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Aim: To the outcomes of lower extremities burn wounds management by using of controlled moist environment., Material and Methods: Burn wounds management by using of controlled moist environment in 23 patients is presented in the article. Physiological moist conditions on the surface of wounds were created with isotonic sodium chloride solution and sterile polyethylene diaphanous containers. Сontrol group included 12 patients who were treated with hydrocolloid patch., Results: It was shown that burn wounds management with moist environment allows to use and improve this method further. This technique gives good analgesic effect within the first days after burn trauma, allows to implement permanent clinical monitoring of the wound and preserve functional activity of the limbs.

Surgical reconstruction of the left ventricle is an effective method of treatment for ischaemic cardiomyopathy. One of the conditions of successful intervention is correctly choosing a method of intraoperative myocardial protection. Currently, two techniques of myocardial protection are used: cardioplegic cardiac arrest and continuous myocardial perfusion on the beating heart. A series of experimental studies demonstrated that myocardial oxygen requirements in ischaemic cardiomyopathy during permanent perfusion are three times higher than during cardioplegic cardiac arrest. However, the technique of continuous myocardial perfusion in conditions of the beating heart makes it possible to prevent ischaemia of the most sensitive subendocardial layers of the myocardium. In order to determine optimal strategy of myocardial protection during surgical reconstruction of the left ventricle we retrospectively assessed therapeutic outcomes in a total of 136 patients presenting with ischaemic cardiomyopathy, an ejection fraction below 30%, and an end-systolic volume index of more than 100 ml/m2. The patients were divided into two groups: group 1 (n=44) subjected to reconstruction of the left ventricle performed on the beating heart and group 2 (n=92) undergoing surgery in conditions of cardioplegic cardiac arrest. We examined early and medium-term clinical and echocardiographic results (30-day mortality, postoperative complications, medium-term survival, and probability of the development of major adverse cardiac and cerebrovascular events (MACCE)). It was determined that short- and medium-term clinical and echocardiographic results of surgical reconstruction of the left ventricle in patients with an ejection fraction less than 30% do not depend on the method of myocardial protection (continuous myocardial perfusion in conditions of the beating heart or crystalloid cardioplegia).

Aim: To study the intensity of soft tissue repair in patients with diabetic foot syndrome (DFS) during local negative pressure wound treatment versus standard wound care., Subjects and Methods: The investigators estimated the clinical (wound sizes, local tissue oxygenation), histological (light microscopy), and immunohistochemical (CD31, CD68, MMP-9, and TIMP-1) markers for reparative processes in patients with DFS during vacuum therapy versus standard wound care. Forty-two patients with the neuropathic and neuroischemic (without critical ischemia) forms of DFS were examined after debridement. In the perioperative period, 21 patients received negative pressure wound therapy and 21 had standard wound care., Results: During vacuum therapy, the area and depth of wound defects decreased by 19.8±7.8 and 42.8±5.6%, respectively (p=0.002) (as compared to the baseline data). In the control group, these indicators were 17.0±19.4 and 16.6±21.6% (p=0.002). There was a significant intensification of local microhemodynamics according to transcutaneous oximetry readings in the negative pressure wound treatment group. After 9±2 days of treatment, histological examination of granulation tissue revealed a significant reduction in edema, cessation of inflammatory infiltration, and formation of mature granulation tissue in Group 1. Immunohistological examination indicated a more obvious increase in the count of macrophages (CD68 staining) and a significant increment in the number of newly formed vessels, as evidenced by anti-CD31 antibody staining. During the treatment, there was a decline of the expression of MMP-9 and an increase in that of TIMP-1, as compared to those in the control group., Conclusion: The findings are indicative of the enhanced intensity of reparative processes in patients with DFS during vacuum therapy versus standard wound care, resulting in more rapidly decreased wound sizes, increased local microhemodynamics, reduced inflammation, and accelerated wound transition from the inflammatory to the proliferative phase.

