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1. Remifentanil: a review of its analgesic and sedative use in the perioperative period

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, Yuliana Babina, and Kateryna Dmytriieva
Subjects: opioid analgesics, remifentanil, general anesthesia, Medicine
Abstract: Adequate perioperative pain relief is an integral part of anesthesia. Opioid analgesics occupy one of the key places in the purchase of acute and chronic pain in the world. The article presents current data on the clinical effectiveness of remifentanil, a derivative of fentanyl, which is a selective ultra-short-acting μ-opioid receptor agonist when used in the perioperative period for the treatment of acute and chronic pain. Comparisons of the therapeutic activity and physicochemical properties, pharmacokinetic and pharmacodynamic characteristics of remifentanil with other opioids (fentanyl, sufentanil, alfentanil) are provided. Its unique properties (eg, organ function-independent metabolism, non-accumulation, rapid onset of action, and short duration of action) distinguish it from other opioid agents. Remifentanil is at least as effective as comparator opioids such as fentanyl, sufentanil in relieving pain and sedating patients during the perioperative period. In addition, it provides rapid and predictable extubation and is associated with shorter duration of mechanical ventilation and shorter length of hospitalization than comparators in some studies. In addition, remifentanil is well tolerated in both adults and children. Thus, remifentanil is a desirable addition to currently available pharmacologic agents used to treat period pain in patients
Published: 2024
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2. Pain management for multiple rib fractures: a narrative review

Author: Andrii Harha, Yaroslava Harha, and Dmytro Dmytriiev
Subjects: rib fractures, pain relief for rib fractures, regional analgesia rib fractures, multimodal analgesia, erector spinae plane block, Medicine
Abstract: Trauma is a leading cause of death in people younger than 40 years, and on the third place after cardiovascular and oncological disease overall. Chest trauma is a fi nding in up to 60 % of patients with multiple trauma and has a mortality rate as high as 20–25 %. Rib fractures are the most common fi ndings in patients with thoracic trauma with mortality rates among hospitalised patients between 10 and 22 %. The mortality rate is higher in elderly patients and patients with flail chest. The incidence of pneumonia in the elderly population with three to four and more than six rib fractures is 31 % and 51 %, respectively. Pain due to rib fractures is challenging to manage but effective analgesia reduces hypoventilation, promotes deep breathing, sufficient coughing, clearance of secretions, and better adherence to chest physiotherapy. Th erefore, high-quality analgesia is not only increasing patient comfort but also is very important in preventing complications and improving the outcome. Th e purpose of this review is to analyse the modern literature regarding pain management for a patient with rib fractures and extract the best evidence-based practice.
Published: 2024
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3. Perioperative hemodynamic protective assessment of adaptive support ventilation usage in pediatric surgical patients

Author: Dmytro Dmytriiev, Mykola Melnychenko, Oleksandr Dobrovanov, Oleksandr Nazarchuk, and Marian Vidiscak
Subjects: adaptive support ventilation, estimated continuous cardiac output, hemodynamic, perioperative period, pressure-controlled ventilation, ventilation, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract: Background The aim of this study was to evaluate the hemodynamic protective effects of perioperative ventilation in pressure-controlled ventilation (PCV) and adaptive support ventilation (ASV) modes based on non-invasive hemodynamic monitoring indicators. Methods The study included 32 patients who were scheduled for planned open abdominal surgery. Depending on the chosen ventilation strategy, patients were included in two groups of PCV mode ventilation (n=14) and ASV mode ventilation (n=18). The hemodynamic effects of the ventilation strategies were assessed by estimated continuous cardiac output (esCCO) and cardiac index (esCCI). Results Preoperative cardiac output (CO) was 6.1±1.3 L/min in group 1 patients and 6.3±0.8 L/min in group 2 patients, and preoperative cardiac index (CI) was 3.9±0.4 L/min/m2 in group 1 patients and 3.8±0.8 L/min/m2 in group 2 patients. The ejection fraction (EF) in group 1 subjects was 55.4%±0.3%; this rate was 56.5%±0.5% in group 2 subjects. Group 1 patients experienced a 14.7% CO decrease to 5.2±0.7 L/min, a 17.9% CI decrease to 3.2±0.6 L/min/m2, and a 12.8% mean arterial pressure decrease to 82.3±9.4 mm Hg 30 minutes after the start of surgery. One hour after the start of surgery, the CO mean values of group 2 patients were lower than baseline by 7.9% and differed from the dynamics of patients in group 1, in whom CO was lower than baseline by 13.1%. At the end of the operation, the CO values were lower than baseline by 11.5% and 6.3% in patients of groups 1 and 2, respectively. Our data showed that the changes in EF during and after surgery correlated with CO indicators determined by the esCCO. Conclusions In our study, perioperative ventilation in ASV mode was more protective than PCV mode and was characterized by lower tidal volume (16.2%) and driving pressure (12.1%). Hemodynamically-controlled mechanical ventilation reduces the negative impact of cardiopulmonary interactions.
Published: 2022
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4. The effect of local anesthetics against planktonic forms and film formation of S. aureus strains and its dependence on antiseptics activity

Author: Mariia Faustova, Oleksandr Nazarchuk, Dmytro Dmytriiev, Yuliana Babina, Halyna Nazarchuk, and Alina Dudar
Subjects: surgical site infections, Staphylococcus, antiseptics, local anesthetics, biofilms, Microbiology, QR1-502
Abstract: Today surgical site infections (SSIs) remain the second among hospital acquired infections in Europe and the USA. Staphylococcus aureus as a pathogen of nosocomial infections occur more frequently in surgical hospitals. The work was aimed to establish the effect of local anesthetics against planktonic forms and biofilm-formation of S. aureus clinical strains and the relationship between the sensitivity of S. aureus strains to local anesthetics and antiseptics in vitro. The antimicrobial activity of local anesthetics (0.5%, bupivacaine, 2.0% lidocaine, 0.375% ropivacaine) and antiseptics (decamethoxine 0.02%, chlorhexidine 0.05%) against clinical strains of S. aureus was observed and studied their ability to produce biofilms. The antimicrobial effect of local anesthetics was lower compared to antiseptics, but we observed inhibition of growth and reproduction of S. aureus in their presence. The ropivacaine solution and the lidocaine solution demonstrated almost the same activity against the studied microorganism isolates. Along with this, bupivacaine solution had the highest activity against the studied microorganisms. The minimal inhibitory concentration of bupivacaine for S. aureus was 2.2 times lower than the minimal inhibitory concentration of lidocaine and 2.1 times lower than the minimal inhibitory concentration of ropivacaine significantly (p
Published: 2023
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5. Optimization of the target strategy of perioperative infusion therapy based on monitoring data of central hemodynamics in order to prevent complications

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, Mykola Melnychenko, and Bohdan Levchenko
Subjects: ERAS (Enhanced Recovery After Surgery), GDT, infusion therapy, hemodynamic monitoring, central hemodynamics, cardiac output, Medicine (General), R5-920
Abstract: Enhanced Recovery After Surgery (ERAS) protocols are increasingly used in the perioperative period around the world. The concept of goal-directed fluid therapy (GDT) is a key element of the ERAS protocols. Inadequate perioperative infusion therapy can lead to a number of complications, including the development of an infectious process, namely surgical site infections, pneumonia, urinary tract infections. Optimal infusion therapy is difficult to achieve with standard parameters (e.g., heart rate, blood pressure, central venous pressure), so there are various methods of monitoring central hemodynamics – from invasive, minimally invasive to non-invasive. The latter are increasingly used in clinical practice. The current evidence base shows that perioperative management, specifically the use of GDT guided by real-time, continuous hemodynamic monitoring, helps clinicians maintain a patient’s optimal fluid balance. The manuscript presents the analytical data, which describe the benefits and basic principles of perioperative targeted infusion therapy based on central hemodynamic parameters to reduce the risk of complications.
Published: 2022
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6. Erector spinae plane block for affective and safe analgesia in a patient with severe penetrating chest trauma caused by an explosion in the battlefield

Author: Dmytro Dmytriiev, Dan Sebastian Dîrzu, Mykola Melnychenko, and Rudiger Eichholz
Subjects: combat anesthesia, continuous peripheral nerve block, erector spinae plane block (ESP), postoperative regional anesthesia, Medicine, Medicine (General), R5-920
Abstract: Abstract The ongoing conflict in Ukraine continues to generate many complex traumatic injuries and provides unique challenges to anaesthesiologists who provide medical care at various levels of medical evacuation. We report the successful use of an ultrasound‐guided continuous erector spinae plane (ESP) block in a patient with severe posterolateral chest trauma. The acute perioperative outcome of the patient was improved with the ESP block, the main benefits being excellent analgesia and minimal postoperative morphine requirements without influencing the risk of bleeding and coagulopathy. We conclude that continuous ESP block can be utilized to provide excellent analgesia following massive thoracic trauma. It's ease of placement under ultrasound guidance and low risk of complications makes this technique particularly useful in war medicine.
Published: 2022
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7. Chronic pain in cancer patients

Author: Anastasiia Moisieienko, Oleksandr Marchuk, Ivan Lisnyy, and Dmytro Dmytriiev
Subjects: Pain, Chronic pain, Cannabis, Anesthesiology, RD78.3-87.3
Abstract: Background. Pain is a complex clinical sign that is highly variable in both intensity and perception by patients. Often, a combination of symptoms and signs can indicate a pain syndrome specific to oncology. Virtually all patients with malignant diseases experience recurrent episodes of acute pain, which may accompany previous surgery, invasive procedures, or complications such as pathologic fractures or disease progression. Chronic pain is a huge economic burden on society, both in terms of health care and lost productivity. Effective treatment of chronic pain results in significant improvements in general and psychological wellbeing and functioning of cancer patients and reduces the burden of chronic pain on health services. The purpose is to clarify the problems of the prevalence of chronic pain in cancer patients, the complexity and variability of the pathophysiological mechanisms of the development of pain syndrome, to consider modern approaches to the management of patients with chronic pain. Materials and methods. Modern foreign guidelines for the management of cancer patients with pain syndrome, written in English, data from metaanalyses, reviews and clinical studies were used. Conclusions. Data from a 2016 crosssectional study to determine the prevalence and impact of depression on health care costs in patients with complex chronic pain indicated that patients with chronic pain are at increased risk of developing depressive disorder of varying severity. About onethird of the study sample had major depression, and the overall prevalence of depression among individuals with chronic pain was higher than 50% [3]. Up to 75% of all cancer patients with chronic pain have nociceptive (somatic or visceral) or neuropathic syndromes, which are a direct consequence of the development and progression of the neoplasm. Other causes include anticancer drugs and disorders unrelated to the disease or its treatment. Several systems are used to classify the pain syndrome, in particular — ECS-CP, IASP, ACTTION-APS. Today, in the management of cancer patients with chronic pain, the WHO threestep analgesic ladder is used: the first two steps are paracetamol and NSAIDs, mild opioids (control of mild and moderate pain), the third is opioids. The selection of opioids, their dosage and titration features should take into account the individual characteristics of the patient in order to avoid overdose and addiction. In addition to the abovementioned drugs, studies are being conducted to determine the effectiveness and feasibility of using medical cannabis as an alternative means, the use of which will improve the general condition of patients by relieving pain, and preventing the development of opioid addiction. Interventional techniques (neurolytic blockades, neuraxial infusions, trigger point injections, spinal cord stimulation, intrathecal drug administration, and vertebral augmentation) are also used to control chronic pain. The application of physical and psychosocial methods in the comprehensive management of such patients is studied.
Published: 2022
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8. Elevated serum TLR4 level as a potential marker for postsurgical chronic pain in pediatric patients with different approaches to analgesia

