A case of successful intensive treatment of a child with a severe burn injury

V.A. Matskevich1, Yu.B. Shukhat1, J.N. Kolegova1, O.L. Maximova1, E.O. Vasilieva1,2, A.I. Gritsan1,2

1 Krasnoyarsk Regional Clinical Hospital, Regional Public Health Institution, Krasnoyarsk

2 Krasnoyarsk State Medical University named after professor V.F. Voyno-Yasenetsky, Ministry of Health of the Russian Federation, Krasnoyarsk

For correspondence: Alexey I. Gritsan, Dr. med. Sci., Professor, Chief of the Department of Anaesthesiology and Intensive Care Krasnoyarsk of the State Medical University named after Professor V.F. Voyno-Yasenetsky, Ministry of Health of the Russian Federation, Krasnoyarsk; e-mail: gritsan67@mail.ru

For citation: Matskevich VA, Shukhat YuB, Kolegova JN, Maximova OL, Vasilieva EO, Gritsan AI. A case of successful intensive treatment of a child with a severe burn injury. Alexander Saltanov Intensive Care Herald. 2019;1:100–3.

DOI: 10.21320/1818-474X-2019-1-100-103


In this article presented the positive clinical experience of treatment of a child with deep extensive burns up to 85 % of the body surface. It is proved that successful treatment of this patient is possible only in a multidisciplinary clinic with combination of active surgical tactics, balanced infusion-transfusion, adequate antibacterial and immuno-substitutive therapy, control of microbiome of wound secret and biological fluids, usage of the air fluidized bed, personified dressing tactics, suitable nutritional support, a complex of modern rehabilitation measures.

Keywords: child, burn, narcosis, necrectomy, autodermoplasty, intensive care, wounds, air fluidized bed, antibiotics, rehabilitation

Received: 23.11.2018


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Intensive treatment of ovarian hyperstimulation syndrome. Clinical guidelines (treatment protocol)

L.V. Adamyan1, N.V. Artymuk2, T.E. Belokrinickaya3, A.V. Kulikov4, D.V. Marshalov5, A.P. Petrenko5, I.A. Salov5, O.S. Filippov6, E.M. Shifman7

1 FGBU «National medical research center for obstetrics, gynecology and perinatology named after V.I. Kulakov» Ministry of Health of Russia, Moscow

2 FGBOU VO “Kemerovo State Medical University” Ministry of Health of Russia, Kemerovo

3 FGBOU VO “Chita State Medical University” Ministry of Health of Russia, Chita

4 FGBOU VO “Uralʼsk State Medical University” Ministry of Health of Russia, Uralʼsk

5 FGBOU VO “Saratov State Medical University named after V.I. Razumovskij” Ministry of Health of Russia, Saratov

6 FGAOU VO “Moscow State Medical University named after I.M. Sechenov” Ministry of Health of Russia, Moscow

7 GBUZ MO “Moscow Regional Scientific Research Clinical Institute named after M.V. Vladimirsky”, Moscow

For correspondence: Marshalov Dmitrij — PhD, Associate Professor at the Department of Simulation Technologies and Emergency Medicine of the Saratov State Medical University named after V.I. Razumovskij, Saratov; e-mail: Marshald@mail.ru

For citation: Adamyan L.V., Artymuk N.V., Belokrinickaya T.E., Kulikov A.V., Marshalov D.V., Petrenko A.P., Salov I.A., Filippov O.S., Shifman E.M. Intensive treatment of ovarian hyperstimulation syndrome. Clinical guidelines (treatment protocol). Alexander Saltanov Intensive Care Herald. 2018;4:8–25.

