular ejection fraction with an increase in mechanical load on the heart, which led to changes in systolic contraction and diastolic relaxation of the left ventricle of the heart with the development of heart failure. Switching off the AVM from the cerebral blood flow did not cause significant changes in heart functions in the early postoperative period; positive changes occurred over a long period. Dynamic observation showed a positive restructuring of the functioning of the circulatory system in patients after endovascular exclusion of the malformation.Conclusions. Arteriovenous malformations are hemodynamically active systems that lead to hemodynamic-perfusion changes, both at the local and at the general hemodynamic level. The exclusion of the malformation from the bloodstream contributes to the regression of disorders of cerebral and intracardiac blood flow caused by the anatomical and functional characteristics of the malformation itself and its clinical course.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44733376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-4(34)-19-33
V. Moroz
Objective ‒ to analyze the results of surgical treatment of basilar artery (BA) bifurcation arterial aneurysms (AA), taking into account the method of BA obliteration, the type of disease, to summarize the results of surgical treatment of BA.Materials and methods. A retrospective analysis of the results of a comprehensive examination and surgical treatment of 132 patients with AA of BA bifurcation in a group of 387 operated patients with posterior cerebral circulation aneurysms, who were hospitalized and operated in the vascular departments of the State Institution Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine in the period from 1998 to 2019 years is made. Patients were divided into groups according to the type of disease and the method of surgical treatment of AA of BA bifurcation. The analysis of the results of surgical treatment AA of BA bifurcation was performed taking into account the method of occlusion and the clinical type.Results. The balloon occlusion technique was used in 16 (12.1 %) patients with AA of BA bifurcation, including hemorrhagic and other types of disease. Radical exclusion of AA of BA bifurcation was achieved only in 1 (6.25 %) patients of this group. Exclusion of AA of BA bifurcation at level IIR was also recorded in only 1 (6.25 %) patient. In 4 (25.0 %) patients, the level of AA occlusion corresponded to IIIR. In 10 (62.5 %) patients, after surgery using the balloon occlusion technique, AA of BA bifurcation remained not excluded. Satisfactory functional results of treatment using the balloon occlusion technique, according to mRs, were obtained in 7 (43.7 %) patients of this group, without taking into account the radicality of AA of BA bifurcation exclusion. Transcranial technique, taking into account hemorrhagic and other types of flow, was used in 5 (3.8 %) patients with AA of BA bifurcation. In 4 (80.0 %) patients of this group, radical exclusion from the bloodstream was achieved by clipping (occlusion level ‒ IR). In 1 (20.0 %) wrapping of aneurysm walls were strengthened (occlusion level ‒ AA of BA bifurcation is strengthened). Satisfactory functional treatment results in this group were obtained in 3 (60.0 %) observations. Using modern methods of aneurysm coil embolization, 111 (84.0 %) patients with AA of BA bifurcation were operated. Radical exclusion of AA from the bloodstream at the level of IR was achieved in 40 (36.0 %) patients. The level of occlusion IIR was observed in 48 (43.2 %) patients. In 26 (23.4 %) cases, the level of occlusion corresponded to IIIR. In 1 (0.9 %) case, the aneurysm was excluded at level IIID. Satisfactory functional results, according to mRs, in this group were obtained in 89 (80.2 %) observations.Conclusions. The main method of treatment of AA of BA bifurcation, regardless of the type of disease, should be considered endovascular with the use of modern methods of endovascular obliteration of aneurysm. Methods of transcranial clipping of aneurysms