Author: Yaroslav Semkovych and Dmytro Dmytriiev
Subjects: pain, chronic pain, Toll-like receptor 4, children, regional anesthesia, Medicine (General), R5-920
Abstract: IntroductionThe perioperative period of any surgery is accompanied by immune suppression. The level of Toll-like receptor 4 (TLR4) is known to increase in inflammation and after nerve injury and contributes to the development of neuropathic pain. The interaction of TLRs in response to the effect of opioids results in paradoxical hyperalgesia. Regional anesthesia techniques are the standard of care for perioperative pain management in children.AimThe aim of the study was to determine and evaluate the indicators of TLR4 for different methods of pain relief in anesthetic management of hernia repair in children and their effect on pain chronification.Materials and methodsThere were examined 60 children with inguinal hernia during 2020–2022. Children were divided into 3 groups: Group I included 20 children who underwent surgery under general anesthesia using the block of the anterior abdominal wall—transversalis fascia plane block (TFPB), combined with the quadratus lumborum block (QLB-4) via a single intramuscular injection; Group II included 20 children who underwent surgery under general anesthesia using the TFPB; Group III comprised 20 children who underwent surgery under general anesthesia using opioid analgesics. The levels of TLR4 were evaluated at a discharge from the hospital, 3 and 6 months after surgery.ResultsThere was no difference in age and body weight among all groups. In Group II, boys prevailed. In Group III, the length of hospital stay was the longest (3.28 ± 0.24 days, p < 0.05, t = 4.09) as compared to children of Group II and Group I (3.0 ± 0.30 (p < 0.05, t = 2.647) and 2.1 ± 0.16 days, respectively). While staying in the surgical department, children of Group III demonstrated significantly higher FLACC and VAS scores. The prevalence of chronic pain was the highest among children of Group III (35%) as compared to those in Group II and Group I (20 and 15%, respectively). The highest increase in the level of TLR4 was found in the group of opioid analgesia on the third and sixth months after surgery (68.86 + 10.31 pg/ml and 143.15 + 18.77 pg/ml (p < 0.05, t = 6.33), respectively) as compared to patients who received regional anesthesia.ConclusionsThere were confirmed the following advantages of the transversalis fascia plane block combined with the quadratus lumborum block (QLB + TFPB) via a single intramuscular injection: ease of use; adequate perioperative pain control as evidenced by the FLACC and VAS pain assessment scales; reduced perioperative use of opioid analgesics; shortening the length of hospital stay.
Published: 2022
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9. Management of pain treatment in the early postoperative period. Practice of using ketorolac. A clinical case

Author: Dmytro Dmytriiev, A Andriiets, E Andriiets, V Bankivsky, and S Yatsenko
Subjects: ketorolac, analgesia, clinical case, pain, Anesthesiology, RD78.3-87.3
Abstract: The current strategy of rational perioperative analgesia involves reducing the use of opioid analgesics and preventing associated side effects. Today it is known that the use of opioid analgesics can further lead to the development of hyperalgesia. Opioid-induced hyperalgesia is an adaptive response of the body in response to exogenous administration of opioids, the mechanisms of development of which are associated with the activation of the central glutamatergic system and the release of spinal dinorphins. In contrast, gabapentin, NSAIDs, and ketamine have opioid-preserving properties, reducing the number of opioid-associated side effects. Hyperalgesia is a condition that underlies the formation of chronic pain and develops regardless of the degree of postoperative wound repair. For the treatment of pain in the postoperative period, the main group of treatment agents are opioid analgesics, which are prescribed to 60% of patients. However, with severe pain, there is a need for opioids in doses that exceed the standard recommended. It is known that the tactics of increasing the dose of opioid analgesics leads to an increase in the frequency of adverse reactions: severe sedation, respiratory depression, nausea, vomiting, intestinal paresis, dysfunction of the biliary and urinary systems, hallucinations. In order to reduce side effects, the doctor reduces the dose of opioids, which is accompanied by inadequate analgesia. Given the above, clinicians prescribe additional drugs of other drug groups that can enhance the analgesic effect of opioids. An important aspect is the ability to reduce the dose of opioids. Our data and data of other authors. Until recently, NSAIDs were rarely used in intensive care units, mainly in mild to moderate pain.
Published: 2020
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10. Innervation Anomalies and Interneural Anastomoses: Is There Clinical Relevance or Not?

Author: Dmytro Dmytriiev, Kostiantyn Dmytriiev, and Yevhenii Lysak
Subjects: interneural anastomosis, innervation anomalies, conductive anaesthesia, electroneuromyography, Anesthesiology, RD78.3-87.3
Abstract: Failed block could be one of the adverse results of the conductive anaesthesia. There are situations, when in seemingly perfect technique of the block, properly chosen drug, dosage, adjuvant – the block is not achieved (it does not occur or is incomplete or so-called “mosaic block” occurs). It is necessary to remember about atypical or abnormal nerves branching, possible interneural anastomoses, when looking for the possible cause of it. Information about most common types of interneural anastomosis of arm’s and leg’s long nerves is presented in this article. Knowledge of possible abnormal neural innervation can provide an understanding of inefficacy of some simple blocks, decrease amount of mistakes in data interpretation, that was obtained during electroneuromyographic (ENMG) investigations, improve understanding of clinical pattern in the peripheral nerve injuries, that form anastomosis.
Published: 2020
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11. Adjuvants in pain medicine. Selection of the drug depending on the desired effect – so which drug to choose?

Author: Dmytro Dmytriiev, Yevhenii Lisak, and Olesia Zaletska
Subjects: adjuvant, local anesthetic, regional anesthesia, pain medicine, conduction anesthesia, Anesthesiology, RD78.3-87.3
Abstract: To date, much research has focused on finding the ideal adjuvant for local anesthetics. Each of them can have different effects. In anesthesiology and pain medicine, depending on the purpose, one or another effect may be desirable. For example, in some situations it is desirable to accelerate the onset of action or prolong the duration of the block, in others the desired effect may be a “response to intravascular administration”, it should also be borne in mind that not all adjuvants are allowed for intrathecal administration.
Published: 2020
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12. Use of dexmedetomidine in complex treatment of patients in intensive care units

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, and Yuliana Babina
Subjects: sedation, dexmedetomidine, mechanical ventilation, non-invasive ventilation, COVID-19, Medicine
Abstract: Sedation is an important aspect of adequate treatment of patients in the intensive care unit. Recent drug developments and new ventilation strategies provide improved sedation management that allows for better adaptation to the clinical condition and individual needs of the patient. This article provides an overview of the general principles of sedation of patients in intensive care units and focuses on a relatively new drug in the pharmaceutical market of Ukraine — dexmedetomidine. Given the pandemic of coronavirus disease COVID-19, there was carried out a review of the international and domestic literature describing the use of dexmedetomidine as a sedative and analgesic in patients with acute respiratory distress syndrome caused by SARS-COV-2 virus. Its anti-inflammatory and antioxidant properties are also described, which will allow the use of the drug in complex therapy in the treatment of COVID-19 in severe patients.
Published: 2022
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13. Availability and Quality of Grief and Bereavement Care in Pediatric Intensive Care Units Around the World, Opportunities for Improvement

Author: Michelle Grunauer, Caley Mikesell, Gabriela Bustamante, Danielle Aronowitz, Kevin Zambrano, Andrea P. Icaza-Freire, Antonio W. D. Gavilanes, Rafael Barrera, the PICU-MIC Research Group, Jorge López González, Jesús López-Herce, Emanuele Rossetti, Chiusolo Fabrizio, Oliver Karam, Marie Saint-Faust, Paolo Biban, Silvia Carlassara, Bettina von Dessauer, Nadia Ordenes, Fabiola Figueroa Urízar, Adriana Wegner A, Michael Canarie, Kathryn Miller, José Irazuzta, Daniel Tawfik, Elizabeth W. Tucker, Nicole Shilkofski, Wang Wenchao, Zhang Yuxia, Lucy Lum Chai See, Sister Priscilla, Recep Tekin, Fesih Aktar, Duygu Sönmez Düzkaya, Oguz Dursun, Ebru Atike Ongun, Resul Yilmaz, Dincer Yildizdas, Hakan Tekgüç, Vitaliy Sazonov, Timur Tsoy, Askhat Saparov, Elizaveta Kalmbakh, Ernesto Quiñones, Luis Eguiguren, Killen Briones, Yaneth Tovilla, Sandra Tania Ventura Gómez, Silvio Fabio Torres, Paul Cobarrubias, Dmytro Dmytriiev, Alejandro Martínez, Gustavo Guzaman, Rudy Sanabria, Ravikumar Krupanandan, Bala Ramachandran, Nirmal Choraria, Jignesh Patel, Puneet A Pooni, Karambir Singh Gill, John Adabie Appiah, Tigist Bacha Heye, Rahel Argaw, Asrat Demtse, and Israel Abebe Admasu
Subjects: grief, bereavement, pediatric palliative care, pediatric critical care, end of life, Pediatrics, RJ1-570
Abstract: Pediatric Intensive Care Units (PICUs) provide multidisciplinary care to critically ill children and their families. Grief is present throughout the trajectory of illness and can peak around the time of death or non-death losses. The objective of this study was to assess how PICUs around the world implement grief and bereavement care (GBC) as part of an integrated model of care. This is a multicenter cross-sectional, prospective survey study. Questionnaires with multiple-choice and open-ended questions focusing on unit infrastructure, personnel, policies, limited patient data, and practices related to GBC for families and health care professionals (HCPs) were completed by on-site researchers, who were HCPs on the direct care of patients. PICU fulfillment of GBC goals was evaluated using a custom scoring based on indicators developed by the Initiative for Pediatric Palliative Care (IPPC). We compared average total and individual items fulfillment scores according to the respective country's World Bank income. Patient characteristics and details of unit infrastructure were also evaluated as potential predictors of total GBC fulfillment scores. Statistical analysis included multilevel generalized linear models (GLM) with a Gaussian distribution adjusted by child age/gender and clustering by center, using high income countries (HICs) as the comparative reference. Additionally, we applied principals of content analysis to analyze and summarize open-ended answers to contextualize qualitative data. The study included 34 PICUs from 18 countries: high-income countries (HICs): 32.4%, upper middle-income countries (UMICs): 44.1%, low middle-income and low-income countries (LMI/LICs): 23.5%. All groups reported some compliance with GBC goals; no group reported perfect fulfillment. We found statistically significant differences in GBC fulfillment scores between HICs and UMICs (specifically, HCP grief support), and between HICs and LMICs (specifically, family grief support and HCP grief support). PICUs world-wide provide some GBC, independent of income, but barriers include lack of financial support, time, and training, overall unit culture, presence of a palliative care consultation service, and varying cultural perceptions of child death. Disparities in GBC for families and HCPs exist and were related to the native countries' income level. Identifying barriers to support families and HCPs, can lead to opportunities of improving GBC in PICUs world-wide.
Published: 2021
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14. The effectiveness of moxifloxacin in the treatment of community-acquired pneumonia