DOI: 10.21320/1818-474X-2018-4-8-25


Ovarian hyperstimulation syndrome (OHSS) is a systemic disease that develops as a result of activation of the production of vasoactive mediators by the ovaries against the background of stimulation of superovulation. OHSS is characterized by an increase in the permeability of the capillary walls, which leads to the release of intravascular fluid into the extravascular space, its accumulation in the third space and hemoconcentration. Severe OHSS is characterized by the risk of thrombosis, impaired liver function, kidney function and the occurrence of adult respiratory distress syndrome (ARDS). In these clinical guidelines, the main provisions for the prognosis, diagnosis, prevention and intensive care of OHSS are presented, including the principles of treatment of intra-abdominal hypertension (IAH).

Keywords: ovarian hyperstimulation syndrome, intensive care, OHSS prevention

Received: 23.10.2018


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Critical and Respiratory Care Medicine Needs a Humanitarian Culture

A.P. Zilber

Federal State Budgetary Educational Institution of Higher Education «Petrozavodsk State University» (PetrSU), Petrozavodsk

For correspondence: Anatoly P. Zilber — M.D., Ph.D., Chief of Chair of Critical and Respiratory Care Medicine Petrozavodsk University Medical School, Petrozavodsk; e-mail: anatoly.zilber@gmail.com

For citation: Zilber AP. Critical and Respiratory Care Medicine Needs a Humanitarian Culture. Intensive Care Herald. 2017;2:8–11.


The Humanitarian culture specificity is discussed in critical care medicine as well as in the divisions of the critical care medicine: intensive care, anesthesiology, reanimatology, emergency and disaster medicine. The role of humanitarian culture and a humour are emphasized in burnout syndrome prevention.

Keywords: intensive care, critical care medicine, humanitarian culture

Received: 12.04.2017


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The Thromboelastography: Clinical Significance of Functional Fibrinogen Test

A.Yu. Bulanov1, 2, K.V. Yatsckov1, E.L. Bulanova1,3, N.V. Dobrova1

1 52th Moscow City hospital, Moscow

2 Russian University of Friendship, Moscow

3 First Moscow Medical University, Moscow

For correspondence: Bulanov Andrey Yulievich — Doctor of Medical Science, Head of consultative transfusiology team of 52th Moscow City hospital, Professor of Department of Anesthesiology and Reanimatology of Russian University of Friendship, Moscow; e-mail: buldoc68@mail.ru

For citation: Bulanov AYu, Yatsckov KV, Bulanova EL, Dobrova NV. The Thromboelastography: Clinical Significance of Functional Fibrinogen Test. Intensive Care Herald. 2017;1:5–11.


The hemostatic system is a frequent subject of interest of critical care. Critical hemostasis has been studied most commonly using thromboelastography. Presented study report the experience in the use of special TEG technology fictional fibrinogen test. As the main working area of FF-test should be marked posthemorrhagic coagulopathy, a situation demanding close attention to the function of the platelets when combined with hyperfibrinogenemia (increase in fibrinogen associated with nonspecific inflammation, gestational hyperofibrinogenemia). A significant difference (more than 2 g/l) between the level of fibrinogen of the plasma is estimated by the method of Claus and FF-test can serve as a marker of dysfibrinogenemia. The clinical importance of the methodology is a predictor of thrombotic and haemorrhagic problems, the diagnostic marker, a reference point for the purpose of transfusion therapy.

Keywords: thromboelastography, functional fibrinogen, bleeding, thrombosis, intensive care

Received: 21.01.2017 


References

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  7. Pruller F., Raggan R.B., Mahla E. et al. Whole blood fibrinogen test results in thromboelastography and thromboelastometry — which one is true? Transfusion Med.. 2014: 24(suppl. 1): 45.
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Perioperative Management of Patients with Diabetes Mellitus

Y.P. Malyshev1, I.B. Zabolotskih1, K.M. Lebedinskii2, M.I. Neymark3, P.V. Dunts4

1FGBOU HE «Kuban State Medical University» Ministry of Health of the Russian Federation, Krasnodar

2FGBOU HE «Northwest State Medical University named I.I. Mechnikov» Ministry of Health of the Russian Federation, Saint-Petersburg