{"title":"Results of surgical treatment of arterial aneurysms of the basilar artery bifurcation","authors":"V. Moroz","doi":"10.26683/2304-9359-2020-4(34)-19-33","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-4(34)-19-33","url":null,"abstract":"Objective ‒ to analyze the results of surgical treatment of basilar artery (BA) bifurcation arterial aneurysms (AA), taking into account the method of BA obliteration, the type of disease, to summarize the results of surgical treatment of BA.Materials and methods. A retrospective analysis of the results of a comprehensive examination and surgical treatment of 132 patients with AA of BA bifurcation in a group of 387 operated patients with posterior cerebral circulation aneurysms, who were hospitalized and operated in the vascular departments of the State Institution Romodanov Neurosurgery Institute National Academy of Medical Sciences of Ukraine in the period from 1998 to 2019 years is made. Patients were divided into groups according to the type of disease and the method of surgical treatment of AA of BA bifurcation. The analysis of the results of surgical treatment AA of BA bifurcation was performed taking into account the method of occlusion and the clinical type.Results. The balloon occlusion technique was used in 16 (12.1 %) patients with AA of BA bifurcation, including hemorrhagic and other types of disease. Radical exclusion of AA of BA bifurcation was achieved only in 1 (6.25 %) patients of this group. Exclusion of AA of BA bifurcation at level IIR was also recorded in only 1 (6.25 %) patient. In 4 (25.0 %) patients, the level of AA occlusion corresponded to IIIR. In 10 (62.5 %) patients, after surgery using the balloon occlusion technique, AA of BA bifurcation remained not excluded. Satisfactory functional results of treatment using the balloon occlusion technique, according to mRs, were obtained in 7 (43.7 %) patients of this group, without taking into account the radicality of AA of BA bifurcation exclusion. Transcranial technique, taking into account hemorrhagic and other types of flow, was used in 5 (3.8 %) patients with AA of BA bifurcation. In 4 (80.0 %) patients of this group, radical exclusion from the bloodstream was achieved by clipping (occlusion level ‒ IR). In 1 (20.0 %) wrapping of aneurysm walls were strengthened (occlusion level ‒ AA of BA bifurcation is strengthened). Satisfactory functional treatment results in this group were obtained in 3 (60.0 %) observations. Using modern methods of aneurysm coil embolization, 111 (84.0 %) patients with AA of BA bifurcation were operated. Radical exclusion of AA from the bloodstream at the level of IR was achieved in 40 (36.0 %) patients. The level of occlusion IIR was observed in 48 (43.2 %) patients. In 26 (23.4 %) cases, the level of occlusion corresponded to IIIR. In 1 (0.9 %) case, the aneurysm was excluded at level IIID. Satisfactory functional results, according to mRs, in this group were obtained in 89 (80.2 %) observations.Conclusions. The main method of treatment of AA of BA bifurcation, regardless of the type of disease, should be considered endovascular with the use of modern methods of endovascular obliteration of aneurysm. Methods of transcranial clipping of aneurysms ","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43171871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-3(33)-12-18
Y. Barinov, L. Lysytsia
The simplest method of screening eye pathology in infant is red reflex examination. Present, absence or change of red reflex is key point in early detection of eye pathology. Objective – establish possibility using of mobile phone camera for eye pathology screening at home.Materials and methods. 750 children were included in research. Patient parents allowed photo their child before ophthalmology exam. First step was taking photo on parent’s mobile telephone in playing room from different distance and lighting. Second step was photo in exam room in mesopic condition in 1, 2 and 4 m distance with using maximum zoom and then ophthalmologic exam. After that, all photos was analysed by next signs: present or absence of red reflex, intensive of red reflex, present or absence pathology shadow, in case of red reflex changing, distance where changing is best viewed, comparison photo with result of ophthalmology exam. Results. After analysing photos all children was divided in three groups depending on red reflex chan-ging. In the first group red reflex was even without additional shadow, same in both eye. In this group after ophthalmology exam ametropy low level and eyelid pathology was diagnosed. In the second group red reflex was irregular by colour with additional light shadow or different intensity of red reflex in both eye. Ametropy high level was diagnosed in this group. In the third group we observed absence or colour change of red reflex. Cataract, congenital glaucoma, retinoblastoma, retinal and choroidal coloboma, Coats retinitis was diagnosed. Changing of red reflex possible to find on all photos from different distance, but the most informative was photo that was done from 1 m in mesopic condition. Conclusion. By equability and colour changing of red reflex on photo, all children may divided in three groups: 1 – children require only prophylactic ophthalmology exam, 2 – children require additional ophthalmology exam, 3 – children require immediate ophthalmology exam.
