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Publications (51)
Introduction. The problem of an adequate assessment of the prognosis of the outcome of severe community-acquired pneumonia (CAP) is particularly difficult if it is caused by an unusual pathogen for it, in particular Klebsiella pneumoniae .
The objective was to develop the approach for predicting the survival of a heterogeneous population of patient...
The paper represents the clinical guidelines for septic shock in adults, approved by the All-Russian public organization “Federation of anesthesiologists and reanimatologists” in 2023. Septic shock is a widespread condition with a high mortality rate. The recommendations cover the issues of etiology, pathogenesis, clinical signs and symptoms, metho...
INTRODUCTION. The need for accurate risk stratification is obvious. Modern methods are quite cumbersome, which can cause difficulties when applied in routine practice, and therefore relatively simple but accurate forecasting methods have become very popular, which, however, have not been validated in Russia: SORT (Surgical Outcome Risk Tool), SRS (...
Community-acquired pneumonia is one of the most common acute infectious diseases that has a significant share in the structure of mortality from respiratory diseases. It is extremely important to select rational antibiotic therapy which ensures optimal clinical efficacy, improved outcome, reduced rate of antibiotic resistance selection, and minimiz...
Strains of microorganisms characterized by resistance to antimicrobial drugs used in medical organizations continue to spread In most regions of the world including Russia. It is clear that it affects both the effectiveness of antimicrobial therapy and tactics and strategy of its use not only in adults patients but also in children. The pandemic of...
Introduction. The greatest difficulties arise in the differential diagnosis of hypovolemic or distributive (septic) shock. The aim of this study was to critically analyze the information value of the blood plasma content of lactate and procalcitonin (PCT) in patients with septic and hypovolemic shock.
Materials and methods. The diagnosis of «Sepsis...
The aimof our study was to evaluate the safety of ropivacaine given to lactating patients as a continuous infusion according to the selected local continuous wound infiltration (CWI) protocol after cesarean section (CS). Materials and methods.Elective CSs were performed under spinal anesthesia with bupivacaine 5% -2 ml at the L2L3 level. At the end...
Aim. Determinations of concentrations of total ropivacaine in venous blood with use of the selected scheme of prolonged analgesia of the postoperative wound after cesarean operation. Materials and Methods. The study involved 47 female patients after cesarean operation in whom during suturing of the laparotomy wound a multiperforated catheter was in...
The objective: to analyze the validity of recommendations of the special research committee of the European Society of Intensive Care Medicine (ESICM) and Society of Critical Care Medicine (SCCM) concerning the most important provisions for the management of patients with sepsis and septic shock identifying predictors of long-term need for medical...
It is known that the greatest difficulties in predicting the outcome of severe community-acquired pneumonia occur in elderly patients with gram-negative pneumonia.The objective: to compare the differentiating capacity of the PSI/PORT, SOFA, APACHE II, and MODS-2 scales in elderly patients with severe community-acquired pneumonia caused by K. pneumo...
Introduction. Despite the advances in modern anesthesiology, it is impossible to guarantee a safe course of anesthesia, and even with planned surgical interventions, there is a risk of death. At present, there is no unanimity in approaches to assessing perioperative risk, and many systems for determining this risk have not been validated in Russia....
According to the recommendations of the Surviving Sepsis Campaign (SSC), antibiotics should be administered within 1 hour after the onset of sepsis, and the centers for Medicare & Medicaid Services prescribe their administration within 3 hours.
The objective of this publication is to analyze the literature data on the start time of ABT when a patie...
Purpose of the study. To determine the need for perioperative antibiotic prophylaxis in video endoscopic operations in bariatric surgery. Materials and methods. The observational study included 152 patients who underwent sleeve gastrectomy for morbid obesity - 94 (61.84 %), gastric bypass surgery - 21 (13.82 %), mini-gastric bypass surgery - 31 (20...
This article described the main theses of clinical guidelines of the Russian Federation of Anesthesiologists and Reanimatologists on the perioperative management of patients with arterial hypertension. The classification of hypertension, the principles of stratification of the risk of perioperative complications associated with the patients hyperte...
Introduction. Strains of microorganisms resistant to antimicrobial agents are commonly found in medical units throughout most regions of the world, including Russia. This leads to lower antimicrobial therapy efficacy when treating nosocomial infections. In this regard, the timely implementation of adequate antibiotic therapy is of great importance....
Aim:
to identify risk factors for Clostridium difficile infection in patients of a therapeutic clinic in a multidisciplinary hospital.
Materials and methods:
A retrospective analysis of 110 case histories of patients who were hospitalized in therapeutic departments in the Municipal Autonomous Institution "City Clinical Hospital No. 40" in Yekate...
The objective: to evaluate the current diagnostic and prognostic significance of proadrenomedullin, as well as determine feasibility to expand its use in routine clinical practice.Subjects and methods. The main publications on proadrenomedullin published in the period from 1993 to 2019 were analyzed.Results. Determining the severity of systemic dis...
Показана эволюция становления реанимации и интенсивной терапии в мире и в России и роль отдельных специалистов в ее формировании и развитии. Продемонстрировано значение специальности и службы в современной клинической медицине. Отмечено, что роль медицины критических состояний с течением времени возрастает. Будет наблюдаться рост числа коек интенси...
Objective.
To compare the Quick Sequential (Sepsis-Related Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS) and Systemic Inflammatory Response Syndrome (SIRS) scores value in predicting poor outcomes in emergency department patients with/without infection in Russia.
Materials and Methods.
This prospective observational stud...
Aim:
To identify risk factors of adverse outcomes in patients with nonvariceal upper gastrointestinal bleeding.