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, and Yuliana Babina
Subjects: fluoroquinolones, moxifloxacin, treatment, pneumonia, COVID-19, Medicine
Abstract: The article presents the results of domestic and international studies of the use of the fourth-generation fluoroquinolone moxifloxacin in the treatment of commu-nity-acquired pneumonia and pneumonia caused by SARS-CoV-2. Analysis of the clinical use of moxifloxacin in the treatment of complications of the respiratory tract infec-tions indicates its high efficiency and bioavailability, a low risk of resistance, which makes it possible to recommend it for widespread use in the work of a practicing doctor. Ge-neric drug Maxicin (Yuria-Pharm), available as a 20 mg/ml concentrate in a 20 ml vial, can significantly reduce the cost of treatment and optimize infusion therapy by choosing both volume and solvent.
Published: 2021
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15. Pain Assessment and Management in Pediatric Intensive Care Units Around the World, an International, Multicenter Study

Author: Michelle Grunauer, Caley Mikesell, Gabriela Bustamante, Gissela Cobo, Sebastián Sánchez, Ana María Román, Andrea P. Icaza-Freire, Antonio W. D. Gavilanes, Nancy Ewen Wang, The PICU-MIC Research Group, Jorge López González, Jesús López-Herce, Emanuele Rossetti, Chiusolo Fabrizio, Oliver Karam, Marie Saint-Faust, Paolo Biban, Silvia Carlassara, Bettina von Dessauer, Nadia Ordenes, Fabiola Figueroa Urízar, Adriana Wegner A, Michael Canarie, Kathryn Miller, José Irazuzta, Nicolas Chiriboga, Daniel Tawfik, Barbara Sourkes, Hursuong Vongsachang, Elizabeth W. Tucker, Nicole Shilkofski, 王文超 Wang, Wenchao RN, Zhang Yuxia RN, Lucy Lum Chai See, Sister Priscilla, Recep Tekin, Fesih Aktar, Duygu Sönmez Düzkaya, Oguz Dursun, Ebru Atike Ongun, Resul Yilmaz, Dincer Yildizdas, Hakan Tekgüç, Vitaliy Sazonov, Timur Tsoy, Askhat Saparov, Elizaveta Kalmbakh, Luis Eguiguren, Killen Harold Briones Claudette, Yaneth Tovilla, Sandra Tania Ventura Gómez, Silvio Fabio Torres, Paul Cobarrubias, Dmytro Dmytriiev, Alejandro Martínez, Gustavo Guzaman, Rudy Sanabria, Ravikumar Krupanandan, Bala Ramachandran, Nirmal Choraria, Jignesh Patel, Puneet A Pooni, Karambir Singh Gill, John Adabie Appiah, Komfo Anokye, Tigist Bacha Heye, Rahel Argaw, Asrat Demtse, and Israel Abebe Admasu
Subjects: pain, pediatric critical care units, pediatric palliative care, under resourced settings, pediatric, Pediatrics, RJ1-570
Abstract: The adequate assessment and management of pain remains a challenging task in the Pediatric Intensive Care Unit (PICU). Our goal is to describe how pain is assessed and managed in PICUs around the world and to examine how human and material resources impact achievement of this goal. An international multicenter cross-sectional observational study was designed with the participation of 34 PICUs located in urban, suburban, and rural areas of 18 countries. We evaluated how PICUs around the world assessed and managed pain according to the Initiative for Pediatric Palliative Care recommendations, and how human and material resources impacted achievement of this goal. Data was collected for this study from 2016 to 2018 using questionnaires completed by medical doctors and nurses. In this paper, we focus on the indicators related to how pain is managed and assessed. The average achievement of the goal of pain relief across all centers was 72.2% (SD: 21.1). We found a statistically significant trend of more effective pain management scores, routine assessment, proper documentation, and involvement of pain management experts by increasing country income. While there are efforts being made worldwide to improve the knowledge in pain assessment and management, there is a lack of resources to do so appropriately in low-middle-income countries. There is a mismatch between the existing guidelines and policies, which are mainly designed in high income countries, and the resources available in lower resourced environments.
Published: 2021
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16. Mini-invasive methods of treatment of diabetic foot pain

Author: Dmytro Dmytriiev, Yevhenii Lysak, Yevhenii Glazov, Stanislav Geranin, and Olesia Zaletska
Subjects: pain, neuropathic pain, sensitization, diabetic peripheral neuropathy, regional analgesia, Anesthesiology, RD78.3-87.3
Abstract: Neuropathic pain occurs with diabetic polyneuropathy more often than with all polyneuropathies of another etiology. Because the cause of pain can rarely be cured, treatment is usually symptomatic. Neuropathic pain is usually poorly controlled by analgesics. Management of neuropathic pain is started with conservative pharmacotherapy before invasive pain management is applied. Although there are many drugs that can be used in patients with diabetic pain syndrome, pain syndrome can not be surely stoped with monotherapy. In addition, the patient may not tolerate the full therapeutic dose of the drug. All this dictates the need for combination therapy. It is believed that regional anesthesia as an independent type of analgesia or a component of combined anesthesia is the method of choice for the elderly and senile patients. The main reasons for this choice, when comparing regional anesthesia with narcosis, are less stressful response of the organism, absence of depression of the central nervous system, stable reliable analgesia with complete blockade of nociceptive reflexes with the provision of adequate muscle relaxation, prevention of neurovegetative reactions, which ultimately helps to reduce the incidence of postoperative complications and mortality. Clinicians have accumulated considerable experience demonstrating the need for regional analgesia in the management of diabetic foot pain.
Published: 2019
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17. Neuropathic pain: mechanisms of development, principles of diagnostics and treatment

Author: Dmytro Dmytriiev, Pylyp Prudius, Olesia Zaletskaya, Yevhen Lisak, Yurii Rudnitsky, and Natalia Korenchuk
Subjects: pain, neuropathic pain, sensitization, diabetic peripheral neuropathy, analgesia, Anesthesiology, RD78.3-87.3
Abstract: Neuropathic pain is a pain caused by a disease or focal damage to the somatosensory nervous system. The prevalence of chronic pain with neuropathic features in different countries is estimated at 7–10 %. Damages to the nervous system can occur at the level of peripheral nerves, plexus and dorsal roots (peripheral neuropathic pain) or spinal cord and brain (central neuropathic pain). Neuropathic pain is based on pathological activation of pain pathways. Neuropathic pain occurs with diabetic polyneuropathy more often than with all polyneuropathies of another etiology. Hyperglycemia is the major cause of chronic diabetes mellitus and its progression. Since the cause of pain can rarely be cured, treatment is usually symptomatic. Neuropathic pain is generally poorly controlled by analgesics. NB management is started with conservative pharmacotherapy before applying invasive analgesia. Although there are many drugs that can be used in patients with DPN, monotherapy can not always stop pain syndrome. In addition, the patient may not tolerate the full therapeutic dose of the drug. All this dictates the need for combination therapy.
Published: 2019
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18. Ropivacaine as the drug of choice for regional anesthesia: why so?

Author: Dmytro Dmytriiev and Yevhen Lisak
Subjects: ropivacaine, regional anesthesia, local anesthesia, local anesthetics, adjuvants, Anesthesiology, RD78.3-87.3
Abstract: While writing the article, we analyzed all the studies related to ropivacaine for the first half of 2021, which were published in PubMed. Previous review articles on ropivacaine were also analyzed. Purpose: collection and analysis of the latest research results on ropivacaine. Assessment of the place of ropivacaine in modern regional anesthesia.
Published: 2021
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19. Possibilities of using postnatal ultrasound screening of the uropoietic tract

Author: Kateryna Dmytriieva and Dmytro Dmytriiev
Subjects: diagnosis, newborn, obstructive uropathy, postnatal period, screening, Slovakia, Medicine
Abstract: The article provides information on the possibilities of using postnatal ultrasound screening of the uropoietic tract illustrated by the results of using this method in the Slovak Republic. Its main task is to identify malformations of the uropoietic system that were not diagnosed during prenatal diagnosis. The most clinically significant malformations of the kidneys are associated with impaired urine flow (obstructive uropathy). Patients with these malformations often require surgical intervention in the neonatal period or in early childhood. Early diagnosis and timely correction of obstructive uropathy allows maintaining the normal functioning and morphological integrity of the kidneys, preventing the development of chronic kidney disease, improving the quality and life expectancy of patients. Thus, the costs of screening research are incommensurate with the consequences of an untimely diagnosed pathology and the treatment of complications such as chronic kidney disease, kidney failure, recurrent urinary tract infections (antibiotic therapy, hemodialysis, etc.).
Published: 2021
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20. High-dose N-acetylcysteine therapy in the treatment of pneumonia

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, and Yuliana Babina
Subjects: COVID-19, N-acetylcysteine, pneumonia, Medicine
Abstract: The article presents modern data on the use of N-acetylcysteine in the treatment of infectious diseases of the respiratory tract in the practice of a physician. Its antioxidant, mucolytic, anti-inflammatory, pulmoprotective and antitoxic properties are described. The emphasis is placed on the antioxidant properties of N-acetylcysteine, which are expressed when used in high doses of 1200 mg/day or more. There is a review of the literature on the use of high doses of N-acetylcysteine in the treatment of pneumonia, cystic fibrosis, COPD, ARDS. The effect of N-acetylcysteine on individual risk factors for prolonged pneumonia is analyzed. Given the epidemiological situation around the world, the antioxidant properties of N-acetylcysteine in the treatment of pneumonia, including complicated COVID-19, are relevant and require further study.
Published: 2021
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21. Perioperative antibiotic prophylaxis in surgery

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, and Yuliana Babina
Subjects: antibiotic prophylaxis, cephalosporins, cefoperazone, sulbactam, Laxers, Medicine
Abstract: Infectious complications in surgery occupy a significant place among the causes of death and increase in the cost of medical care for various pathologies. Antibiotic prophylaxis takes one of the first places in the perioperative period, in addition to surgical treatment and compliance with the rules of asepsis and antiseptics. Laxers is a new drug in the cephalosporin group, consisting of a combination of cefoperazone and sulbactam. It has a wide range of action on gram(-) and anaerobic flora and antistaphylococcal activity, which is not inferior to cefoperazone. Due to sulbactam, it has antimicrobial activity against Pseudomonas aeruginosa and Acinetobacter spp. This article describes the main properties and advantages of Laxers over other cephalosporins in this group as the drug of choice in the treatment of surgical pathologies and alternative antibiotic prophylaxis in the perioperative period in severe patients at risk of contamination of the operating field with hospital flora.
Published: 2021
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22. Rationale for analgesia to prevent postoperative hyperalgesia in children, according to the morphological study of skin in the wound