{"title":"Screening of pediatric eye disease at home by using camera of mobile phone","authors":"Y. Barinov, L. Lysytsia","doi":"10.26683/2304-9359-2020-3(33)-12-18","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-3(33)-12-18","url":null,"abstract":"The simplest method of screening eye pathology in infant is red reflex examination. Present, absence or change of red reflex is key point in early detection of eye pathology. Objective – establish possibility using of mobile phone camera for eye pathology screening at home.Materials and methods. 750 children were included in research. Patient parents allowed photo their child before ophthalmology exam. First step was taking photo on parent’s mobile telephone in playing room from different distance and lighting. Second step was photo in exam room in mesopic condition in 1, 2 and 4 m distance with using maximum zoom and then ophthalmologic exam. After that, all photos was analysed by next signs: present or absence of red reflex, intensive of red reflex, present or absence pathology shadow, in case of red reflex changing, distance where changing is best viewed, comparison photo with result of ophthalmology exam. Results. After analysing photos all children was divided in three groups depending on red reflex chan-ging. In the first group red reflex was even without additional shadow, same in both eye. In this group after ophthalmology exam ametropy low level and eyelid pathology was diagnosed. In the second group red reflex was irregular by colour with additional light shadow or different intensity of red reflex in both eye. Ametropy high level was diagnosed in this group. In the third group we observed absence or colour change of red reflex. Cataract, congenital glaucoma, retinoblastoma, retinal and choroidal coloboma, Coats retinitis was diagnosed. Changing of red reflex possible to find on all photos from different distance, but the most informative was photo that was done from 1 m in mesopic condition. Conclusion. By equability and colour changing of red reflex on photo, all children may divided in three groups: 1 – children require only prophylactic ophthalmology exam, 2 – children require additional ophthalmology exam, 3 – children require immediate ophthalmology exam.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47191554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-4(34)-60-69
F. Glumcher, Ye.Yu Dyomin
Objective ‒ to compare the incidence of complications and the main treatment outcomes of non-invasive mechanical ventilation (NIV) with a helmet versus NIV with a full face mask.Materials and methods. A monocentric randomized open-labeled controlled clinical trial. Patients with exacerbation of chronic obstructive pulmonary disease (COPD) with signs of respiratory failure were randomized to receive NIV through a mask or helmet. The study included 59 patients who were randomized into two groups: NIV through helmet (n = 29) or mask (n = 30). The average age of the patients was (59.24 ± 14.20) and (59.06 ± 15.90) years, respectively. In both groups men predominated ‒ 23 (79 %) and 27 (90 %) respectively. Ventilation was performed with a Draeger Carina apparatus in pressure support (PS) mode. The primary endpoint was the cumulative incidence of NIV complications. Secondary endpoints were PaO2/FiO2 ratio, tolerance to therapy, frequency of intubations, duration of stay in the intensive care unit (ICU), and ICU mortality. A total of 59 patients were involved in the study.Results. The complication rate was lower in the helmet group (10 % (n = 3) versus 43 % (n = 13), p = 0.004) and the PaO2/FiO2 ratio was higher at the first hour and at the end of NIV (253.14 ± 64.74) mm Hg versus (216.06 ± 43.86) mm Hg and (277.07 ± 84.89) mmHg versus (225.81 ± 63.64) mm Hg, p = 0.013 and p = 0.012) compared with NIV through a full face mask. More patients noted excellent helmet tolerance than masks at the 4th hour of therapy (24 (83 %) versus 14 (47 %), p = 0.004) and at the end of ventilation (69 % (20/29) versus 30 % (9/30), p = 0.03). One patient was unable to continue therapy due to mask intolerance. Differences in intubation rates, length of ICU stay, and mortality were statistically insignificant (p = 0.612, p = 0.100, p = 1.000 respectively).Conclusions. NIV through a helmet can reduce the incidence of complications and increase the PaO2/FiO2 ratio, as well as improve tolerance compared to NIV through a face mask in patients with exacerbation of COPD. A larger scale of study is needed to establish the effect of interface choice on ICU mortality, time spent in ICU, and frequency of intubation.