3FGBOU HE «Altai State Medical University» Ministry of Health of the Russian Federation, Barnaul

4FGBOU HE «Vladivostok State Medical University» Ministry of Health of the Russian Federation, Vladivostok

For correspondence: Malyshev Yuri Pavlovich — Ph.D., Professor, Department of Anesthesiology, Intensive Care and Transfusion FPC and PPP Medical University, «Kuban State Medical University» Ministry of Health of the Russian Federation, Krasnodar; e-mail: malyshevyp@mail.ru

For citation: Malyshev YP, Zabolotskikh IB, Lebedinskii KM, Neumark MI, Dunts PV. Perioperative Management of Patients with Diabetes Mellitus. Intensive Care Herald. 2016;4:41–51.


The article summarizes current understanding of the endocrine disorders caused by diabetes mellitus. Preoperative evaluation and assessment of patients with concomitant diabetes mellitus before anaesthesia are presented. Key points include preoperative period optimization, intraoperative management, prevention of urgent diabetes complications, blood glucose correction for urgent and elective surgery.

Keywords: diabetes mellitus, diagnosis, management of the patient, anesthesia, intensive care, perioperative

Received: 10.08.2016


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Experience of Treatment of Seasonal Influenza, Complicated by Viral and Bacterial Pneumonia: a Multicenter Retrospective Study

D.L. Shukevich1, G.P. Plotnikov1, L.E. Shukevich3, S.V. Voevodin4, E.A. Kameneva2, R.A. Kornelyuk1, S.V. Vostrikov3, D.C. Peredelkin3, P.G. Sitnikov4, E.F. Malyugin5, E.I. Tutolmin5, V.E. Shipakov5, E.V. Grigorev1

1 FGBNU «Institute for Complex Problems of cardiovascular disease», Kemerovo

2 MBUZ «City Clinical Hospital № 3», Kemerovo

3 GAUZ «Kemerovo Regional Clinical Hospital», Kemerovo

4 MLPU «City Clinical Hospital № 1», Novokuznetsk

5 GAUS «Tomsk Regional Clinical Hospital», Tomsk

For citation: Shukevich DL, Plotnikov GP, Shukevich LE, Voevodin SV, Kameneva EA, Kornelyuk RA, Vostrikov SV, Peredelkin DC, Sitnikov PG, Malyugin EF, Tutolmin EI, Shipakov VE, Grigorev EV. Experience of Treatment of Seasonal Influenza, Complicated by Viral and Bacterial Pneumonia: a Multicenter  Retrospective Study. Intensive Care Herald. 2016;2:46–50.


Тhe aim of the study. To conduct a comparative analysis of the experience of intensive care of severe viral-bacterial pneumonia, complicated by ARDS. Materials and methods. We conducted a retrospective analysis of clinical, historical, laboratory and instrumental data which were done by comparing the array of indicators for the periods (1) 2009 and (2) 2015–2016. We used the standard methods of investigations, including clinical, instrumental and laboratory methods. Results. The period 2015–2016 was characterized by an early hospitalization of patients in the ICU, a quick decision to intubate the patients and the rejection of non-invasive respiratory support, the expansion of indications for extrapulmonary oxygenation procedures and for renal replacement therapy.

Conclusions

  1. Following the principles of intensive treatment of severe viral and bacterial pneumonia flu season A(H1N1) have improved outcomes in the studied group of patients.
  2. Initial experience of the extracorporeal membrane oxygenation (ECMO) demonstrated the perspective for achieving optimal oxygenation without the ventilator-associated lung injury. The criteria for the initiation of ECMO can be moved into the area of critical values decrease the oxygen fraction, plateau pressure and positive end-expiratory pressure.
  3. Methods of renal replacement therapy with the use of membranes with the function of cytokine adsorption can neutralize the systemic inflammatory response.

Keywords: seasonal flue, acute respiratory distress syndrome, intensive care

Received: 09.05.2016


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