Author: Dmytro Dmytriiev, Oleksandr Marchuk, and Olena Kovalchuk
Subjects: analgesia, hyperalgesia, skin biopsy, Anesthesiology, RD78.3-87.3
Abstract: In the article, morphological changes of skin in the area of postoperative wound are displayed. It was discovered that continuous infusion of high-dose fentanyl (10–20 mcg/kg/h) for analgesia in the early postoperative period in children operated on for tumors of abdominal cavity can result into opiod-induced hyperalgesia, which is followed by skin morphological changes around the postoperative wound with the development of necrosis in it center with expressed perifocal reactive changes in the form of severe inflammation, and significant violations of microcirculation with the formation of small nerve fibers on day 14. In its turn, using TAP-block and combined spinal-epidural analgesia showed small perineural edema. The fragmentation of nerve fibers was not determined, which indicates the absence of development of postoperative hyperalgesia. Ketamine infusion results into negligible perineural edema and reduction of postoperative hyperalgesia.
Published: 2021
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23. Experience in the use of dexmedetomidine for sedation in patients with pneumonia in the intensive care unit

Author: Dmytro Dmytriiev, Dmytro Bortnik, Kateryna Dmytriieva, and Mykola Melnychenko
Subjects: dexmedetomidine, artificial lung ventilation, pneumonia, sedation, Medicine
Abstract: The experience of using dexmedetomedine for sedation with respiratory disorders of varying severity has been known for a long time. This article examined two clinical cases in which dexmedetomedine was used for connection and adaptation of patients to mechanical ventilation of lungs. The purpose of the work is evaluation of the effectiveness and depth of sedation with varying degrees of respiratory failure, as well as the effect of dexmedetomedine on respiration.
Published: 2020
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24. Dexmedetomidine for sedation in intensive care. Literature review and clinical experience

Author: Dmytro Dmytriiev, Dmytro Bortnik, Y Rudnitsky, S Heranin, and N Korenchuk
Subjects: dexmedetomidine, sedation, pain, intensive care, sleep, delirium, Medicine
Abstract: Dexmedetomidine is a fairly new and promising drug for use in intensive care and surgery. Due to the fact that it is an agonist of alpha-2-adrenoceptors, dexmedetomidine has an analgesic, sedative effect and affects hemodynamic parameters. Due to the fact that dexmedetomedin does not have the ability to suppress respiration, it is used in patients with respiratory disorders. Dexmedetomidine has minimal side effects and a wide range of uses.
Published: 2020
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25. PedSQL™ Family Impact Module as an Instrument foe Quality of Life Assessment (PedsQL™) in Children with Chronic Postsurgical Pain

Author: Yaroslav Semkovych, Dmytro Dmytriiev, and Oleksandr Dobrovanov
Subjects: General Medicine
Abstract: BACKGROUND: The concept of quality of life (QoL) is today an integral part of the health-care system and clinical, medical, and social research. Untreated chronic pain in children increases the risk of developing mental disorders later in life. The pediatric QoL inventory 3.0 (PedsQL™) is one of the most valid and widely used tools for assessing pediatric QoL. AIM: The study was to assess QoL in children with chronic postsurgical pain 7 days, 3 months, and 6 months after surgery with different analgesic techniques by means of the PedsQL™ 3.0 Family Impact Module questionnaires. METHODS: Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic techniques. The patients were asked to fill in the questionnaires repeatedly 3 and 6 months after hospital discharge. RESULTS: QoL in patients with chronic pain syndrome reduced significantly (p < 0.001) on the scales of physical functioning, emotional functioning, social functioning, cognitive functioning, communication, worry, daily activities, family relationships, as well as pediatric QoL summary score, parent QoL summary score, and family functioning summary score 3 and 6 months after surgery with conventional analgesic techniques. CONCLUSIONS: Chronic pain syndrome reduces QoL in children aged 7–18 years after anterior abdominal wall surgery by reducing their physical, emotional, social, and cognitive functioning. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.
Published: 2023
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26. Chronic pain in post-COVID syndrome

Author: Oleksandr DOBROVANOV, Dmytro DMYTRIIEV, Augustin PROCHOTSKY, Marian VIDISCAK, and Katarina FURKOVA
Subjects: Economics and Econometrics, Materials Chemistry, Media Technology, Forestry
Published: 2023
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27. Neonates undergoing pyloric stenosis repair are at increased risk of difficult airway management