{"title":"Noninvasive mechanical ventilation with helmet in patients with exacerbation of chronic obstructive pulmonary disease: a randomized controlled trial","authors":"F. Glumcher, Ye.Yu Dyomin","doi":"10.26683/2304-9359-2020-4(34)-60-69","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-4(34)-60-69","url":null,"abstract":"Objective ‒ to compare the incidence of complications and the main treatment outcomes of non-invasive mechanical ventilation (NIV) with a helmet versus NIV with a full face mask.Materials and methods. A monocentric randomized open-labeled controlled clinical trial. Patients with exacerbation of chronic obstructive pulmonary disease (COPD) with signs of respiratory failure were randomized to receive NIV through a mask or helmet. The study included 59 patients who were randomized into two groups: NIV through helmet (n = 29) or mask (n = 30). The average age of the patients was (59.24 ± 14.20) and (59.06 ± 15.90) years, respectively. In both groups men predominated ‒ 23 (79 %) and 27 (90 %) respectively. Ventilation was performed with a Draeger Carina apparatus in pressure support (PS) mode. The primary endpoint was the cumulative incidence of NIV complications. Secondary endpoints were PaO2/FiO2 ratio, tolerance to therapy, frequency of intubations, duration of stay in the intensive care unit (ICU), and ICU mortality. A total of 59 patients were involved in the study.Results. The complication rate was lower in the helmet group (10 % (n = 3) versus 43 % (n = 13), p = 0.004) and the PaO2/FiO2 ratio was higher at the first hour and at the end of NIV (253.14 ± 64.74) mm Hg versus (216.06 ± 43.86) mm Hg and (277.07 ± 84.89) mmHg versus (225.81 ± 63.64) mm Hg, p = 0.013 and p = 0.012) compared with NIV through a full face mask. More patients noted excellent helmet tolerance than masks at the 4th hour of therapy (24 (83 %) versus 14 (47 %), p = 0.004) and at the end of ventilation (69 % (20/29) versus 30 % (9/30), p = 0.03). One patient was unable to continue therapy due to mask intolerance. Differences in intubation rates, length of ICU stay, and mortality were statistically insignificant (p = 0.612, p = 0.100, p = 1.000 respectively).Conclusions. NIV through a helmet can reduce the incidence of complications and increase the PaO2/FiO2 ratio, as well as improve tolerance compared to NIV through a face mask in patients with exacerbation of COPD. A larger scale of study is needed to establish the effect of interface choice on ICU mortality, time spent in ICU, and frequency of intubation.","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45487658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-31DOI: 10.26683/2304-9359-2020-4(34)-45-59
Tinglan Zuo, F. Glumcher, S. Dubrov
Objective ‒ to compare the hemodynamic effects and safety of the infusion of succinylated gelatin solution, sorbitol-containing solution, and 0.9 % normal saline (0.9 % sodium chloride), analyze their effect on the treatment of septic shock and mortality.Materials and methods. A prospective randomized clinical trial that included 94 adult patients with an active surgical infection and septic shock was conducted. There were 34 (36.2 %) male and 60 (63.8 %) female patients aged between 19 and 96 years, mean age was (66.51 ± 17.06) years. An appropriate solution in a volume of 500 ml was used for resuscitation, then hemodynamic and other clinical and laboratory parameters were monitored.Results. There was no significant difference in mean arterial pressure (MAP) between the 3 groups until the 40th minute (p>0.05). At the 45th minute MAP in the NS group differed only from MAP in the Gel group (p=0.007). At the 50th minute MAP in the NS group did not differ from the baseline (p=0.139). From the 50th minute to 2 hours, MAP in the Gel and Sorb groups was higher than in the NS group in all measurements (p<0.05). There was no statistically significant difference in heart rate (HR) in any measurement (p>0.05). Cardiac output (CO) did not differ up to the 30th minute (p>0.05), at the 35th minute, CO differed only between Gel and NS groups (p=0.019), from the 40th minute to 2 hour CO in Gel and Sorb groups were significantly higher than in NS group in all measurements (p<0.05). Oxygen delivery (DO2) also did not differ up to the 30th minute (p>0.05), from the 35th minute to the 45th minute a significant difference was found only between Gel and NS groups (p<0.05), from the 50th minute to 2 hour DO2 in Gel and Sorb group was significantly higher than in NS group in all measurements (p<0.05). After infusion of the gelatin-containing solution and sorbitol-containing solution, the