The dynamics of microbial endotoxemia in group of 149 patients with cholelithiasis complicated by obstructive jaundice has been studied as dependent on the perioperative tactics of infusion therapy. The perioperative period in obstructive jaundice patients is complicated by a significant increase in lipopolysaccharidemia caused by translocation mechanisms and disorders of the liver detoxification function. In Group 1, 47 patients received infusion therapy including Ringer's solution and 10% glucose solution at a 1:1 ratio. In group 2, 55 patients received infusion therapy with only Sterofundin G-5 solution. In Group 3, 47 patients received the infusion therapy with remaxol in a dose of 800 ml/day. It is established that the infusion of Sterofundin G-5, and to a greater extent the infusion of remaxol, reduces the early postoperative degree of decompensation and accelerates recovery of the detoxifying function of Kupffer cells with respect to microbial endotoxin.

Total replacement of hip joint is considered as the most traumatic and bloody intervention in surgery as it is characterized with an expressed bleeding. It is done a total hip joint replacement of 1044 patients of both sexes from 25 to 80 years old. It was developed a complex and optimal infusion-transfusion therapy with total hip joint replacement. It is described a case of the female patient who had acute bleeding after an operation and further syndrome of disseminated intravascular coagulation DIC. It had developed a vicious circle: coagulation factors were consumed quicker than they could restore. It was applied controlled hypotension to decrease bleeding intensity. It resulted in drainage bleeding reduction. Simultaneously it was conducted complex infusion-transfusion therapy, substitution therapy with blood preparations, it was transfused fresh frozen plasma by the generally accepted methods. Infusion therapy was done with crystalloids and colloids in ratio 2/1. In 3 days there were improved coagulogramm performances and total blood count, the critical status of the patient was improved. Therefore, we should note that acute bleeding is a serious problem that requires adequate complex infusion-transfusion therapy, circulating blood volume restoration, microcirculation improvement and prevention of all reasons of bleeding. In case of need in order to reduce bleeding intensity at the same time with the complex infusion-transfusion therapy use controlled hypotension.

Unlabelled: The purpose of research is to study the influence of infusion therapy structure on the of metabolic disorders and biliary excretion correction in patients with obstructive jaundice., Materials and Methods: The study was carried out in 139 patients divided into 3 groups with the same volume of infusion therapy (1600 ml/day). In 1-St group (54 patients) infusion therapy included ringer's lactate and 10% glucose solution in the ratio of 1:1. In the 2nd group (37 patients) infusion therapy was sterofundine - G-5. In the 3rd group (48 patients) in infusion therapy have included remaxol with dosage of 800 ml/day., Results: The inclusion of remaxol and sterofundin in infusion therapy leads to the improvement of biliary excretion in the early postoperative period versus ringer's lactate and 10% glucose solution. Remaxol has the advantage in metabolic disorders and biliary excretion correction versus sterofundine-G-5.

The aim of this paper is to report the results of a multicenter open randomized clinical study of the efficacy of nasal and nasopharyngeal irrigation for the prevention of seasonal morbidity due to acute respiratory infections (ARIs) in the groups of preschool and school children. A total of 2386 children attending secondary schools and 519 ones attending kindergartens were examined. The study has demonstrated that irrigation of the nasal cavity and nasopharynx efficaciously reduces (by 2.4-3.2 times) the morbidity due to ARIs in organized children's collectives throughout the entire length of the epidemiological period; moreover, it improves the clinical course of ENT organ diseases and bronchial asthma.

The efficacy of Sterofundin, Normofundin, and physiological solutions in correcting hypernatremia and impaired acid-base balance was analyzed in patients with sellar region tumors. Twenty-one patients were enrolled in the study; three groups were formed. Physiological solution added by 4% of potassium chloride and 25% magnesium sulfate solution was used in Group 1 (n = 7). Normofundin was employed in Group 2 (n = 7). Sterofundin was applied to Group 3 (n = 7). The volume of administered fluid corresponded to the sum of volumes of basic needs and those of fluid losses. The study revealed that the most adequate correction of hypernatremia was seen with the use of Sterofundin. The use of Normofundin is associated with a risk of a rapid and significant reduction in the level of sodium and that of physiological solution fails to correct hypernatremia. Metabolic alkalosis was typical for all the patients included into the study. Its effective correction was noted only when Sterofundin was used.

The paper analyzes the results of a comparative study of different infusion therapy modalities in victims with polytrauma during transportation to a specialized traumatological center. A combination of crystalloids and dextrans was applied to a control group and hydroxyethyl starch (HES) 130/0.4 was used in a study group. The evaluation criteria were the maintenance of stable hemodynamic parameters during transportation; a negative effect on hemostatic parameters and a preventive effect against the development of multiple organ dysfunction during transportation. Infusion therapy using HES has an advantage by all the parameters estimated.

