ASSESSING THE RISK OF COMPLICATIONS DURING INDUCTION IN THE PATIENTS WITH LARGE MEDIASTINAL MASS
https://doi.org/10.21292/2078-5658-2018-15-5-39-44
Abstract
Anesthetic management of surgery in patients with large mediastinal mass remains a topical issue of thoracic anesthesiology, since such patients often develop superior mediastinal compression (SMC) which results in a high risk of hemodynamic and respiratory disorders during induction. The degree of compression does not always depend on the mass size, and the prediction of SMC progression during induction becomes a challenge.
The method to evaluate the degree of mediastinal compression through the functional orthoclinostatic test was developed – the patient is to be placed in Fowler position for 45 degrees in order to follow changes in the cardiac index.
It was found out that the patients with SMC detected during the test (increased cardiac index in Fowler position) had their arterial blood pressure reduced after induction, and the number of critical incidents was statistically significantly higher. The test proved to be a non-invasive and safe method of pre-operative prediction of the risk of SMC development and progression during induction.
About the Authors
E. G. Kryukova
Samara Regional Clinical Cancer Dispensary.
Russian Federation
Russian Federation
Eleonora G. Kryukova - Anesthesiologist and Emergency Physician.
50, Solnechnaya St., Samara, 443031.
B. A. Akselrod
Russian Surgery Research Center named after B. V. Petrovsky.
Russian Federation
Russian Federation
Boris A. Akselrod - Russian Surgery Research Center named after B.V. Petrovsky,
Doctor of Medical Sciences, Head of Anesthesiology and Intensive Care Unit no. II.
2, Abrikosovsky Lane, Moscow, 119991.
V. V. Stadler
Samara Regional Clinical Cancer Dispensary.
Russian Federation
Russian Federation
Vladimir V. Stadler - Candidate of Medical Sciences, Head of Anesthesiology and Intensive Care Department.
50, Solnechnaya St., Samara, 443031 .
M. O. Vozdvizhenskiy
Samara Regional Clinical Cancer Dispensary.
Russian Federation
Russian Federation
Mikhail O. Vozdvizhenskiy - Doctor of Medical Sciences, Deputy Chief Doctor in Therapy.
50, Solnechnaya St., Samara, 443031 .
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Review
For citations:
Kryukova E.G., Akselrod B.A., Stadler V.V., Vozdvizhenskiy M.O. ASSESSING THE RISK OF COMPLICATIONS DURING INDUCTION IN THE PATIENTS WITH LARGE MEDIASTINAL MASS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2018;15(5):39-44. (In Russ.) https://doi.org/10.21292/2078-5658-2018-15-5-39-44
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