Author: Nicola Disma, Thomas Engelhardt, Tom G. Hansen, Jurgen C. de Graaff, Katalin Virag, Walid Habre, Christian Breschan, Rudolf Likar, Manuela Platzer, Isole Edelman, Johanes Eger, Stefan Heschl, Brigitte Messerer, Maria Vittinghof, Ruth Kroess, Martina Stichlberger, David Kahn, Thierry Pirotte, Caroline Pregardien, Francis Veyckemans, France Stevens, Johan Berghmans, Annemie Bauters, Luc De Baerdemaeker, Stefan De Hert, Koen Lapage, Aliaksandra Parashchanka, Jurgen Van Limmen, Piet Wyffels, Julie Lauweryns, Nadia Najafi, Joris Vundelinckx, Diana Butković, Ivana Kerovec Sorić, Sandra Kralik, Ana Markić, Josip Azman, Josko Markic, Daniela Pupacic, Michal Frelich, Petr Reimer, René Urbanec, Petra Cajková, Vladimír Mixa, Yvona Sedláčková, Lenka Knoppová, Alena Zlámalová (neé Květoňová), Martin Vavřina, Jiří Žurek, Tom Hansen, Arash Afshari, Anders Bastholm Bille, Marguerite Ellekvist, Mari-Liis Ilmoja, Reet Moor, Reet Kikas, Merle Väli, Kariantti Kallio, Elisa Reponen, Pertti Suominen, Sami Suvanto, Raisa Vähätalo, Hannu Kokki, Merja Kokki, Jarkko Harju, Miia Kokkonen, Jenni Vieri, Tuula Manner, Amory Catherine, Hugues Ludot, Dina Bert, Juliette Godart, Anne Laffargue, Hervé Dupont, Benjamin Urbina, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Maryline Bordes, Karine Nouette Gaulain, Yann Hamonic, François Semjen, Olivier Jacqmarcq, Caroline Lejus-Bourdeau Cécile Magne, Léa Petry, Lilica Ros, Aurélien Zang, Mehdi Bennis, Bernard Coustets, Rose Fesseau, Isabelle Constant, Eliane Khalil, Nada Sabourdin, Noemie Audren, Thomas Descarpentries, Fanny Fabre, Aurélien Legrand, Emilie Druot, Gilles Orliaguet, Lucie Sabau, Lynn Uhrig, François de la Brière, Karin Jonckheer, Jean-Paul Mission, Lucia Scordo, Caroline Couchepin, Christophe Dadure, Pablo De la Arena, Laurent Hertz, Philippe Pirat, Chrystelle Sola, Myriam Bellon, Souhayl Dahmani, Florence Julien-Marsollier, Daphne Michelet, Veronique Depret-Donatien, Anne Lesage, Jost Kaufmann, Michael Laschat, Frank Wappler, Karin Becke, Lena Brunner, Karin Oppenrieder, Gregor Badelt, Karin Hochmuth, Bernhard Koller, Anita Reil, Sebastian Richter, Thomas Fischer, Anja Diers, Clemens Schorer, Andreas Weyland, Ruth Cohausz, Franz-Josef Kretz, Michaela Löffler, Markus Wilbs, Claudia Hoehne, Johanna Ulrici, Christiane Goeters, Armin Flinspach, Matthias Klages, Simone Lindau, Leila Messroghli, Kai Zacharowski, Christoph Eisner, Thomas Mueller, Daniel Richter, Melanie Schäfer, Markus Weigand, Sebastian Weiterer, Miriam Ochsenreiter, Michael Schöler, Tom Terboven, Isabel Eggemann, Sascha Haussmann, Nicolas Leister, Christoph Menzel, Uwe Trieschmann, Sirin Yücetepe, Susanna Keilig, Peter Kranke, Yvonne Jelting, Torsten Baehner, Richard Ellerkmann, Shahab Ghamari, Claudia Neumann, Martin Söhle, Pelagia Chloropoulou, Vagia Ntritsou, Pinelopi Papagiannopoulou, Eleana Garini, Afroditi Karafotia, Panagoula Mammi, Evangelia Bali, Despoina Iordanidou, Anna Malisiova, Artemis Polyzoi, Adelais Tsiotou, Erzsebet Sapi, Edgar Székely, Nandor Kosik, Veronika Maráczi, Janos Schnur, Judit Csillag, János Gál, Gergely Göbl, Balázs Hauser, András Petróczy, Gyula Tövisházi, Stuart Blain, Sarah Gallagher, Sinead Harte, Mandy Jackson, Emma Meehan, Zeenat Nawoor, Brendan O’Hare, Mark Ross, Daniela Lerro, Marinella Astuto, Chiara Grasso, Rita Scalisi, Giulia Frasacco, Elena Lenares, Roberto Leone, Maurizia Grazzini, Carmelo Minardi, Nicola Zadra, Gilda Cinnella, Antonella Cotoia, Dario Galante, Brita De Lorenzo, Beate Kuppers, Giulia Bottazzi, Fabio Caramelli, Maria Cristina Mondardini, Emanuele Rossetti, Sergio Picardo, Alessandro Vittori, Anna Camporesi, Francesca Izzo, Edoardo Calderini, Laura Brigitta Colantonio, Simona Anna Finamore, Giuliana Anna Porro, Rachele Bonfiglio, Svetlana Kotzeva, Girolamo Mattioli, Camilla Micalizzi, Alessia Montaguti, Angela Pistorio, Anna Guddo, Gerald Rogan Neba, Moreno Favarato, Bruno Guido Locatelli, Micol Maffioletti, Valter Sonzogni, Rossella Garra, Maria Sammartino, Fabio Sbaraglia, Andrea Cortegiani, Alessandra Moscarelli, Elena Attanasi, Simonetta Tesoro, Cristina Agapiti, Francesca Pinzoni, Cesare Vezzoli, Bilotta Federico, Arta Barzdina, Zane Straume, Anda Zundane, Laura Lukosiene, Irena Maraulaite, Ilona Razlevice, Bernd Schmitz, Stephanie Mifsud, Carolin Aehling, Celia Allison, Rients De Boer, Dina Emal, Markus Stevens, Marielle Buitenhuis, Jurgen de Graaff, Inge De Liefde, Andreas Machotta, Gail Scoones, Lonneke Staals, Jeremy Tomas, Anouk Van der Knijff-van Dortmont, Marianne Veldhuizen, David Alders, Eva Schafrat, Jan Schreiber, Petronella Mari Vermeulen, Mark Hendriks, Sandra Lako, Marieke Voet-Lindner, Barbe Pieters, Gert-Jan Scheffer, Luc Tielens, Anthony R. Absalom, Margot Bergsma, Joke De Ruiter, Sascha Meier, Martin Volkers, Tjerk Zweers, Anne M. Beukers, Christa Boer, Jurgen Dertinger, Sandra Numan, Bas Van Zaane, Wenche B. Boerke, Nil Ekiz, Kristoffer Stensrud, Inger Marie Drage, Erik Ramon Isern, Alicja Bartkowska-Sniatkowska, Malgorzata Grzeskowiak, Magdalena Juzwa-Sobieraj, Jowita Rosada-Kurasińska, Artur Baranowski, Karina Jakubowska, Dorota Lewandowska, Magdalena Mierzewska-Schmidt, Piotr Sawicki, Magdalena Urban-Lechowicz, Pomianek Przemyslaw, Marzena Zielinska, Teresa Leal, Maria Soares, Pedro Pina, Sílvia Pinho, Maria Domingas Patuleia, Catarina Cruz Esteves, Helena Salgado, Maria João Santos, Rodica Badeti, Iulia Cindea, Loredana Oana, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Radu Tabacaru, Irina Trante, Valentin Munteanu, Mihai Morariu, Emese Nyíri, Ivana Budic, Vesna Marjanovic, Biljana Drašković, Marina Pandurov, Jordanka Ilic, Ana Mandras, Zdenka Rados, Nikola Stankovic, Maja Suica, Sladjana Vasiljevic, Mirjana Knezevic, Irina Milojevic, Ivana Petrov, Selena Puric Racic, Dusica Simic, Irena Simic, Marija Stevic, Irena Vulicevic, Banská Bystrica, Barbora Cabanová, Miloslav Hanula, Jelena Berger, Darja Janjatovic, Špela Pirtovšek Štupnik, Dolores Méndez, Gema Pino, Paloma Rubio, Alberto Izquierdo, Silvia López, Cristina González Serrano, Jesús Cebrián, Ana Peleteiro, Pilar Del Rey de Diego, Ernesto Martínez García, Carolina Tormo de las Heras, Pablo Troncoso Montero, Celia Arbona, David Artés, Alicia Chamizo, Silvia Serrano, Montserrat Suarez Comas, Francisco Escribá, Cristina Auli, Osvaldo Pérez Pardo, Natalia Sierra Biddle, Ceferina Suárez Castaño, María Isabel Villalobos Rico, Susana Manrique Muñoz, Irene García Martínez, Nuria Montferrer Estruch, Elena Vilardell Ortíz, Rodrigo Poves-Álvarez, Ivan Kohn, Ulf Lindestam, Jarl Reinhard, Albert Castellheim, Kerstin Sandström, Sporre Bengt, Rainer Dörenberg, Peter Frykholm, Maria Garcia, Ann Kvarnström, Emma Pontén, Thomas Bruelisauer, Gabor Erdoes, Heiko Kaiser, Mathias Marchon, Thomas Riva, Stefan Seiler, Yann Bögli, Mirko Dolci, Carine Marcucci, Isabelle Pichon, Laszlo Vutskits, Mattias Casutt, Martin Hölzle, Thomas Hurni, Martin Jöhr, Anna-Ursina Malär, Jacqueline Mauch, Thomas Erb, Karin Oeinck, Mine Akin, Gulsen Keskin, Yesim Senayli, Guner Kaya, Pinar Kendigelen, Ayse Çiğdem Tutuncu, Zehra Hatipoğlu, Dilek Özcengiz, Hale Aksu Erdost, Elvan Öçmen, Çimen Olguner, Hilmi Ayanoglu, Pelin Corman Dincer, Tumay Umuroglu, Mustafa Azizoglu, Handan Birbiçer, Nurcan Doruk, Aslı Sagun, Sibel Baris, Dmytro Dmytriiev, Sridevi Kuchi, Nuria Masip, Peter Brooks, Alison Hare, Nargis Ahmad, Michelle Casey, Sam De Silva, Nadine Dobby, Prakash Krishnan, L. Amaki Sogbodjor, Ellie Walker, Suellen Walker, Stephanie King, Katy Nicholson, Michelle Quinney, Paul Stevens, Andrew Blevin, Mariangela Giombini, Chulananda Goonasekera, Sadia Adil, Stephanie Bew, Carol Bodlani, Dan Gilpin, Stephanie Jinks, Nalini Malarkkan, Alice Miskovic, Rebecca Pad, Juliet Wolfe Barry, Joy Abbott, James Armstrong, Natalie Cooper, Lindsay Crate, John Emery, Kathryn James, Hannah King, Paul Martin, Stefano Scalia Catenacci, Rob Bomont, Paul Smith, Sara Mele, Alessandra Verzelloni, Philippa Dix, Graham Bell, Elena Gordeva, Lesley McKee, Esther Ngan, Jutta Scheffczik, Li-En Tan, Mark Worrall, Carmel Cassar, Kevin Goddard, Victoria Barlow, Vimmi Oshan, Khairi Shah, Sarah Bell, Lisa Daniels, Monica Gandhi, David Pachter, Chris Perry, Andrew Robertson, Carmen Scott, Lynne Waring, David Barnes, Sophie Childs, Joanne Norman, Robin Sunderland, Dowell Julia, Feijten Prisca, Harlet Pierre, Herbineaux Sarah, Leva Brigitte, Plichon Benoît, Virág Katalin, and Anesthesiology
Subjects: Europe, Anesthesiology and Pain Medicine, Infant, Newborn, Intubation, Intratracheal, Humans, Infant, airway management, complications, difficult airway, neonatal anaesthesia, pyloric stenosis, tracheal intubation, Anesthesia, Pyloric Stenosis, Hypertrophic, Airway Management, Child, Hypoxia
Abstract: Background: Hypertrophic pyloric stenosis in otherwise healthy neonates frequently requires urgent surgical procedure but anaesthesia care may result in respiratory complications, such as hypoxaemia, pulmonary aspiration of gastric contents, and postoperative apnoea. The primary aim was to study whether or not the incidence of difficult airway management and of hypoxaemia in neonates undergoing pyloric stenosis repair was higher than that in neonates undergoing other surgeries. Methods: Data on neonates and infants undergoing anaesthesia and surgery for pyloric stenosis were extracted from the NEonate and Children audiT of Anesthesia pRactice In Europe (NECTARINE) database, for secondary analysis. Results: We identified 310 infants who had anaesthesia for surgery for pyloric stenosis. Difficult airway management (more than two attempts at laryngoscopy) was higher in children with pyloric stenosis when compared with the entire NECTARINE cohort (7.9% [95% confidence interval {CI}, 5.22–11.53] vs 4.4% [95% CI, 1.99–6.58]; relative risk [RR]=1.81 [95% CI, 1.21–2.69]; P=0.004), whereas transient hypoxaemia with oxygen saturation
Published: 2022

28. Bezoar gastrointestinal disease in children (literature review and interpretation of clinical observation)

Author: Viktor Konoplitsky, Dmytro Dmytriiev, Oleksandr Kalinchuk, Denys Konoplitskyi, and Serhii Blazhko
Subjects: bezoar disease, children, trichobezoir, stomach, Medicine
Abstract: The article presents data on the causes of the formation of various types of bezoars in children, traces the causes of their complicated course in the form of bezoar disease. Modern issues of diagnostics, methods of treatment and formation of foreign bodies of the digestive tract in children are covered in the article. A clinical case of a giant trichobezoar of the stomach and duodenum in a 14-year-old girl is presented and analyzed. in a histological examination of the gastric wall.
Published: 2019
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29. Selecting an intravascular catheter: a modern look and own experience

Author: Dmytro Dmytriiev, Oleksandr Nazarchuk, Yuliana Babina, A Andriiets, and E Andriiets
Subjects: intravascular cannulas, complications, catheter-associated infections, vein choice, selecting aintravascular cannula, polyurethane, Medicine
Abstract: The choice of an intravascular cannula (catheter) is a rather difficult and important issue in modern medicine, especially in the anesthesiology and intensive care unit. In today’s market there are many variants of cannulas, which differ in size and material. As for the size of the cannula, the issue is resolved. The American Medical Device Manufacturers Association proposed measuring the outer diameter of cannulas in “gauge” G. The European Standard ISO 10555.5 regulates the outer diameter of cannulas in millimeters and states that each catheter should have a color marker indicating the nominal outer tube. Color marking helps to find quickly the right size of cannula in extreme situations. The marking of cannulas in “gauge” G and mm is made on the packaging of the product. As to the choice of material, the question remains open. Therefore, in this article, we decided to cover the issue of choice of intravascular cannulas on the material. We have also developed some practical guidelines that facilitate catheterization of peripheral veins and allow cannula to stay longer in the vein. This article will be interesting for doctors and nursing staff.
Published: 2019
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30. Central anticholinergic syndrome (CAS) in anesthesiology: a narrative review

Author: Dmytro Dmytriiev and Dmytro Bortnik
Subjects: central anticholinergic syndrome, galantamine, physostigmine, cholinolytics, muscarinic receptors, anticholinesterase, Medicine
Abstract: Psychomotor excitation, delayed recovery of consciousness after general anesthesia – well-known conditions. But only in the literature of Germany, it was first isolated in a separate central anticholinergic syndrome (CAS). This article discusses the main aspects and symptoms that will help to differentiate this syndrome with other conditions, and the methods for relief of this state.
Published: 2019
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31. Prevalence of chronic pain after herniorrhaphy, orchiopexy, and bernardi procedure in children. A retrospective-prospective study

Author: Dmytro Dmytriiev and Yaroslav Semkovych
Subjects: Pediatrics, Perinatology and Child Health, Surgery
Abstract: Chronic postsurgical pain (CPSP) is defined as pain that develops or increases in intensity after a surgical procedure and persists for at least three months. Its prevalence rate ranges from 5% to 54%. Aim - to assess the prevalence of CPSP among children at the age of 7-18 years residing in the Precarpathian region at three and six months after herniorrhaphy, orchiopexy and Bernardi procedure. Materials and methods. There were observed 92 children at the age of 7-18 years, who underwent treatment for abdominal wall hernia, cryptorchidism, varicocele, and hydrocele at the surgical department. Children were divided into the following groups: Group 1a included children at the age of 7-12 years with acute pain syndrome in the postoperative period; Group 1b comprised children at the age of 13-18 years with acute pain syndrome in the postoperative period; Group 2a included children at the age of 7-12 years with chronic pain syndrome; Group 2b included children at the age of 13-18 years with chronic pain syndrome. Results. The prevalence of CPSP following surgery among children of the Precarpathian region was found to be 33.7%, with a male predominance (р
Published: 2022
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32. Does the Gln27Gln polymorphism of the adrenoreceptor beta 2 gene affect the clinical course of chronic obstructive pulmonary disease?

