FAST-TRACK ANESTHESIA DURING ABDOMINAL CAVITY SURGERY IN PATIENTS WITH OBESITY

Implementation of the Fast-track anesthesia is interesting for the Fast-track surgery concept realization in obese patients. We evaluated the influence of combined inhalation-epidural anesthesia (CIEA) and total intravenous anesthesia (TIVA) on the recovery of 56 patients with BMI 37 ± 6 kg/m2 after laparotomy. CIEA-group patients (n = 28) in comparison with TIVA-group pa- tients (n = 28) were extubated earlier (18 ± 10 min vs 37 ± 14 min, accordingly, p < 0.05), developed less amount of pulmonary complications (3 vs 12 cases, accordingly, p < 0.05), felt less level of pain (100 vs 50 % of patients, accordingly, p < 0.05), restored earlier the peristalsis on the 1st day (36 vs 0 % of patients accordingly, p < 0.05) and on the 2nd day (90 vs 39 % of patients, accordingly, p < 0.05). We concluded that CIEA can be considered as a Fast-track technique of anesthesia during laparotomy in obese patients.

THE INFLUENCE OF ANESTHETIC TECHNIQUE ON THE BLOOD CIRCULATION DURING AND AFTER HIP ARTHROPLASTY

Hip arthroplasty can cause hemodynamic instability, especially dangerous for patients with concurrent diseases. With the aim of comparing the effects of various anesthetic methods on the circulation, estimated continuous cardiac output was studied in 132 patients during and after hip arthroplasty. The patients were randomly divided in six groups (n= 22 each). In group 1, intraoperative spinal anesthesia and postoperative systemic analgesia; in group 2 spinal anesthesia and prolonged paravertebral analgesia; in group 3, spinal anesthesia and prolonged epidural analgesia; in group 4, peripheral nerve anesthesia and systemic analgesia; in group 5, caudal anesthesia and prolonged paravertebral analgesia; in group 6, general anesthesia and systemic analgesia, respectively, were used. The most stable circulation was with peripheral nerve anesthesia. Neuraxial anesthesia, especially spinal anesthesia, produced significant decrease of cardiac output. In conclusion, estimated continuous cardiac output is a useful method for assessment of anesthesia quality.

THE USE OF INTERMEDIATES OF THE KREBS CYCLE AND MODERATE NORMOBARIC HYPEROXIA SESSIONS IN INTENSIVE CARE IN PATIENTS WITH SEVERE TRAUMATIC BRAIN INJURY

The paper presents the results of a comparative study of the effect of therapeutic measures complex recommended by the Brain Trauma Foundation as well as intensive therapy in accordance with these recommendations in combination with the use of succinate and moderate normobaric hyperoxia sessions on the recovery rate of consciousness function and the dynamics of cerebral blood flow characteristics in two groups of the patients with severe traumatic brain injury. The research reveals the signs of significant acceleration of consciousness function recovery and normalization of cerebral blood flow during the application of succinate in combination with moderate normobaric hyperoxia sessions.

INFLAMMATORY AND ENDOTHELIAL FACTORS IN PROGRESSION OF TARGET-ORGAN DAMAGE IN PATIENTS WITH ARTERIAL HYPERTENSION WITH COMORBID PATHOLOGY

The study analyzed the role of inflammation and endothelial function in the progression of target organs damage in arterial hypertension with diabetes mellitus 2 type and obesity. The levels of serum concentrations of cytokines, CRP, chemerin, and ICAM-1 were studied using ELISA. As a result, it was established statistically significant contribution of these markers as predictors of progression of arterial hypertension combined with the type 2 diabetes mellitus with obesity. The presence of inflammatory compo- nent in the body of patients with arterial hypertension, and especially the violation of endothelial function, contributes to the progression of lesions of target organs.

COMBINATION THERAPY OF COGNITIVE IMPAIRMENT IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION

The paper deals with the study of 2ethyl6methyl 3hydroxypyridine succinate and morpholinium 3methyl 1,2,4triazolyl5thioacetate impact in correction of cognitive disorders in patients with acute myocardial infarction. The study enrolled 105 patients with acute myocardial infarction and cognitive impairment up to the age of 60 without aggravated neurological history. Additionally, Creactive protein and blood cortisol content was assessed. Depending on the kind of treatment the patients were divided into 3 groups: Group 1 (n = 35) — morpholinium 3methyl 1,2,4triazolyl5thioacetate was applied along with standard treatment and quercetinum; Group 2 (n = 35) 2ethyl 6methyl3hydroxypyridine succinate was applied along with standard treatment and quercetinum; Group 3 (n= 35) standard treatment and quercetinum. The study has made it possible to prove that 2ethyl6methyl3hydroxypyridine succinate and morpholinium 3methyl1,2,4triazolyl 5thioacetate applied along with standard treatment leads to significant decrease cognitive disorders in patients under 60 with acute myocardial infarction.

INFLUENCE OF THE LEVEL OF P-SELECTINE ON THE DEVELOPMENT OF ADVERSE REASONS IN PATIENTS WITH STABLE CORONARY ARTERY DESEASE

Coronary artery disease is currently the leading cause of death in all developed countries, including Ukraine. In this case, both the diagnosis of CAD and the assessment of the severity of the course and prognosis of the disease are important. It is known that the severity of the course of coronary heart disease closely correlates with the degree of coronary artery disease. Numerous studies suggest that the determination of the P-selectin level makes it possible to identify patients at high risk of developing cardiovascular events. 89 patients with ischemic heart disease and type 2 diabetes mellitus were examined, it was revealed that in patients with high P-selectin there was a significantly higher number of cardiovascular events compared to patients with low P-selectin level, which allows using the P-selectin level for estimates of the prognosis in patients with stable angina.

INFLUENCE OF AVERAGE INDICATORS OF ARTERIAL PRESSURE AND PULSE ON THE DAILY SPECIFIC WEIGHT OF EXTENDED INTERVAL QTc IN PATIENTS WITH ARTERIAL HYPERTENSION

The dependence of the specific gravity of the extended QTc interval on average blood pressure and pulse rate in patients with arterial hypertension were studied.

The analysis of the data was carried out in the context of mean daily and average nighttime indices, depending on the type of daily profile of systolic and diastolic blood pressure. 3 groups were identified depending on the duration of QTc interval extended. The average daily and night-time indices of daily blood pressure monitoring are determined.