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  • 1
    Online-Ressource
    Online-Ressource
    Forum Multimedia Publishing LLC ; 2011
    In:  The Heart Surgery Forum Vol. 14, No. 6 ( 2011-12-13), p. 384-
    In: The Heart Surgery Forum, Forum Multimedia Publishing LLC, Vol. 14, No. 6 ( 2011-12-13), p. 384-
    Kurzfassung: 〈 p 〉 〈 b 〉 Background: 〈 /b 〉 The aim of the present study was to investigate the cardioprotective effects of the perioperative use of N(2)-L-alanyl-L-glutamine (GLN) in patients with ischemic heart disease (IHD) who undergo their operations under cardiopulmonary bypass (CPB). 〈 /p 〉 〈 p 〉 〈 b 〉 Methods: 〈 /b 〉 This double-blind, placebo-controlled, randomized study included 50 patients who underwent cardiac surgery with CPB. Exclusion criteria were a left ventricular ejection fraction 〈 50%, diabetes mellitus, 〈 3 months since the onset of myocardial infarction, and emergency surgery. Patients in the study group (n = 25) received 0.4 g/kg GLN (Dipeptiven, 20% solution) per day. Patients in the control group (n = 25) were administered a placebo (0.9% NaCl). The primary end point was the dynamics of troponin I at the following stages: (1) prior to anesthesia, (2) 30 minutes after CPB, (3) 6 hours after CPB, (4) 24 hours after surgery, and (5) 48 hours after surgery. Secondary end points included measurements of hemodynamics with a Swan-Ganz catheter. 〈 /p 〉 〈 p 〉 〈 b 〉 Results: 〈 /b 〉 On the first postoperative day after the surgery, the median troponin I level was significantly lower in the study group than in the placebo group: 1.280 ng/mL (interquartile range [IQR], 0.840-2.230 ng/mL) versus 2.410 ng/mL (IQR, 1.060-6.600 ng/mL) ( 〈 i 〉 P 〈 /i 〉 = .035). At 4 hours after cardiopulmonary bypass (CPB), the median cardiac index was higher in the patients in the study group: 2.58 L/min per m 〈 sup 〉 2 〈 /sup 〉 (IQR, 2.34-2.91 L/min per m 〈 sup 〉 2 〈 /sup 〉 ) versus 2.03 L/min per m 〈 sup 〉 2 〈 /sup 〉 (IQR, 1.76-2.32 L/min per m 〈 sup 〉 2 〈 /sup 〉 ) ( 〈 i 〉 P 〈 /i 〉 = .002). The median stroke index also was higher in the patients who received GLN: 32.8 mL/m 〈 sup 〉 2 〈 /sup 〉 (IQR, 27.8-36.0 mL/m 〈 sup 〉 2 〈 /sup 〉 ) versus 26.1 mL/m 〈 sup 〉 2 〈 /sup 〉 (IQR, 22.6-31.8 mL/m 〈 sup 〉 2 〈 /sup 〉 ) ( 〈 i 〉 P 〈 /i 〉 = .023). The median systemic vascular resistance index was significantly lower in the study group than in the placebo group: 1942 dyn�s/cm 〈 sup 〉 5 〈 /sup 〉 per m 〈 sup 〉 2 〈 /sup 〉 (IQR, 1828-2209 dyn�s/cm 〈 sup 〉 5 〈 /sup 〉 per m 〈 sup 〉 2 〈 /sup 〉 ) versus 2456 dyn�s/cm 〈 sup 〉 5 〈 /sup 〉 per m 〈 sup 〉 2 〈 /sup 〉 (IQR, 2400-3265 dyn�s/cm 〈 sup 〉 5 〈 /sup 〉 per m 〈 sup 〉 2 〈 /sup 〉 ) ( 〈 i 〉 P 〈 /i 〉 = .001). 〈 /p 〉 〈 p 〉 〈 b 〉 Conclusion: 〈 /b 〉 Perioperative administration of GLN during the first 24 hours has cardioprotective effects in IHD patients following CPB. This technique enhances the troponin concentration at 24 hours after surgery and is associated with improved myocardial function. 〈 /p 〉
    Materialart: Online-Ressource
    ISSN: 1522-6662 , 1098-3511
    Sprache: Unbekannt
    Verlag: Forum Multimedia Publishing LLC
    Publikationsdatum: 2011
    ZDB Id: 2069230-4
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    Akademiai Kiado Zrt. ; 2012
    In:  Interventional Medicine and Applied Science Vol. 4, No. 1 ( 2012-03-1), p. 9-14
    In: Interventional Medicine and Applied Science, Akademiai Kiado Zrt., Vol. 4, No. 1 ( 2012-03-1), p. 9-14
    Kurzfassung: Aim: To evaluate endogenous toxic substrates and liver monooxygenase function in cardiosurgical patients with multiple organ dysfunction syndrome (MODS). Methods: 45 patients with MODS and 34 patients with an uneventful postoperative period were studied. The endogenous substrates were quantified with blood middle molecules (MM). Liver monooxygenase function was evaluated with antipyrine (AP) pharmacokinetics. Results: On the first postoperative day, MODS patients were characterized by high concentration of toxic substrates (MM: +43.8%) and a significant decrease in liver monooxygenase function (AP clearance: −44%), while controls patients had a