Author: Yuliia Smereka, Oleksandr Nazarchuk, Dmytro Dmytriiev, Nataliia Slepchenko, Yuriy Mostovoy, and Kostiantyn Dmytriiev
Subjects: General Biochemistry, Genetics and Molecular Biology
Published: 2022
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33. Highly multidrug-resistant Gram-negative bacterial infections in war victims in Ukraine, 2022

Author: Oskar Ljungquist, Oleksandr Nazarchuk, Gunnar Kahlmeter, Vigith Andrews, Thalea Koithan, Lisa Wasserstrom, Dmytro Dmytriiev, Nadiia Fomina, Vira Bebyk, Erika Matuschek, and Kristian Riesbeck
Subjects: Infectious Diseases
Published: 2023
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34. GENETIC INFLUENCES ON PAIN MECHANISMS

Author: Yaroslav, Semkovych and Dmytro, Dmytriiev
Subjects: Adult, Humans, General Medicine, Chronic Pain, Child
Abstract: The aim: To review the available results for genetic influences on pain syndrome development. Materials and methods: In the period from 2009 to 2020, a total of 45 research papers describing the key points of genetic influences on pain mechanisms in both adults and children were published in Ukrainian and English and they are now included in the PubMed, EMBASE, Cochrane, and Google Scholar research databases. Conclusions: Pain is a comprehensive characteristic of a person; therefore, it is inevitable that several genes with little individual effect interact with each other and environmental factors, influencing pain susceptibility and chronic pain syndrome manifestation. This requires searching for biomarkers for diagnosing and predicting the development of acute and chronic pain syndromes, especially in pediatric practice.
Published: 2022
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35. CCL2/MCP-1 serum chemokine level in patients with odontogenic infectious and inflammatory diseases of the soft tissues of the maxillofacial area and mediastinum

Author: Mariia Faustova, Oleksandr Nazarchuk, Dmytro Dmytriiev, David Avetikov, Galina Loban, Yuliana Babina, and Maiia Ananieva
Subjects: General Medicine
Abstract: Aim. The paper was aimed at determining the CCL2/MCP-1 level in patients with odontogenic infectious and inflammatory diseases of soft tissues of the maxillofacial area and mediastinum. Methods. The study involved 46 patients with odontogenic infectious and inflammatory diseases of soft tissues of the maxillofacial area and 12 healthy volunteers. The level of patients' plasma CCL2/MCP-1 level was determined using a kit for specific ELISA. Results. The findings of the studies showed a statistically significant increase in the concentration of plasma CCL2/MCP-1 in patients of all study groups. Our study shows a significant increase in plasma CCL2/MCP-1 level in patients with odontogenic phlegmonas, abscesses and mediastinitis, compared to the group of healthy subjects. Conclusion. CCL2/MCP-1 may play an important role in the pathogenesis of odontogenic infectious and inflammatory diseases of soft tissues of the maxillofacial area and mediastinum, which requires a careful follow-up study.
Published: 2022
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36. A 16-Year-Old Ukrainian Boy Shot at Close-Range to the Back of the Neck with a Handgun Who Required Surgical Removal of a 9×18-mm Bullet Shell from the Left Posterior Maxilla and Recovered Following Physical Therapy

Author: Viktor Konoplitskyi, Dmytro Dmytriiev, Mykola Sidoryk, Oleksandr Dobrovanov, and Marian Vidiscak
Subjects: General Medicine
Published: 2023
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37. Pre-emptive administration of intravenous acetaminophen with transversus abdominis plane block (tap-blocke) in the prevention of fentanil-induced hyperalgesia in pediatric oncological patient undergoing abdominal surgery

Author: Dmytro Dmytriiev and Oleksandr Nazarchuk
Subjects: iv preemptive administration acetaminophen, opioid-induced hyperalgesia, fentanil, tap-blocke., Education, Sports, GV557-1198.995, Medicine
Abstract: Dmytriiev Dmytro, Nazarchuk Oleksandr. Pre-emptive administration of intravenous acetaminophen with transversus abdominis plane block (tap-blocke) in the prevention of fentanil-induced hyperalgesia in pediatric oncological patient undergoing abdominal surgery. Journal of Education, Health and Sport. 2015;5(10):98-107. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.32514 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2810%29%3A98-107 https://pbn.nauka.gov.pl/works/659929 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.08.2015. Revised 05.09.2015. Accepted: 20.10.2015. UDC: 616-089.5-053.2: 616-006 PRE-EMPTIVE ADMINISTRATION OF INTRAVENOUS ACETAMINOPHEN WITH TRANSVERSUS ABDOMINIS PLANE BLOCK (TAP-BLOCKE) IN THE PREVENTION OF FENTANIL-INDUCED HYPERALGESIA IN PEDIATRIC ONCOLOGICAL PATIENT UNDERGOING ABDOMINAL SURGERY Dmytro Dmytriiev, Oleksandr Nazarchuk Department of Anesthesiology and Intensive care, Vinnytsya National Pirogov Memorial Medical University Abstract Background: Acetaminophen is a selective COX-2 agonist that has been shown to decrease the intensity of opioid-induced hyperalgesia (OIH) in children. We aimed to investigate the effects of preemptive administration of intravenous acitomenofen in the prevention of high-dose fentanil-induced hyperalgesia in pediatric patients. Methods: 45 patients of American Society of Anesthesiologists physical status 1-3 undergoing abdominal surgery were randomly assigned to one of the following three groups. each of which received either IV acetaminophen (an initial dose of 1.5 ml/kg for 40 min before before the induction of anesthesia) or placebo saline 40 min before the induction of anesthesia and intraoperative fentanil infusion: group LFH received a placebo and 0.05 μg/kg/min fentanil; group FH received a placebo and 0.3 μg/kg/min fentanil; and group AFH received IV preemptive administration acetaminophen and TAP-blocke bupivacaine 0,3 mg/kg. Results: The mechanical hyperalgesia threshold 12 hr after surgery was significantly lower in group FH than in the other two groups. Postoperative pain intensity using visual analog scale (VAS) and cumulative volume of a patient controlled analgesia (PCA) containing morphine over 12 hr were significantly greater in group FH than in group AFH. The time to the first postoperative analgesic requirement was significantly shorter in group RH than in the other two groups. The sevoflurane requirement was significantly greater in group LFH than in the other groups. The frequency of hypotension and bradycardia was significantly higher, but shivering and postoperative nausea and vomiting were significantly lower in group AFH than in the other two groups. Conclusions: High-doses of fentanil induced hyperalgesia, which presented a decreased mechanical hyperalgesia threshold, enhanced pain intensity, a shorter time to first postoperative analgesic requirement, and greater morphine consumption, but IV preemptive administration acetaminophen alleviated those symptoms. IV preemptive administration acetaminophen may be an effective treatment option for preventing or attenuating OIH. Key words: IV preemptive administration acetaminophen, Opioid-induced hyperalgesia, fentanil, TAP-blocke.
Published: 2015

38. Оценка аналгетической эффективности блокады квадратной мышцы поясницы (quadratus lumborum block) у детей после оперативных вмешательств на органах брюшной полости

Author: B.V. Zaletskyi and Dmytro Dmytriiev
Subjects: business.industry, Anesthesia, Block (telecommunications), Analgesic, Medicine, business, Surgical interventions
Abstract: Исследование проведено у 34 детей после выполнения оперативных вмешательств на органах брюшной полости. В зависимости от методики обезболивания пациенты были разделены на 2 группы: в 1-й группе использовали блокаду квадратной мышцы поясницы (quadratus lumborum block), во 2-й группе назначали только внутривенную непрерывную инфузию фентанила. Проведение многокомпонентной анальгезии (с использованием блокады квадратной мышцы поясницы) значительно уменьшает негативные последствия недостаточного обезболивания у детей и способствует эффективной анальгезии после травматических операций, уменьшает проявления синдрома интраабдоминальной гипертензии и улучшает кровоток в сосудах брюшной полости.
Published: 2021
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39. Экспериментальное обоснование объема локального анестетика при выполнении блокады квадратной мышцы поясницы (quadratus lumborum block)

Author: A.V. Dusik, V.I. Pivtorak, B.V. Zaletskyi, V. S. Konoplitskyi, Dmytro Dmytriiev, and O.O. Kalinchuk
Subjects: Local anesthetic, medicine.drug_class, business.industry, Block (telecommunications), Anesthesia, medicine, business, Volume (compression)
Abstract: Актуальность. Блокада квадратной мышцы поясницы (qudratus lumborum block) находит широкое применение как компонент периоперационного обезболивания в абдоминальной хирургии у взрослых и мало используется в детской практике. Целью нашего исследования были изучение анатомических особенностей пространства квадратной мышцы поясницы и распределение местного анальгетика в пространстве в зависимости от введенной дозы, что позволит найти наиболее эффективную и безопасную дозу препаратов для обезболивания. Материалы и методы. Исследование проведено на 12 трупах лиц разных полов и возраста (20–73 года). Методом препарирования изучали топографоанатомические особенности мышц, фасциально-клетчаточных пространств, сосудов и нервов поясничной области. Выполнено послойное препарирование тканей поясничной области. Затем после визуализации целевых анатомических структур с помощью ультразвука в технике in-plane иглой 22 G выполнялось введение в передне-медиальном направлении в боковом положении по заднему краю квадратной мышцы поясницы (qudratus lumborum block) красителя метиленового синего для изучения распространения анестетика. Статистическую обработку полученных данных проводили с применением методов вариационной статистики с помощью программы Stаtistica 5.5 (принадлежит ЦНИТ ВНМУ им. Н.И. Пирогова, лицензионный № AXXR910A374605FA). Результаты. Исследовали площадь поверхности поперечной мышцы спины, которая колебалась в пределах 10,4–14,3 см2 и в среднем составляла 12,01 ± 2,30 см2. Исследование распределения раствора в пространстве квадратной мышцы поясницы в зависимости от дозы показало, что при применении дозы 0,2 мл/кг массы тела распределение раствора составляет в среднем всего 6,2 ± 2,1 см2, что не позволяет заполнить все пространство раствором, а при использовании дозы 0,3 мл/кг массы тела — 12,1 ± 1,4 см2, что вполне соответствует средней площади исследуемого пространства. Выводы. Изучение площади распределения раствора в пространстве квадратной мышцы поясницы позволяет предположить, что для обезболивания будет достаточно местного анестетика в дозе 0,3 мл/кг массы тела. Эта доза безопасна для использования как у взрослых, так и у детей. Клиническая эффективность требует дальнейшего изучения.
Published: 2021
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40. Society in Front of a COVID-19 Pandemic: India Versus Ukraine

Author: Svitlana Ilinich, Dmytro Dmytriiev, Chukhrii Inna, Komar Tetiana, and Sandeep Kumar Gupta
Published: 2022
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41. Difficult tracheal intubation in neonates and infants. NEonate and Children audiT of Anaesthesia pRactice IN Europe (NECTARINE)

