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
Dermoid cyst and pregnancy
An ultrasound revealed a mass in my left ovary during the first pregnancy. I was told that it is a dermoid cyst. Five years have passed since then. I gave birth to a second child. An ultrasound was performed annually. There were differences in size, but not significant. Since I’m going to have the 3rd child, another
ultrasound was done today. The doctor said that the cyst had increased. I am concerned about it. Don't know where to start. What tests are needed? Thank you.
...more Surgical treatment is strictly indicated in your case given the long history of the mass in the ovary and its rapid growth in recent times. In our clinic, we perform such an intervention laparoscopically through 3 small punctures. Patients go home next morning after the surgery and may return to work after 3 days.
This surgery must be as delicate to preserve healthy ovarian tissue (considering your reproductive plans) as radical at the same time to remove the mass together with the capsule. At the preoperative stage an expert level ultrasound with Doppler is required, as well as blood tests for Ca-125 and НЕ-4 tumor markers. The decision concerning the necessity of FEGDS and colonoscopy is taken based on the results of these tests.
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Total knee replacement
My mom suffers from gonarthrosis for the past three years. Despite treatment by injections the pain is still present. MRI revealed a meniscal tear in the posterior horn, the presence of small bony osteophytes on the patella, a small amount of fluid in the joint cavity (signs of exudative synovitis were detected)
joint space is asymmetrically narrowed in the medial segment. The pain is ongoing but the knee remains flexible. Tell me, please, whether the surgery is contraindicated for meniscal tear in case of arthrosis? Is it possible to do an arthroscopic surgery on the meniscus in our case or it should be «major» surgery? And what would you advice concerning knee replacement for the patient in the age of 57? What is the life time of the artificial joint?
...more It is necessary to make an X-ray of the knee in direct projection in standing position. If it turns out that there is no medial cartilage in the medial area, then the knee replacement is the only solution. The age of 57 is normal for the prosthetics. Modern artificial knee joint (when properly placed of course) will
serve for a lifetime. You can make an appointment via phone +7 (495) 933-66-44.
...more 
Kardanov Andrey
07 September 2016
Pain
I am 19 years old, professionally engaged in weightlifting. I did an arthroscopy of both knee joint a year ago, now feel pain in them and it prevents me from training at full capacity. I visited a traumatologist, and «osteoarthritis of 1 degree» was diagnosed. Could you advise me some medicines or anything else to
relief the pain? Thank you very much for the answer!
...more
First of all you should undergo an MRI and find out what was done at arthroscopy; if it’s really an arthrosis of 1 degree, hyaluronic acid injections are possible and physiotherapy is not required. Anyway, you are always welcome to consultation for thorough examination.
Question to Dr. Yakobashvili
Tell me, please, at which age child's hearing should be checked-up if we were informed at the hospital before discharge that one ear does not hear. At the moment the child’s age is 1.5 months. Thank you.
These tests done in the hospital are often false negative. Hearing can be tested now, it is necessary to make an appointment to the audiologist.
Cought
A child of 11 years old, suffers from cough for more than six months. The cough is dry, sometimes attack-like, mainly begins during the day, and often occurs before sleep. There is no cough at night. CBC is normal, glucose is 4.16, total IgE 111.80, Toxocara, Ascaride are negative, Cytomegalovirus, Mycoplasma are
negative, PPD test is negative as well. A chest x-ray is normal. We have already consulted with a therapist, otolaryngologist, pulmonologist, neurologist, gastroenterologist... the cough is still present. What should we do?
...more First of all, there are no results of whooping cough testing among the results provided above. The disease cannot be ruled out, even if your child was vaccinated. The blood test for antibodies against the whooping cough germ is required (blood test for class M and G antibodies against Bordetella pertussis). Second,
even a slight increase in class E antibodies is a reason to visit an allergist and to perform an evaluation of respiratory function with bronchodilator. This method will detect a latent bronchial spasm in your child. Even if the results of the test will be normal, allergologist mast rule out the allergic nature of the cough even if it's not obstructive syndrome. Third, this cough can be due to gastroesophageal reflux. It is difficult to draw any conclusions having no data of gastroenterologist’s consultation. 24-hour acidity monitoring of the stomach and esophagus is carried out to confirm or exclude the presence of reflux. Fourth, you didn’t mention whether x-ray of nasopharynx and paranasal sinuses was done. Perhaps, after all, the pathology is associated with ENT organs.
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