Authors
Prigorodov M.V., Kapralov S.V., Simakova M.A., Maslyakov V.V.
Saratov State Medical University named after V.I. Razumovsky, Saratov
Abstract
The study of intraoperative energy consumption is an important indicator of assessing the formation of critical incidents of patients, «the adequacy of patient protection from operational stress». For their prevention, intensive therapy is prescribed, aimed at restoring metabolic losses that have developed under the influence of operational stress.
To investigate this problem, a pilot study was conducted on the basis of the University Clinical Hospital №1 named after S.R. Peacemakers (Saratov, Russia) in order to determine the possibility of dynamic assessment of energy consumption during traumatic surgical interventions. Energy consumption was studied in three surgical oncological patients who underwent abdominal-thoracic interventions under combined anesthesia. According to the monitoring data of the anesthesia device CARETATION 650, based on the data of O2, CO2, MVeexp, barometric pressure, O2 consumption and CO2 elimination were determined, energy consumption was calculated. The above parameters and indicator were recorded at 6 stages of surgical intervention (combined anesthesia, the beginning of the operation, the traumatic stage (abdominal, thoracic), the end of the operation, the end of anesthesia). Critical incidents were noted during anesthesia and surgery. In this work, semantic analysis methods were used to summarize the data of scientific publications published in the scientometric databases Pubmed (PubMed Central® (PMC) is a free full-text archive), Web of Science, Scopus, RSCI.
According to the results of the research, it was noted the need to determine ASA based on background, concomitant diseases, the general condition of the patient, the estimated complexity of anesthesia and the traumatic nature of surgery, for continuous perioperative monitoring it is necessary to analyze the parameters of O2 consumption and CO2 elimination, energy consumption indicators.
It was revealed that, depending on the critical incidents that have arisen, the indicators of gas exchange and energy exchange differ in each of the presented clinical cases.
Keywords: energy consumption, traumatism, surgical intervention, combined anesthesia.
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