#1
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Çàäà÷êà äëÿ àíåñòåçèîëîãîâ.×àñòü âòîðàÿ.
Ïåðåä îòúåçäîì â âîÿæ ïî ìàðøðóòó Íüþ-Äæåðñè-Êèåâ-Âåíà è îáðàòíî, íàáðàëñÿ íàõàëüñòâà îòêðûòü âòîðóþ ÷àñòü.Ïåðâàÿ ñòàíîâèòüñÿ íåóäîáîâàðèìîé èç-çà ðàçìåðîâ. Ãîñïîäà, ïèøèòå,ïîæàëóéñòà ñþäà, íå ñòåñíÿéòåñü
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#2
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Öèòàòà:
1-Ïîñëå ïåðåëèâàíèÿ 2-õ þíèòîâ Î(-) êðîâè. ìîæíî ëè ïåðåëèâàòü áîëüíîìó êðîâü åãî ãðóïïû. 2- åñëè íåò, ÷åðåç êàêîé ïðîìåæóòîê âðåìåíè ìîæíî? |
#3
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Öèòàòà:
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#4
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Öèòàòà:
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#5
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Öèòàòà:
Improved survival following massive transfusion in patients who have undergone trauma. Cinat ME, Wallace WC, Nastanski F, West J, Sloan S, Ocariz J, Wilson SE. Department of Surgery, University of California Irvine Medical Center, Orange 92868, USA. mecinat@uci.edu HYPOTHESIS: Survival following massive transfusion in patients who have undergone trauma has improved during the past 10 years. DESIGN: Retrospective cohort study. SETTING: Academic level I trauma center in an urban community. PATIENTS: All patients who underwent trauma and who received greater than 50 U of packed red blood cells or whole blood in the 48 hours following admission to the emergency department. INTERVENTIONS: Data were obtained from blood bank records, the trauma registry, patient medical records, and hospital purchasing records. Patients were divided into 2 groups for comparison (early [1988-1992] and late [1993-1997] periods). MAIN OUTCOME MEASURES: Survival and changes in trauma care provision. RESULTS: Survival following massive transfusion in patients who have undergone trauma has significantly increased during the past 10 years (16% vs 45%, early vs late period, P = .03). Factors associated with poor outcome included male sex, major vascular injury, high Injury Severity Score, severe acidosis, prolonged hypotension, refractory hypothermia, and decreased use of platelet transfusion (all P<.05). In the later period, there was more aggressive correction of coagulopathy, more efficient use of warming measures, decreased operative times for the initial operation, and increased use of component therapy (all P<.05). CONCLUSIONS: Survival following massive transfusion has significantly (P = .03) increased during the past 10 years. Factors that may have contributed to this include more effective and efficient rewarming procedures, improved application of damage control techniques, more aggressive correction of coagulopathy, and improved blood banking procedures. |
#6
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Öèòàòà:
Óòî÷íèòå ïîæàëóéñòà ïðî FFP. C óâàæåíèåì. |
#7
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Öèòàòà:
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#8
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Öèòàòà:
Áëàãîäàðþ çà óòî÷íåíèå ïî FFP. Êàê ÿ ïîíÿë èç âàøåãî ëèíêà, íåò åäèíîãî ìíåíèÿ íà êîëè÷åñòâî ïåðåëèâàåìîé O(-). Èëè åñòü ÷àñòíûå ðåêîìåíäàöèè äëÿ êàæäîé êëèíèêè? Ñ óâàæåíèåì. |
#9
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Öèòàòà:
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#10
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Öèòàòà:
OK, ïîíÿë. À êàêèì êîëè÷åñòâîì Î(-) âû áû îãðàíè÷èëèñü? Ñ óâàæåíèåì. P.S. Íàâåðíîå, äîíîðñòâî ó âàñ áîëåå âîñòðåáîâàíî, ÷åì ó íàñ, ðàç èìåþòñÿ äîñòàòî÷íûå çàïàñû â Blood Bank. |
#11
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Öèòàòà:
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#12
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èçâèíèòå ÷òî ïèøó âîïðîñîì íà âîïðîñ, íî ðàçâå ïðåïàðò³ êðîâè ÿâëÿþòñÿ ïðïàðàòîì âûáîðà ïðè ãèïîâîëåìè÷åñêîì øîêå
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#13
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Blood transfusions are not the treatment of choice of hypovolemia.
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#14
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êîãäà åñòü â íàëè÷èè êðàñíûå êëåòêè èëè ïëàçìèöèÿ ñ ïðåâåëèêèì óäîâîëüñòâèåì èñïîëüçóþ èõ äëÿ êîððåêöèè ãèïîâîëåìèè (êîãäà ïðè÷èíà ïîñëåäíåé - êðîâîïîòåðÿ - áóäü-òî ñîñòîÿâøååñÿ, áóäü-òî ïðîäîëæàþùàÿñÿ)
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#15
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A kogda net?
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