Material and methods:
Epidemiological observational analytical longitudinal retrospective cohort study included 312 patients who were hospitalized in the Clinical Hospital #40 of Yekaterinburg in 2014-2016. The main inclusion criterion...
Objective:
To define the informative value of qSOFA score in the prediction of outcomes in surgical patients admitted to the Intensive Care Units.
Study design:
Post hoc analysis of multicenter prospective observational study RISES. The following patient information was analyzed: gender, age, diagnosis, presence of infection, SIRS criteria, qSOF...
The objective of the study: to define the informative value of qSOFA score in the prediction of sepsis outcomes in the patients admitted to the intensive care wards of medical units in the Russian Federation.Subjects and methods. The multi-center, prospective, and observational trial was conducted. The following data were analyzed in the patients a...
The review is devoted to one of the most critical issues of modern intensive care – the diagnostics of sepsis in children. The article describes the modern definition of sepsis and presents the review of the recent publications devoted to pediatric sepsis. It speculates on the benefits and drawbacks of Sepsis-3 recommendations for pediatric intensi...
Subjects and methods. The multi-center, prospective, and observational trial was conducted. The following data were analyzed in the patients admitted to intensive care wards: number of qSOFAscores, the presence of SIRS criteria, levels of lactate, procalcitonin, C-reactive protein in blood, the presence of sepsis according to Sepsis-3 criteria. The...
Post-caesarean section peritonitis (whose incidence varies from 0.05 to 1.5% throughout the world) is considered as a potential cause of maternal mortality. Therefore, in case of development of the clinical picture of sepsis the method of surgical choice is hysterectomy. Sepsis as a pathological process of infectious nature results from bilateral i...
Background:
Hospital-acquired infection (HAI) is a common problem in intensive care units (ICU) and other hospital units. The methodical system of surveillance of hospital-acquired infections (HAI) is not available in Russia and there is no reliable data about the prevalence or epidemiology of HAI. We aimed in this pioneer study to determine the p...
GOAL: study of special aspects in system inflammatory reaction caused by nosocomial bacteremia in dependence of the pathogen Gram-origin. The study included 85 patients with nosocomial bacteremia in ICU from 2010 till 2012. The main inclusion criteria was bacteria identification in blood, which was taken more than 48 hours from arrival to ICU withi...
The aim of the research was to reduce the risk ventilator-associated infections (VAI) in neonates with respiratory distress syndrome.
retrospective, observational, single center, historical control.
113 newborns were included in the study. Ventilator-associated pneumonia was diagnosed based on the criteria of VAP CDC/NNIS. Ventilator-associated tra...
These clinical guidelines apply to the implementation of health care for all patients with concomitant hypertension in the perioperative period in a hospital. The guidelines specify the method of stratifying the risk of perioperative cardiac complications. We described methods for the treatment of urgent conditions with hypertension and hypertensiv...
The aim of the study is to measure the effectiveness and safety of tranexam acid during hip and knee joint endoprothesis surgeries. Tranexam (Mir-Pharm, Russia) was administered to 45 patients 30 minutes before the surgery in the dose of 10-15 mg/kg and 6 hours after first infusion in the same dose. In the control group (n = 45) Tranexam was not ad...
The authors propose to put the 1991 US Consensus Conference criteria for sepsis into practice and research methodology. This will be helpful in reaching the consensus in definitions.
It is difficult to precisely predict the severity of each specific patient with acute pancreatitis (AP), by using conventional statistical methods or single clinical and laboratory criteria. By using the patient database, the authors developed an artificial neuronal network (ANN) to predict the severity of AP and compared it with the Ranson, Imrie/...
Two large intensive care centers performed a prospective controlled, randomized study evaluating the efficiency of closed aspiration systems in the prevention of lower respiratory tract infections during sustained artificial ventilation. Analysis of the results of the study has ascertained that the closed aspiration systems make it possible to atte...
The purpose of the investigation was to optimize the diagnosis and treatment of ventilator-associated pneumonia (VAP) in children. The prevalence, etiology, and onset of VAP in a pediatric intensive care unit, and the diagnostic value the clinical pulmonary infection score scale were studied. The prevalence of VAP was found to be 37.56 per 1,000 me...
The authors validate their positions in terminology of sepsis and evaluation of its severity, based on analysis of this problem evolution during the century, review of the most significant publications, and their own findings. Problems of intensive care are discussed. The authors claim that intensive care methods should be determined by the phase o...
A multicentre trial was performed on the activity of cefepime in comparison with ceftazidime, ceftriaxone, piperacillin/tazobactam, imipenem and ciprofloxacin against severe hospital infection pathogens in intensive care units. The isolates of Escherichia coli and Proteus spp. from the majority of the centres were highly susceptible to the antibiot...
The development of the multiorgan dysfunction syndrome, directly determining the severity of the septic process, is characterized by not only inverse ratio of the energy and plastic material, but by metabolic changes which are still unclear and cannot yet be explained. Our purpose was to detect some features of amino acid metabolism in patients wit...
A score for quantitative evaluation of the severity of clinical status has been created for a more objective assessment of the clinical status of patients with sepsis and septic shock. The system includes five sections: physiological parameters, level of respiratory support, age, localization of the focus, concomitant diseases. The final score repr...
This paper presents retrospective analysis of currently existing approaches to the medical treat� ment of severe sepsis and septic shock in patients from 7hospitals in 6 Russian cities. Two hundreds and eighty eight patients aged 16 to 75 years were included in this study. The most common diagnosis was sepsis associated with intraabdominal infec� t...