Are you I V Aleksandrova?

Claim your profile

Publications (9)0 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of the study was to investigate the role of early multiple organ failure in 152 patients with severe acute pancreatitis admitted to the intensive care unit for the period from 2002 to 2009. The group of patients with early progressive multiple organ failure had high early (29%) and overall mortality (45%) rate, infectious complications rate (39%) and long intensive care unit stay (median - 8 (5; 18) days). Based on the statistical analysis of data the criteria to predicted risk progression of multiple organ failure on admission were: APACHE II score ≥12, SOFA score ≥4, failure >2 organs/systems, Ranson score ≥7.
    Khirurgiia 01/2013;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Regardless of modern achievements in intensive therapy the mortality from severe acute pancreatitis progressed to a polyorganic insufficiency reaches 60%. Analysis of mortality structures shows that more than 50% of patients die from severe acute pancreatitis in first 72 hours, which is indicated as early severe pancreatitis. In the recent years the experimental and clinical studies proved that continuous vein to vein hemifiltration in the early stage allowes to lower the severity of poliorgan insufficiency and early death. The aim of the study was to measure the efficiency of vein to vein hemifiltration in the complex treatment of early severe acute pancreatitis. The retrospective analysis consisted of 106 patients, which were divided into 2 groups. 1st with vein to vein hemifiltration in the dose of less than 30ml/kg/h (n = 45) and more than 30 ml/kg/h (n = 20) respectively, the 3rd group did not receive vein to vein hemifiltration (n = 41). The study showed the decrease of early mortality (14 days) in the 2nd group (p = 0.022) and a tendency of decrease in the 2nd group (p = 0.093) compared to the 3rd group. The median interval from admission to death in the first two groups was 14 days while in the 3rd group it was only 5 days. The use of vein to vein hemifiltration in complex therapy of early severe acute pancreatitis patients allows to lower the early mortality. The best results were reached in the 2nd group.
    Anesteziologiia i reanimatologiia 01/2011;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Severe sepsis and septic shock remain the most serious problem of critical care medicine today with a mortality of 25-80%. Bacterial endotoxin is of considerable importance in the pathogenesis of sepsis. A selective hemosorbent in which endotoxin adsorption is accomplished via its binding to a synthetic peptide (LPS-A) has been recently designed in Sweden. The purpose of the study was to evaluate the efficiency of using the LPS-A in the complex treatment of patients with severe sepsis. Eight patients in whom the course of the underlying disease was complicated by the development of gram-negative sepsis in the postoperative period were examined. The patients had an APACHE II score of 20.4 +/- 4.5 LPS-A was performed using the hemosorbent Alteco LPS (Lund, Sweden) and an Aquarius hemoprocessor (Edwards Lifesciences) (U.S.A.). The use of LPS-A caused a significant reduction in endotoxin levels by 2.9 times. The level of procalcitonin was increased in all patients; after a LPS-A session, it was significantly decreased by 1.9 times. The use of LPS-A resulted in diminished tachycardia, elevated blood pressure and could reduce the doses of vasopressor amines. There was an improvement in lung gas exchange parameters. A study of the effect of LPS-A on the immune system showed a significant reduction (36.6%) in neutrophil oxygen-dependent metabolism according to the data of the spontaneous HCT test, a 2.4-fold decrease in large circulating immune complexes, and a rise in the count of mononuclear cells that died both by necrosis and apoptosis, the count of the cells significantly increased by 5.3 times in late apoptosis. A LPS-A session caused a significant drop in the blood level of endotoxin and procalcitonin and it was accompanied by a trend toward better hemodynamics and lung gas exchange and alleviated organ dysfunction. At the same time LPS-A showed the ambiguous effect on immune system parameters, which calls for further study.
    Anesteziologiia i reanimatologiia 01/2010;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Acute purulent mediastinitis (APM) is one of the most difficult forms of surgical infection with severe clinical course and lethality from 17 to 80%. Overall 80 patients with APM were treated; plasmapheresis in postoperative period was used at 66 of them. The main criteria of negative prognosis at the patients with APM were elderly age, high score on APACHE-2, SAPS-2 and SOFA scales, higher level of creatinine and urea serum concentration, hyperglycemia, leucopenia. Early application of plasmapheresis was associated with lower lethality (12.5% at the group with early beginning of plasmapheresis, 35.3% at the group with late beginning, 36.2% at the control group). Plasmapheresis promotes normalization of hemostasis, microcirculation and immune parameters, reduction of intoxication and systemic inflammation syndrome.
    Khirurgiia 02/2008;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Acute purulent mediastinitis (APM) is one of the most complicated forms of surgical infection, showing a high incidence of sepsis--from 45 to 100%, mortality rates of 17 to 80%. Sixty-eight patients with APM admitted to the N. V. Sklifosovsky Research Institute of Emergency Care in October 2002 to March 2007 were examined. Postoperatively, all the patients received extracorporeal hemocorrection techniques (EHT): plasmapheresis (PA) via filtration and continuous venovenous hemofiltration (CVVHF). According to the time of initiation of EHT, the patients were divided into 2 groups: 1) 34 patients in whom EHT was initiated within the first 24 hours after surgery; 2) 34 patients in whom it was started on postoperative day 2. The efficiency of early use of EHT in the complex therapy of APM was evaluated. The early initiation of EHT (PA and CVVHF) caused a reduction in endogenous intoxication and the magnitude of a systemic inflammatory reaction, which resulted in the rapidest restoration of the size of major populations and subpopulations of lymphocytes and prevented the development of immune system incompetence. The early use of EHT caused a significant reduction in hospital mortality (11.8 and 35.3% in the early and late EHT use groups, respectively).
    Anesteziologiia i reanimatologiia 01/2008;
  • S G Musselius, I V Aleksandrova, V A Strokov
    Sovetskaia meditsina 02/1987;
  • Klinicheskaia meditsina 02/1983; 61(1):82-7.
  • I V Aleksandrova, S I Reĭ, E I Pervakova
    Anesteziologiia i reanimatologiia
  • Anesteziologiia i reanimatologiia