mild increase in endogenous substrates and a slight depression in monooxygenase function. On the 3rd–4th postoperative day, in the main group, endogenous substrates increased (MM: +53.1%), while in the control group toxic substrates decreased (MM: +6.9%). In both groups, an increase in liver monooxygenase function was noticed. Major differences were observed on the 10th–12th postoperative day. In the main group, toxic substrates remained elevated (MM: +37.5%) and monooxygenase function was depressed (AP clearance: −45.4%), while in the control group endogenous substrates and monooxygenase function were equal to the baseline. The correlation analysis showed a negative relationship between AP pharmacokinetics and endogenous substrates. Conclusion: Slowdown in liver microsomal oxidation is one of the main reasons for the accumulation of endogenous toxic substrates in MODS cardiac patients.
    Materialart: Online-Ressource
    ISSN: 2061-1617 , 2061-5094
    Sprache: Unbekannt
    Verlag: Akademiai Kiado Zrt.
    Publikationsdatum: 2012
    ZDB Id: 2573851-3
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    In: Complex Issues of Cardiovascular Diseases, NII KPSSZ, Vol. 12, No. 2 ( 2023-06-25), p. 144-155
    Kurzfassung: Highlights The article presents the analysis of anxiety and depressive disorders in patients who were followed as outpatients after surgery for chronic thromboembolic pulmonary hypertension in the long term, taking into account the study during the COVID–19 pandemic. The prevalence of clinically pronounced anxiety disorders in the group was 10.9%, depression - 18.6%, a combination of anxiety-depressive disorders was noted in 10.3% of cases. Multifactorial analysis revealed that the development of severe anxiety disorders in patients with chronic thromboembolic pulmonary hypertension in the long term is associated with a complicated postoperative course. Independent risk factors for clinically pronounced depressive disorders in these patients were older age, a history of cerebral circulation disorders, as well as pronounced post-COVID-19 functional disorders.   Aim. To study the frequency and severity of anxiety-depressive disorders in patients with chronic thromboembolic pulmonary hypertension (CTEPH) in the long term after pulmonary thromboendarterectomy and to identify factors affecting their development. Methods. 156 patients with CTEPH were examined in the long term after surgery using the generalized anxiety disorder (GAD) questionnaire GAD-7 and the Beck`s Depression Inventory. In patients who suffered COVID-19, a “Post-COVID-19 Functional Status scale” (PCFS) was used to measure functional status over time after COVID-19. Logistic regression analysis was used to identify predictors of clinically pronounced GAD and depression in the long-term period after surgery. Results. In patients with CTEPH, clinically significant GAD and depression in the long term after surgery were observed in 10.9 and 18.6% of cases, respectively. A combination of anxiety and depressive disorders was noted in 10.3% of patients. The development of GAD was associated with cardiopulmonary insufficiency in the early postoperative period (ОR 3,1; CI 1,2–13,8; p = 0,009). Clinically pronounced depression was associated with older age (ОR 1,3; CI 1,04–2,0; p = 0,02), chronic cerebral circulatory insufficiency (ОR 7,6; CI 1,8–17,5; p = 0,02) and pronounced post-COVID-19 functional neurological disorders according to the PCFS scale (ОR 6,7; CI 1,9–14,5; p = 0,007). The combination of clinically expressed anxiety and depression was correlated with older age (ОR 1,1; CI 1,02–1,3; p = 0,04). Conclusion. The prevalence of clinically pronounced GAD in the group was 10.9%, depression was 18.6%, and a combination of anxiety and depressive disorders was noted in 10.3% of patients. The development of clinically significant GAD is associated with a complicated course of cardiac surgery. Independent risk factors for clinically significant depression were older age, a history of cerebral circulatory disorders and pronounced post-COVID-19 functional neurological disorders.