Author: Nicola Disma, Katalin Virag, Thomas Riva, Jost Kaufmann, Thomas Engelhardt, Walid Habre, Christian Breschan, Rudolf Likar, Manuela Platzer, Isole Edelman, Johanes Eger, Stefan Heschl, Brigitte Messerer, Maria Vittinghof, Ruth Kroess, Martina Stichlberger, David Kahn, Thierry Pirotte, Caroline Pregardien, Francis Veyckemans, France Stevens, Johan Berghmans, Annemie Bauters, Luc De Baerdemaeker, Stefan De Hert, Koen Lapage, Aliaksandra Parashchanka, Jurgen Van Limmen, Piet Wyffels, Julie Lauweryns, Nadia Najafi, Joris Vundelinckx, Diana Butković, Ivana Kerovec Sorić, Sandra Kralik, Ana Markić, Josip Azman, Josko Markic, Daniela Pupacic, Michal Frelich, Petr Reimer, René Urbanec, Petra Cajková, Vladimír Mixa, Yvona Sedláčková, Lenka Knoppová, Alena Zlámalová (neé Květoňová), Martin Vavřina, Jiří Žurek, Tom Hansen, Arash Afshari, Anders Bastholm Bille, Marguerite Ellekvist, Mari-Liis Ilmoja, Reet Moor, Reet Kikas, Merle Väli, Kariantti Kallio, Elisa Reponen, Pertti Suominen, Sami Suvanto, Raisa Vähätalo, Hannu Kokki, Merja Kokki, Jarkko Harju, Miia Kokkonen, Jenni Vieri, Tuula Manner, Catherine Amory, Hugues Ludot, Dina Bert, Juliette Godart, Anne Laffargue, Hervé Dupont, Benjamin Urbina, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Maryline Bordes, Karine Nouette Gaulain, Yann Hamonic, François Semjen, Olivier Jacqmarcq, Caroline Lejus-Bourdeau, Cécile Magne, Léa Petry, Lilica Ros, Aurélien Zang, Mehdi Bennis, Bernard Coustets, Rose Fesseau, Isabelle Constant, Eliane Khalil, Nada Sabourdin, Noemie Audren, Thomas Descarpentries, Fanny Fabre, Aurélien Legrand, Emilie Druot, Gilles Orliaguet, Lucie Sabau, Lynn Uhrig, François de la Brière, Karin Jonckheer, Jean-Paul Mission, Lucia Scordo, Caroline Couchepin, Christophe Dadure, Pablo De la Arena, Laurent Hertz, Philippe Pirat, Chrystelle Sola, Myriam Bellon, Souhayl Dahmani, Florence Julien-Marsollier, Daphne Michelet, Veronique Depret-Donatien, Anne Lesage, Michael Laschat, Frank Wappler, Karin Becke, Lena Brunner, Karin Oppenrieder, Gregor Badelt, Karin Hochmuth, Bernhard Koller, Anita Reil, Sebastian Richter, Thomas Fischer, Anja Diers, Clemens Schorer, Andreas Weyland, Ruth Cohausz, Franz-Josef Kretz, Michaela Löffler, Markus Wilbs, Claudia Hoehne, Johanna Ulrici, Christiane Goeters, Armin Flinspach, Matthias Klages, Simone Lindau, Leila Messroghli, Kai Zacharowski, Christoph Eisner, Thomas Mueller, Daniel Richter, Melanie Schäfer, Markus Weigand, Sebastian Weiterer, Miriam Ochsenreiter, Michael Schöler, Tom Terboven, Isabel Eggemann, Sascha Haussmann, Nicolas Leister, Christoph Menzel, Uwe Trieschmann, Sirin Yücetepe, Susanna Keilig, Peter Kranke, Yvonne Jelting, Torsten Baehner, Richard Ellerkmann, Shahab Ghamari, Claudia Neumann, Martin Söhle, Pelagia Chloropoulou, Vagia Ntritsou, Pinelopi Papagiannopoulou, Eleana Garini, Afroditi Karafotia, Panagoula Mammi, Evangelia Bali, Despoina Iordanidou, Anna Malisiova, Artemis Polyzoi, Adelais Tsiotou, Erzsebet Sapi, Edgar Székely, Nandor Kosik, Veronika Maráczi, Janos Schnur, Judit Csillag, János Gál, Gergely Göbl, Balázs Hauser, András Petróczy, Gyula Tövisházi, Stuart Blain, Sarah Gallagher, Sinead Harte, Mandy Jackson, Emma Meehan, Zeenat Nawoor, Brendan O’Hare, Mark Ross, Daniela Lerro, Marinella Astuto, Chiara Grasso, Rita Scalisi, Giulia Frasacco, Elena Lenares, Roberto Leone, Maurizia Grazzini, Carmelo Minardi, Nicola Zadra, Gilda Cinnella, Antonella Cotoia, Dario Galante, Brita De Lorenzo, Beate Kuppers, Giulia Bottazzi, Fabio Caramelli, Maria Cristina Mondardini, Emanuele Rossetti, Sergio Picardo, Alessandro Vittori, Anna Camporesi, Andrea Wolfler, Edoardo Calderini, Laura Brigitta Colantonio, Simona Anna Finamore, Giuliana Anna Porro, Rachele Bonfiglio, Svetlana Kotzeva, Leila Mameli, Girolamo Mattioli, Camilla Micalizzi, Alessia Montaguti, Angela Pistorio, Clelia Zanaboni, Anna Guddo, Gerald Rogan Neba, Moreno Favarato, Bruno Guido Locatelli, Micol Maffioletti, Valter Sonzogni, Rossella Garra, Maria Sammartino, Fabio Sbaraglia, Andrea Cortegiani, Alessandra Moscarelli, Elena Attanasi, Simonetta Tesoro, Cristina Agapiti, Francesca Pinzoni, Cesare Vezzoli, Federico Bilotta, Arta Barzdina, Zane Straume, Anda Zundane, Laura Lukosiene, Irena Maraulaite, Ilona Razlevice, Bernd Schmitz, Stephanie Mifsud, Carolin Aehling, Celia Allison, Rients De Boer, Dina Emal, Markus Stevens, Marielle Buitenhuis, Jurgen de Graaff, Inge De Liefde, Andreas Machotta, Gail Scoones, Lonneke Staals, Jeremy Tomas, Anouk Van der Knijff-van Dortmont, Marianne Veldhuizen, David Alders, Wolfgang Buhre, Eva Schafrat, Jan Schreiber, Petronella Mari Vermeulen, Mark Hendriks, Sandra Lako, Marieke Voet-Lindner, Barbe Pieters, Gert-Jan Scheffer, Luc Tielens, Anthony R. Absalom, Margot Bergsma, Joke De Ruiter, Sascha Meier, Martin Volkers, Tjerk Zweers, Anne M. Beukers, Christa Boer, Jurgen Dertinger, Sandra Numan, Bas Van Zaane, Wenche B. Boerke, Nil Ekiz, Kristoffer Stensrud, Inger Marie Drage, Erik Ramon Isern, Alicja Bartkowska-Sniatkowska, Malgorzata Grzeskowiak, Magdalena Juzwa-Sobieraj, Jowita Rosada-Kurasińska, Artur Baranowski, Karina Jakubowska, Dorota Lewandowska, Magdalena Mierzewska-Schmidt, Piotr Sawicki, Magdalena Urban-Lechowicz, Pomianek Przemyslaw, Marzena Zielinska, Teresa Leal, Maria Soares, Pedro Pina, Sílvia Pinho, Maria Domingas Patuleia, Catarina Cruz Esteves, Helena Salgado, Maria João Santos, Rodica Badeti, Iulia Cindea, Loredana Oana, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Radu Tabacaru, Irina Trante, Valentin Munteanu, Mihai Morariu, Emese Nyíri, Ivana Budic, Vesna Marjanovic, Biljana Drašković, Marina Pandurov, Jordanka Ilic, Ana Mandras, Zdenka Rados, Nikola Stankovic, Maja Suica, Sladjana Vasiljevic, Mirjana Knezevic, Irina Milojevic, Ivana Petrov, Selena Puric Racic, Dusica Simic, Irena Simic, Marija Stevic, Irena Vulicevic, Barbora Cabanová, Miloslav Hanula, Jelena Berger, Darja Janjatovic, Špela Pirtovšek Štupnik, Dolores Méndez, Gema Pino, Paloma Rubio, Alberto Izquierdo, Silvia López, Cristina González Serrano, Jesús Cebrián, Ana Peleteiro, Pilar Del Rey de Diego, Ernesto Martínez García, Carolina Tormo de las Heras, Pablo Troncoso Montero, Celia Arbona, David Artés, Alicia Chamizo, Silvia Serrano, Montserrat Suarez Comas, Francisco Escribá, Cristina Auli, Osvaldo Pérez Pardo, Natalia Sierra Biddle, Ceferina Suárez Castaño, María Isabel Villalobos Rico, Susana Manrique Muñoz, Irene García Martínez, Nuria Montferrer Estruch, Elena Vilardell Ortíz, Rodrigo Poves-Álvarez, Ivan Kohn, Ulf Lindestam, Jarl Reinhard, Albert Castellheim, Kerstin Sandström, Sporre Bengt, Rainer Dörenberg, Peter Frykholm, Maria Garcia, Ann Kvarnström, Emma Pontén, Thomas Bruelisauer, Gabor Erdoes, Heiko Kaiser, Mathias Marchon, Stefan Seiler, Yann Bögli, Mirko Dolci, Carine Marcucci, Isabelle Pichon, Laszlo Vutskits, Mattias Casutt, Martin Hölzle, Thomas Hurni, Martin Jöhr, Anna-Ursina Malär, Jacqueline Mauch, Thomas Erb, Karin Oeinck, Mine Akin, Gulsen Keskin, Yesim Senayli, Guner Kaya, Pinar Kendigelen, Ayse Çiğdem Tutuncu, Zehra Hatipoğlu, Dilek Özcengiz, Hale Aksu Erdost, Elvan Öçmen, Çimen Olguner, Hilmi Ayanoglu, Pelin Corman Dincer, Tumay Umuroglu, Mustafa Azizoglu, Handan Birbiçer, Nurcan Doruk, Aslı Sagun, Sibel Baris, Dmytro Dmytriiev, Sridevi Kuchi, Nuria Masip, Peter Brooks, Alison Hare, Nargis Ahmad, Michelle Casey, Sam De Silva, Nadine Dobby, Prakash Krishnan, L. Amaki Sogbodjor, Ellie Walker, Suellen Walker, Stephanie King, Katy Nicholson, Michelle Quinney, Paul Stevens, Andrew Blevin, Mariangela Giombini, Chulananda Goonasekera, Sadia Adil, Stephanie Bew, Carol Bodlani, Dan Gilpin, Stephanie Jinks, Nalini Malarkkan, Alice Miskovic, Rebecca Pad, Juliet Wolfe Barry, Joy Abbott, James Armstrong, Natalie Cooper, Lindsay