Damage control reanimation

Life saving surgery is the surgery which has to be performed during the acute or reanimation period (1 to 3 h) and during the primary or stabilisation period (first day surgery). During the reanimation period lifethreatening conditions are identified and management is begun simultaneously. Many trauma surgeons talk about the first "golden hours" as the time interval starting immediately after the injury when rapid intervention will save lives and a lack of intervention will result in life loss. Most common, these critical conditions are exsanguinating hemorrhage, acute pump failure, obstruction of airways, mechanical failure of ventilation or severe brain damage with tentorial herniation...

The complex approach to both restoration and maintenance of vital functions in patients with severe nervous system diseases is described in this article. The respiratory reanimation is thought to be the main problem of neuroreanimatology. The long-term experience of the Institute of Neurology of Rus. Acad. Med. Sci. in this field is presented. It was concerned with the arbitrary respiratory control disorders, automatic respiratory regulation disturbances, the damages of peripheral centers associated with respiratory function...

BACKGROUND: The aim of this study was to evaluate the viability of arrested pig hearts harvested after animal death. METHODS: Hearts (n = 25) were preserved for 2 hours by cold storage (4 degrees C) with St. Thomas' cardioplegic solution no warm ischemia (0 minutes; control) or 10, 20, 30, or 60 minutes of in situ warm ischemia (animal exsanguination). Hearts were then reperfused for 1 hour with whole blood with an in vitro functional testing system. Left ventricular developed pressure and coronary flow were measured during reperfusion...

Cardiovascular arrest may be followed by severe respiratory insufficiency due to an increase in the pressure in the pulmonary vascular system, an alteration in capillary permeability, or both. Extracorporeal circulation (ECC), on the other hand, can lead to a change in capillary integrity ('capillary leakage') caused by the unphysiologic perfusion patterns and/or activation of various mediator systems. Pulmonary hyperhydration (increased extravascular lung water [EVLW]) seems to be the most important factor limiting pulmonary function in this situation...

The Wiktor stent, a new coronary balloon-expandable tantalum stent, was implanted in 17 patients for other wise nonmanageable occlusion after balloon angioplasty (n = 11) and for recurrent restenosis (n = 6). Stents of 3.0 to 4.0 mm were implanted (right coronary artery: n = 10, left anterior descending artery: n = 4, left circumflex artery: n = 2, venous graft: n = 1). All patients were fully anticoagulated initially with heparin followed by coumadin for 3 months and were treated with acetylsalicylic acid indefinitely...