    Materialart: Online-Ressource
    ISSN: 2587-9537 , 2306-1278
    Sprache: Unbekannt
    Verlag: NII KPSSZ
    Publikationsdatum: 2023
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    Frontiers Media SA ; 2023
    In:  Frontiers in Anesthesiology Vol. 2 ( 2023-5-9)
    In: Frontiers in Anesthesiology, Frontiers Media SA, Vol. 2 ( 2023-5-9)
    Materialart: Online-Ressource
    ISSN: 2813-480X
    Sprache: Unbekannt
    Verlag: Frontiers Media SA
    Publikationsdatum: 2023
    ZDB Id: 3164679-7
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    In: PULMONOLOGIYA, Scientific and Practical Reviewed Journal Pulmonology, Vol. 31, No. 6 ( 2021-12-15), p. 710-717
    Kurzfassung: Aim. To assess the effectiveness of medical rehabilitation after pneumonia associated with the novel coronavirus infection (COVID-19), based on the study of functional capacity of the cardiovascular system and the external respiratory system. Methods. The study included 70 patients who had COVID-19 pneumonia and underwent a medical rehabilitation program from September to December 2020. Before being included in the rehabilitation program, all patients underwent pulmonary function tests (PFT), including an assessment of the lungs diffusion capacity, cardiopulmonary exercise testing, multispiral computed tomography (MSCT) of the chest, echocardiography, an evaluation of the quality of life according to the SF-36 questionnaire and the severity of shortness of breath on the mMRC scale. The effectiveness of rehabilitation was evaluated against the changes in PFT parameters, exercise tolerance, and quality of life. Results. At the enrollment, 46% of patients retained lung tissue lesions shown by MSCT and accompanied by a decrease in the lung diffusion capacity (67 (55 - 79%) of predicted value), dyspnea of 1.6 (1.0 - 3.0) points according to mMRC scale, moderate level of exercise tolerance and quality of life. Complex cardiopulmonary rehabilitation for 12 - 14 days in a specialized hospital led to a significant improvement in the parameters of pulmonary gas exchange and ventilation, peak oxygen consumption, and an increase in the reserve capacity of the cardiorespiratory system. The factors limiting the improvement of pulmonary gas exchange were the older age of the patients and the increased pressure in the pulmonary artery system. The positive influence of rehabilitation on both the physical and psycho-emotional components of the quality of life was noted. Conclusion. Complex cardiopulmonary rehabilitation with the assessment of changes in the oxygen metabolism parameters and functional capacity of the cardiovascular and respiratory systems has shown to be safe and highly effective in the studied group of patients who have had COVID-19 pneumonia.
    Materialart: Online-Ressource
    ISSN: 2541-9617 , 0869-0189
    Sprache: Unbekannt
    Verlag: Scientific and Practical Reviewed Journal Pulmonology
    Publikationsdatum: 2021
    Standort Signatur Einschränkungen Verfügbarkeit
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