Despite the extended potentials of modern medicine, noncompensated blood loss remains one of the leading causes of death in the able-bodied population all over the world. At present, there is no uniform policy of transfusion maintenance and intensive care in victims with severe decompensated blood loss. The purpose of the study was to assess the results of compensation for acute blood loss in victims with concomitant injury and wounds at various sites, which were attended by the loss of a circulating blood volume (CBV) with the use of new technologies. The authors retrospectively assessed the specific features of the course of anesthesia and compensation for blood loss in 66 male victims (mean age 37 +/- 1.5 years) with concomitant injury and various wounds complicated by acute CBV loss. CBV was compensated for by the currently available infusion media; globular blood volume deficit was restored via intraoperative instrumental reinfusion of autoblood and donor blood. The proposed procedure for infusion-transfusion therapy made it possible to stabilize the patient's condition and to perform emergency surgical treatment in victims with fatal blood loss. Total mortality in the chosen intensive care modality was 62.1%.

The paper considers current approaches to the strategy and tactics of infusion-transfusion therapy (ITT) in the development of obstetric bleedings. The results of treatment were analyzed in 124 patients in whom pregnancy or labor had been complicated by hemorrhage. Various ITT options are presented depending on the volume of blood loss and physiological background. The ITT programs applied are based on the combined used of colloid and crystalloid solutions and hypertonic sodium chloride solution. With increased blood loss volume, artificial colloids are gradually excluded from an ITT program in the following order: dextrans, hydroxyethyl starch, and gelatin derivatives. Subsequently, priority is given to natural colloids. Blood components were transfused if strictly indicated. The studies have indicated that the baseline blood circulation of patients with physiological and severe gestosis-complicated pregnancy should be taken into account during ITT for acute obstetric blood loss. The differential approach to ITT and its pattern and type depend on the quantity of lost blood, that should be calculated as percentage with reference to the volume of circulating blood of a pregnant woman rather than relied on its total volume. The pathophysiologically substantiated approach to ITT for acute obstetric blood loss with the physiological background being kept in mind makes it possible to stabilize the parameters of blood circulation, volemic and colloid-osmotic homeostasis, thereby reducing the incidence of postoperative complications.

The course of anesthesia during uterine extirpation for large and giant myomas depends on the efficiency of blood loss compensation and relative hypovolemia after rapid decompensation when a mass is removed. Thirty-five patients with a uterine myoma with the size corresponding to 18-40-week gestation were examined. Dextrans and voluven (hydroxyethylstarch 130/0.4) were used in Groups 1 (n = 20) and 2 (n = 15). The intraoperative administration of voluven reduced the volume of crystalloids and a need for sympathomimetics and maintained the normal amount of fluid and sectoral distribution.

Compensation of operation blood loss up to 10% of the circulating blood volume (CBV) by autohemotransfusion with intraoperative blood collection (33 patients) and infusion of colloid and crystalloid solutions (33 patients) was studied. It was shown that the intraoperative blood loss up to 10% of CBV resulted in statistically considerable changes in hemoglobin, packed cell volume, erythrocytes, and fibrinogen appearing by the moment of blood loss compensation; within 4-6 hours after surgery the changed clinical and hemostasiological indices caused by blood loss up to 10% of CBV were rapidly arrested by autohemotransfusion with the intraoperatively collected blood or infusion of colloid and crystalloid solutions. No advantages of autohemotransfusion with the intraoperatively collected blood over the infusion of colloid and crystalloid solutions were found in compensation of intraoperative blood loss up to 10% of CBV.

The authors review current views on the treatment of acute rhinitis (AR) in infants and present their experience in AR treatment of 30 infants aged from 3 days to 1 year. Combined treatment with Physiomer baby quickly eradicated inflammation. The drug eliminates crusts and nasal discharge allowing application of other medication on a clear surface of nasal mucosa. As a result, medication becomes more affective and accelerates recovery. A convenient tip is well adapted for the nostrils. Administration of medicine by spray provides optimal lavage of the nasal cavity.