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As the practicing anesthesiologists know well, regional anesthesia has a number of essential advantages before the general. Here more physiologic anesthesia of the place of surgical intervention, maintaining consciousness and reflexes from the upper airways at the patient, good postoperative anesthesia, prevention of tromboemblolichesky complications, early activization of patients and some other enter. Recently regional anesthesia gained considerable distribution with development of techniques of ultrasonic navigation and neurostimulation that allows to improve significantly quality of the carried-out blockade and to make them more comfortable for the patient.
The Postkovidny syndrome (from English Post-COVID-19 Syndrome, it is also known under the term Long Covid) represents a syndrome of consequences of a koronavirusny infection (COVID-19) at which up to 20% of the people who had a koronavirusny infection in the past suffer from the long-term symptoms lasting up to 12 weeks and in certain cases even longer.
The anesthesiology help can be required by patients with a koronavirusny infection who come on treatment to hospitals for several reasons. First, at such patient developing of acute surgical pathology which demands performing surgery is possible. Secondly, an operative measure can be required in aspect of treatment of actually koronavirusny infection (for example, carrying out a tracheostomy in need of long artificial ventilation of the lungs). Thirdly, patients who are in COVID-19 incubation interval can come to hospitals with surgical pathology, without suspecting that they are infected with an infectious disease.
As it is unambiguously established today, fibrillation of ventricles is the most frequent reason of a sudden cardiac standstill at adults. Probability to survive at patients with fibrillation of ventricles decreases in process of a current of time, a past after a cardiac standstill and according to modern literary data each next minute falls on average for 7–10%. On the other hand, primary resuscitation actions (such as cardiac massage and artificial respiration) cannot transfer at such patients fibrillation to a normal rhythm without electric defibrillation. The precardiac blow which was tried to be used for the purpose of replacement of a defibrillator did not show any impressive results in large researches; its efficiency by modern estimates is about one percent. Thus, only the early defibrillation is the only chance to restore hemodynamically effective warm reductions and to save the patient in these situations.
When carrying out artificial ventilation of the lungs at patients with a koronavirusny infection observation of a condition of various respiratory parameters which allows to notice in due time changes in a condition of lungs and the patient is extremely important and also to quickly modify the mode and parameters of ventilation if in it there is a need.
The countershock, to be exact its version - an electric defibrillation is one of the main resuscitation actions at sudden death. It is known that fibrillation of ventricles is the most frequent reason of a cardiac standstill. Proceeding from it, the result of resuscitation often depends on a possibility of the fastest carrying out a defibrillation.
Now the kapnografiya is one of the most widespread and important types of monitoring. In anesthesiology practice this method is the standard for a long time. At the same time, use of monitoring of concentration of carbon dioxide on an exhalation did not gain due distribution in chambers of an intensive care and resuscitation in medical institutions in the former Soviet Union yet.
The defibrillation and cardioversion belong to a countershock (EIT). This two types of EIT at all their similarity, have essential distinctions as the defibrillation represents the procedure of stopping of fibrillation of ventricles by means of drawing electric discharge and it concerns the major a resuscitation action, in cardioversion is a way of treatment of tachyarrhythmias which essence consists in the termination of circulation of excitement in a myocardium by drawing electric discharge in a certain phase of a cardial cycle. While the electric defibrillation - always the emergency manipulation, cardioversion is planned when restoration of a rhythm at a stable hemodynamics is made, at the prepared patient, at inefficiency of other ways of treatment, and emergency when cardioversion is carried out at paroxysms of tachyarrhythmias with an unstable hemodynamics and resistant to other ways of therapy.
Spread of a koronavirusny infection created serious load of intensive care units and an intensive care just because of needs of such patients in serious respiratory support which in certain cases can include artificial ventilation of the lungs. In this article we will deal with whether it is possible to use for mechanical ventilation of patients with a koronavirusny infection the ventilation modes with control on volume.
Today the pulsoksimetriya, no doubt, is the most widespread type of tool monitoring of function of external respiration. Gradually this method removed from the field of anesthesiology resuscitation and to other spheres of medicine, for example, in pulmonology, therapy and the general medical practice. Simplicity of performance of a research, a possibility of continuous monitoring for a long time, not invasiveness of a method made it very popular among as the practicing doctors, and among patients.