Abstract
Objective: to define the efficiency of the intensive care priorities of eclampic coma, which reduce mortality in puer-peras, by studying systemic and metabolic disturbances. Subjects and methods. Studies were conducted in 42 puer-peras with eclampic coma (a study group) in whom the authors used their intensive care algorithm the basis for which was standard (conventional) therapy. Central hemodynamic parameters were studied by the direct method of right heart catheterization using a flow-directed Swan-Ganz catheter. Overall cerebral blood flow was measured by a noninvasive (inhalation) radionuclide method, by using the tracer 133Xe, as described by V. D. Obrist et al., on a modified КПРДИ-1 apparatus (USSR). The rate of brain oxygen uptake was determined from the oxygen content between the artery and the internal jugular vein. Studies were made in four steps: 1) on admission; 2) on days 2—3; 3) emergence from coma; 4) before transition. Results. The use of the authors’ proposed algorithm of intensive care for eclampic coma, which is aimed at enhancing cerebral blood flow due to the slight expanding effect of stabizole and antihypertensive therapy (nimodipine and magnesium sulfate), lowered the mean arterial pressure by not more than 10—25% of the baseline level. Conclusion. The proposed intensive care could reduce mortality by up to 4.8%. Key words: eclampsia, eclampic coma, intensive care.
Highlights
Цель исследования — определить эффективность приоритетных направлений интенсивной терапии эклампсической комы родильниц на основе изучения системных гемодинамических и метаболических нарушений, позволяющих сни зить летальность
Studies were conducted in 42 puer peras with eclampic coma in whom the authors used their intensive care algorithm the basis for which was standard therapy
Overall cerebral blood flow was measured by a non invasive radionuclide method, by using the tracer 133Xe, as described by V
Summary
Цель исследования — определить эффективность приоритетных направлений интенсивной терапии эклампсической комы родильниц на основе изучения системных гемодинамических и метаболических нарушений, позволяющих сни зить летальность. Исследования проведены у 42 родильниц в эклампсической коме (основная группа), у которых использован предложенный нами алгоритм интенсивной терапии, в основе которого лежат совре менные принципы лечения коматозных состояний. The use of the authors' proposed algorithm of intensive care for eclampic coma, which is aimed at enhancing cerebral blood flow due to the slight expanding effect of stabizole and antihyper tensive therapy (nimodipine and magnesium sulfate), lowered the mean arterial pressure by not more than 10—25% of the baseline level. Что в МКБ 10, принятой в на шей стране, нет такого термина, как «эклампсическая кома», а две тяжёлые формы гестоза — эклампсия и эк лампсическая кома — тождественны.
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