acid-base balance of the blood improved significantly. The dose of gelatin-containing and sorbitol-containing solutions applied in this study was safe for the renal function of the patients with septic shock. However, it is possible that a decrease in blood fibrinogen concentrations may be associated with the use of a gelatin-containing solution. Significant improvement in the Glasgow Coma Scale scores was observed only in patients in the group receiving the sorbitol-containing solution. The difference in 28-day mortality between the groups was not statistically significant (p=0.993).Conclusions. In our observations, when using these three types of solution in patients with septic shock, hemodynamic effects up to the 40th minute did not differ between groups. From the 40th minute to 2 hour, the volemic effect of 4 % succinylated gelatin solution and balanced polyionic solution with 6 % sorbitol was significantly better, compared to the 0.9 % sodium chloride solution. The volume of solutions used in these three groups did not affect renal function in patients with septic shock. The amou
{"title":"Hemodynamic efficacy and safety of using modified gelatin solution and polyhydric alcohol solution for fluid resuscitation of patients with septic shock","authors":"Tinglan Zuo, F. Glumcher, S. Dubrov","doi":"10.26683/2304-9359-2020-4(34)-45-59","DOIUrl":"https://doi.org/10.26683/2304-9359-2020-4(34)-45-59","url":null,"abstract":"Objective ‒ to compare the hemodynamic effects and safety of the infusion of succinylated gelatin solution, sorbitol-containing solution, and 0.9 % normal saline (0.9 % sodium chloride), analyze their effect on the treatment of septic shock and mortality.Materials and methods. A prospective randomized clinical trial that included 94 adult patients with an active surgical infection and septic shock was conducted. There were 34 (36.2 %) male and 60 (63.8 %) female patients aged between 19 and 96 years, mean age was (66.51 ± 17.06) years. An appropriate solution in a volume of 500 ml was used for resuscitation, then hemodynamic and other clinical and laboratory parameters were monitored.Results. There was no significant difference in mean arterial pressure (MAP) between the 3 groups until the 40th minute (p>0.05). At the 45th minute MAP in the NS group differed only from MAP in the Gel group (p=0.007). At the 50th minute MAP in the NS group did not differ from the baseline (p=0.139). From the 50th minute to 2 hours, MAP in the Gel and Sorb groups was higher than in the NS group in all measurements (p<0.05). There was no statistically significant difference in heart rate (HR) in any measurement (p>0.05). Cardiac output (CO) did not differ up to the 30th minute (p>0.05), at the 35th minute, CO differed only between Gel and NS groups (p=0.019), from the 40th minute to 2 hour CO in Gel and Sorb groups were significantly higher than in NS group in all measurements (p<0.05). Oxygen delivery (DO2) also did not differ up to the 30th minute (p>0.05), from the 35th minute to the 45th minute a significant difference was found only between Gel and NS groups (p<0.05), from the 50th minute to 2 hour DO2 in Gel and Sorb group was significantly higher than in NS group in all measurements (p<0.05). After infusion of the gelatin-containing solution and sorbitol-containing solution, the acid-base balance of the blood improved significantly. The dose of gelatin-containing and sorbitol-containing solutions applied in this study was safe for the renal function of the patients with septic shock. However, it is possible that a decrease in blood fibrinogen concentrations may be associated with the use of a gelatin-containing solution. Significant improvement in the Glasgow Coma Scale scores was observed only in patients in the group receiving the sorbitol-containing solution. The difference in 28-day mortality between the groups was not statistically significant (p=0.993).Conclusions. In our observations, when using these three types of solution in patients with septic shock, hemodynamic effects up to the 40th minute did not differ between groups. From the 40th minute to 2 hour, the volemic effect of 4 % succinylated gelatin solution and balanced polyionic solution with 6 % sorbitol was significantly better, compared to the 0.9 % sodium chloride solution. The volume of solutions used in these three groups did not affect renal function in patients with septic shock. The amou","PeriodicalId":33226,"journal":{"name":"Endovaskuliarna neirorentgenokhirurgiia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47725613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：