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[Central hemodynamics during therapeutic sedation in children under artificial pulmonary ventilation]
Insights
Dormicum provides the best sedation and comfort for children on artificial lung ventilation (ALV). Gamma oxy-oil acid (GOOA) offers the most stable cardiovascular parameters during ALV in pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Anesthesiology
- Pharmacology
Background:
- Artificial lung ventilation (ALV) is critical for managing severe pediatric conditions.
- Sedation is essential for patient comfort and synchrony with mechanical ventilation.
- Evaluating sedative agents' impact on hemodynamics in pediatric patients is crucial.
Purpose of the Study:
- To compare the efficacy and hemodynamic stability of three sedation techniques in pediatric patients undergoing ALV.
- To assess the impact of gamma oxy-oil acid (GOOA), thiopental sodium, and dormicum on central hemodynamics.
- To determine the optimal sedation strategy for pediatric patients requiring artificial lung ventilation.
Main Methods:
- A study involving 46 pediatric patients (9-14 years) with severe conditions requiring ALV.
- Patients were divided into three groups receiving different sedative agents: GOOA, thiopental sodium, or dormicum.
- Central hemodynamics (stroke volume, cardiac rate, cardiac output, blood pressure, peripheral resistance) were monitored non-invasively. Sedation levels were assessed using Cook's and Palma's scale.
Main Results:
- All investigated sedation techniques ensured satisfactory cardiovascular system function in pediatric patients.
- Gamma oxy-oil acid (GOOA) administration resulted in the highest stability of hemodynamic parameters.
- Dormicum administration led to the highest levels of sedation and patient comfort.
Conclusions:
- Micro-flow introduction of dormicum is an adequate and stable sedation technique for pediatric patients on ALV with minimal hemodynamic impact.
- GOOA demonstrates superior cardiovascular stability compared to thiopental sodium and dormicum.
- The choice of sedative agent should balance hemodynamic stability and sedation efficacy based on individual patient needs.
Abstract:
A total of 46 patients, aged 9 to 14, who underwent the artificial ventilation of the lungs (AVL) for diffusive purulent peritonitis with laparostoma, spastic syndrome, destructive pneumonia, and crania-cerebral trauma of different severities, were investigated. The patients were divided into 3 groups with respect to a medicamental sedation. Group 1--bolus dosing of a 20% solution of gamma oxy-oil acid (GOOA), 75-100 mg/kg; group 2--bolus dosing of a 1% solution of thiopental sodium (5-7 mg/kg); and group 3--micro-flow introduction of dormycum (0.1 mg/kg x h). The central hemodynamics was studied by the NCCKOM apparatus ("Bomed", USA) by applying a non-invasive technique. Stroke volume, cardiac rate, circulation minute volume, mean arterial pressure and general peripheral vascular resistance were determined. The sedation level was assessed by Cook's and Palma's scale (1989). The above investigations showed that all used techniques insured a satisfactory functioning of the cardiovascular system, but the highest stability of parameters was registered in the group, in which COOA was applied. The highest level of sedation and comfort was registered in the group of patients, which received dormycum. A conclusion was made on the basis of the conducted study that the technique of the micro-flow introduction of dormycum indicated for AVL in children is an adequate and stable sedation technique producing a minimal impact on the hemodynamics.