To get an idea of what is happening in the intensive care unit, let's try to answer a few questions.
Who is being treated in intensive care?
The majority of patients in the intensive care unit in our clinic are patients after surgery. With simple surgical procedures, monitoring is carried out from half an hour to several hours, and only after making sure that the patient is fully awake after anesthesia, such important indicators as blood pressure, pulse, breathing are stable, and pain is not bothering him, the issue of transfer to a hospital ward is resolved.
After more complex operations, for example, hip replacement or major surgery on the stomach or intestines, the patient is observed and treated in intensive care for about a day or longer, until the condition is fully stabilized and vital functions are restored.
The most severe category is patients with combined injuries, multiple fractures, or serious health problems requiring temporary replacement of the function of various organs and systems. For example, patients with extremely severe pneumonia undergo mechanical ventilation, and patients with impaired renal function require renal replacement therapy, hemodialysis, or other methods of extrarenal blood purification. Patients with extensive heart attacks are given medications that support heart function in very precise dosages using special infusion pumps.
What do they do in the intensive care unit?
Looking at the equipment of the intensive care unit, the question involuntarily arises: is all this equipment really used? For example, let's look at the situation with a patient after a serious car accident. Chest contusion, rib fracture, lung injury – artificial ventilation is required until the chest regains its former frame and the hematomas and hemorrhages disappear in the lungs after impact. Modern devices allow for very precise selection of ventilation modes in order to maintain the patient's independent breathing, rather than completely replacing it. This provides comfort to the patient and facilitates the transition to independent breathing.
To monitor the work of the heart, a heart monitor is used – a device that records a cardiogram in a preset mode, measures blood pressure, pulse, and saturation (the oxygen content in the blood is measured using a beam of light through a nail). If necessary, the depth of the patient's sleep can be measured when the so–called drug sedation is used - artificial sleep. The technique of measuring the depth of sleep is widely used in the operating rooms of the European Medical Center, which makes it possible to tell the patient with confidence that the fear of "waking up during surgery" is unfounded.
Sometimes patients experience chills after surgery. In these situations, a fan heater is used, which blows warm air over the patient, and the tremor quickly disappears.
Some patients cannot eat for several days after a complex operation on the intestines or stomach. In these cases, the first days of nutrition are carried out intravenously with amino acid solutions, which are administered at a certain precisely calculated rate. As soon as the meal is allowed, feeding begins through the probe, or the patient drinks special nutritional mixtures for postoperative feeding on his own. We can monitor the adequacy of nutrition based on a number of tests performed by our laboratory at any time of the day or night.
In case of severe kidney diseases, we perform hemodialysis or various types of filtration with an artificial kidney device. Temporary replacement of a function makes it possible for a diseased organ to restore it after a certain period. In the photo you can see a hemodialysis session in a patient with renal insufficiency.
In some operations, to relieve pain in the postoperative period, we perform epidural anesthesia, when an anesthetic is constantly injected through a thin catheter connected to the nerve roots in the spine. This allows the patient to move freely and comfortably endure the first difficult days after surgery.Thus, the capabilities of our intensive care unit make it possible to successfully treat patients with various serious illnesses, qualified anesthesiologists, intensive care specialists and nurses do everything necessary for a speedy recovery of the patient.
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Questions and answers
Рancreatic cancer
My wife of 64 years was diagnosed with pancreatic cancer in the autumn of 2014. Stage 4 was concluded. Surgery is impossible. There is a massive thrombosis. Three biopsies were carried out. A benign tumor was revealed. She lost a lot of weight. An episode of severe pain took place about one month ago. Currently, a
significant problem is the ascites, swollen legs; food is poorly digested, general discomfort. What can you recommend? Is it necessary to remove the fluid and what might be the consequences?
...more The picture you described is consisted with the concept of "metastatic ascites". Laparocentesis is appropriate as a therapeutic and diagnostic approach. Given the negative cytology, it is likely that the patient has a neoplastic disease of the colon, ovaries or stomach. Our experts will hold a consultation on the
same day and perform the procedure to verify the diagnosis and consider the possibilities of palliative treatment.
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Pavel Koposov
07 September 2016
Break iafter the last course of chemotherapy
Why a break is necessary after the last course of chemotherapy?
In cases where chemotherapy is not enough effective, some cells of the tumor does not die as a result of exposure and only slow down their biological processes temporarily, so they do not accumulate diagnostic radiopharmaceutical that can lead to a false negative result. After 2-3 weeks, tumor cells return to their
normal state and can be seen at the PET/CT scan. Thus, the break after the last course of chemotherapy should be done in order to obtain reliable results of the quality of treatment.
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Radiation therapy for prostate cancer
What to expect during radiation therapy for prostate cancer?
The procedure of external radiotherapy is similar to conventional x-ray examination. Radiation is invisible, has no smell and gives no sensations, side effects do not appear until 2nd or 3rd week of treatment.
Radiotherapy for prostate cancer is a local treatment; therefore, you may experience some side effects
only in those parts of the body that are exposed.
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Сhronic nonspecific spondylitis
Can we go to your center in the following case: the patient born in 1955. Diagnosis: chronic nonspecific spondylitis T7-T9. A state after interbody fusion T7-T9 with autologous bone. Brown-Sequard's syndrome. Right thoracotomy with interbody fusion using autotransplantation (resected rib) was done in 2010, no bone
block formed during the postoperative period. Transpedicular fixation T 5-6-10-11 was also done in November 2010. There was a primary healing on the wound as a result of treatment. He was able to sit and stand as well as stay in upright position up to 2-3 hours. At the moment, mobility is restored, able to walk and sit. But pain is still present. Can we expect further surgical treatment and rehabilitation at your center?
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In this case surgical care rendered fully, but it is hard to say more without images. If pain is still present, it is necessary to look for the cause of this, but it may be in the early postoperative period. You can contact us for a consultation to clarify the nature of the disease.
MRI or CT scan
Please tell me what kind of examination is better in case of head injury - an MRI or CT scan. I have hit my head in June this year, and now I feel a discomfort at the site of the injury sometimes (there in no acute pain)?
CT has advantages in the visualization of bone structures. MRI is better for soft structures imaging, including the brain substance. According to the description, the intracranial structures damage is unlikely. Why CT or MRI? An ultrasound of soft tissues in the area of injury is also applicable. The pain in the
scull can also be associated with vessel, for example, cranial arteritis, or lymphadenitis, or muscle/enthesis, and then you might need certain blood tests. And maybe these tests are not required. I would recommend you to see the doctor and let him assess the case; he will take a decision concerning following examination as a result of consultation.
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