Crate, John Emery, Kathryn James, Hannah King, Paul Martin, Stefano Scalia Catenacci, Rob Bomont, Paul Smith, Sara Mele, Alessandra Verzelloni, Philippa Dix, Graham Bell, Elena Gordeva, Lesley McKee, Esther Ngan, Jutta Scheffczik, Li-En Tan, Mark Worrall, Carmel Cassar, Kevin Goddard, Victoria Barlow, Vimmi Oshan, Khairi Shah, Sarah Bell, Lisa Daniels, Monica Gandhi, David Pachter, Chris Perry, Andrew Robertson, Carmen Scott, Lynne Waring, David Barnes, Sophie Childs, Joanne Norman, Robin Sunderland, Dowell Julia, Feijten Prisca, Harlet Pierre, Herbineaux Sarah, Leva Brigitte, Plichon Benoît, Virág Katalin, Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Anesthesiology, HUS Children and Adolescents, Children's Hospital, Clinicum, Anestesiologian yksikkö, Disma, Nicola, Virag, Katalin, Riva, Thoma, Kaufmann, Jost, Engelhardt, Thoma, Habre, Walid, Breschan, Christian, Likar, Rudolf, Platzer, Manuela, Edelman, Isole, Eger, Johane, Heschl, Stefan, Messerer, Brigitte, Vittinghof, Maria, Kroess, Ruth, Stichlberger, Martina, Kahn, David, Pirotte, Thierry, Pregardien, Caroline, Veyckemans, Franci, Stevens, France, Berghmans, Johan, Bauters, Annemie, De Baerdemaeker, Luc, De Hert, Stefan, Lapage, Koen, Parashchanka, Aliaksandra, Van Limmen, Jurgen, Wyffels, Piet, Lauweryns, Julie, Najafi, Nadia, Vundelinckx, Jori, Butković, Diana, Kerovec Sorić, Ivana, Kralik, Sandra, Markić, Ana, Azman, Josip, Markic, Josko, Pupacic, Daniela, Frelich, Michal, Reimer, Petr, Urbanec, René, Cajková, Petra, Mixa, Vladimír, Sedláčková, Yvona, Knoppová, Lenka, Zlámalová (neé Květoňová), Alena, Vavřina, Martin, Žurek, Jiří, Hansen, Tom, Afshari, Arash, Bille, Anders Bastholm, Ellekvist, Marguerite, Ilmoja, Mari-Lii, Moor, Reet, Kikas, Reet, Väli, Merle, Kallio, Kariantti, Reponen, Elisa, Suominen, Pertti, Suvanto, Sami, Vähätalo, Raisa, Kokki, Hannu, Kokki, Merja, Harju, Jarkko, Kokkonen, Miia, Vieri, Jenni, Manner, Tuula, Amory, Catherine, Ludot, Hugue, Bert, Dina, Godart, Juliette, Laffargue, Anne, Dupont, Hervé, Urbina, Benjamin, Baujard, Catherine, Roulleau, Philippe, Staiti, Giuseppe, Bordes, Maryline, Nouette Gaulain, Karine, Hamonic, Yann, Semjen, Françoi, Jacqmarcq, Olivier, Lejus-Bourdeau, Caroline, Magne, Cécile, Petry, Léa, Ros, Lilica, Zang, Aurélien, Bennis, Mehdi, Coustets, Bernard, Fesseau, Rose, Constant, Isabelle, Khalil, Eliane, Sabourdin, Nada, Audren, Noemie, Descarpentries, Thoma, Fabre, Fanny, Legrand, Aurélien, Druot, Emilie, Orliaguet, Gille, Sabau, Lucie, Uhrig, Lynn, de la Brière, Françoi, Jonckheer, Karin, Mission, Jean-Paul, Scordo, Lucia, Couchepin, Caroline, Dadure, Christophe, De la Arena, Pablo, Hertz, Laurent, Pirat, Philippe, Sola, Chrystelle, Bellon, Myriam, Dahmani, Souhayl, Julien-Marsollier, Florence, Michelet, Daphne, Depret-Donatien, Veronique, Lesage, Anne, Laschat, Michael, Wappler, Frank, Becke, Karin, Brunner, Lena, Oppenrieder, Karin, Badelt, Gregor, Hochmuth, Karin, Koller, Bernhard, Reil, Anita, Richter, Sebastian, Fischer, Thoma, Diers, Anja, Schorer, Clemen, Weyland, Andrea, Cohausz, Ruth, Kretz, Franz-Josef, Löffler, Michaela, Wilbs, Marku, Hoehne, Claudia, Ulrici, Johanna, Goeters, Christiane, Flinspach, Armin, Klages, Matthia, Lindau, Simone, Messroghli, Leila, Zacharowski, Kai, Eisner, Christoph, Mueller, Thoma, Richter, Daniel, Schäfer, Melanie, Weigand, Marku, Weiterer, Sebastian, Ochsenreiter, Miriam, Schöler, Michael, Terboven, Tom, Eggemann, Isabel, Haussmann, Sascha, Leister, Nicola, Menzel, Christoph, Trieschmann, Uwe, Yücetepe, Sirin, Keilig, Susanna, Kranke, Peter, Jelting, Yvonne, Baehner, Torsten, Ellerkmann, Richard, Ghamari, Shahab, Neumann, Claudia, Söhle, Martin, Chloropoulou, Pelagia, Ntritsou, Vagia, Papagiannopoulou, Pinelopi, Garini, Eleana, Karafotia, Afroditi, Mammi, Panagoula, Bali, Evangelia, Iordanidou, Despoina, Malisiova, Anna, Polyzoi, Artemi, Tsiotou, Adelai, Sapi, Erzsebet, Székely, Edgar, Kosik, Nandor, Maráczi, Veronika, Schnur, Jano, Csillag, Judit, Gál, Jáno, Göbl, Gergely, Hauser, Baláz, Petróczy, Andrá, Tövisházi, Gyula, Blain, Stuart, Gallagher, Sarah, Harte, Sinead, Jackson, Mandy, Meehan, Emma, Nawoor, Zeenat, O’Hare, Brendan, Ross, Mark, Lerro, Daniela, Astuto, Marinella, Grasso, Chiara, Scalisi, Rita, Frasacco, Giulia, Lenares, Elena, Leone, Roberto, Grazzini, Maurizia, Minardi, Carmelo, Zadra, Nicola, Cinnella, Gilda, Cotoia, Antonella, Galante, Dario, De Lorenzo, Brita, Kuppers, Beate, Bottazzi, Giulia, Caramelli, Fabio, Mondardini, Maria Cristina, Rossetti, Emanuele, Picardo, Sergio, Vittori, Alessandro, Camporesi, Anna, Wolfler, Andrea, Calderini, Edoardo, Colantonio, Laura Brigitta, Finamore, Simona Anna, Porro, Giuliana Anna, Bonfiglio, Rachele, Kotzeva, Svetlana, Mameli, Leila, Mattioli, Girolamo, Micalizzi, Camilla, Montaguti, Alessia, Pistorio, Angela, Zanaboni, Clelia, Guddo, Anna, Neba, Gerald Rogan, Favarato, Moreno, Locatelli, Bruno Guido, Maffioletti, Micol, Sonzogni, Valter, Garra, Rossella, Sammartino, Maria, Sbaraglia, Fabio, Cortegiani, Andrea, Moscarelli, Alessandra, Attanasi, Elena, Tesoro, Simonetta, Agapiti, Cristina, Pinzoni, Francesca, Vezzoli, Cesare, Bilotta, Federico, Barzdina, Arta, Straume, Zane, Zundane, Anda, Lukosiene, Laura, Maraulaite, Irena, Razlevice, Ilona, Schmitz, Bernd, Mifsud, Stephanie, Aehling, Carolin, Allison, Celia, De Boer, Rient, Emal, Dina, Stevens, Marku, Buitenhuis, Marielle, de Graaff, Jurgen, De Liefde, Inge, Machotta, Andrea, Scoones, Gail, Staals, Lonneke, Tomas, Jeremy, Van der Knijff-van Dortmont, Anouk, Veldhuizen, Marianne, Alders, David, Buhre, Wolfgang, Schafrat, Eva, Schreiber, Jan, Vermeulen, Petronella Mari, Hendriks, Mark, Lako, Sandra, Voet-Lindner, Marieke, Pieters, Barbe, Scheffer, Gert-Jan, Tielens, Luc, Absalom, Anthony R., Bergsma, Margot, De Ruiter, Joke, Meier, Sascha, Volkers, Martin, Zweers, Tjerk, Beukers, Anne M., Boer, Christa, Dertinger, Jurgen, Numan, Sandra, Van Zaane, Ba, Boerke, Wenche B., Ekiz, Nil, Stensrud, Kristoffer, Drage, Inger Marie, Isern, Erik Ramon, Bartkowska-Sniatkowska, Alicja, Grzeskowiak, Malgorzata, Juzwa-Sobieraj, Magdalena, Rosada-Kurasińska, Jowita, Baranowski, Artur, Jakubowska, Karina, Lewandowska, Dorota, Mierzewska-Schmidt, Magdalena, Sawicki, Piotr, Urban-Lechowicz, Magdalena, Przemyslaw, Pomianek, Zielinska, Marzena, Leal, Teresa, Soares, Maria, Pina, Pedro, Pinho, Sílvia, Patuleia, Maria Dominga, Esteves, Catarina Cruz, Salgado, Helena, Santos, Maria João, Badeti, Rodica, Cindea, Iulia, Oana, Loredana, Gurita, Adriana, Ilie, Luminita, Mocioiu, Gabriel, Tabacaru, Radu, Trante, Irina, Munteanu, Valentin, Morariu, Mihai, Nyíri, Emese, Budic, Ivana, Marjanovic, Vesna, Drašković, Biljana, Pandurov, Marina, Ilic, Jordanka, Mandras, Ana, Rados, Zdenka, Stankovic, Nikola, Suica, Maja, Vasiljevic, Sladjana, Knezevic, Mirjana, Milojevic, Irina, Petrov, Ivana, Puric Racic, Selena, Simic, Dusica, Simic, Irena, Stevic, Marija, Vulicevic, Irena, Cabanová, Barbora, Hanula, Miloslav, Berger, Jelena, Janjatovic, Darja, Pirtovšek Štupnik, Špela, Méndez, Dolore, Pino, Gema, Rubio, Paloma, Izquierdo, Alberto, López, Silvia, González Serrano, Cristina, Cebrián, Jesú, Peleteiro, Ana, Del Rey de Diego, Pilar, Martínez García, Ernesto, Tormo de las Heras, Carolina, Troncoso Montero, Pablo, Arbona, Celia, Artés, David, Chamizo, Alicia, Serrano, Silvia, Suarez Comas, Montserrat, Escribá, Francisco, Auli, Cristina, Pérez Pardo, Osvaldo, Sierra Biddle, Natalia, Suárez Castaño, Ceferina, Villalobos Rico, María Isabel, Manrique Muñoz, Susana, García Martínez, Irene, Montferrer Estruch, Nuria, Vilardell Ortíz, Elena, Poves-Álvarez, Rodrigo, Kohn, Ivan, Lindestam, Ulf, Reinhard, Jarl, Castellheim, Albert, Sandström, Kerstin, Bengt, Sporre, Dörenberg, Rainer, Frykholm, Peter, Garcia, Maria, Kvarnström, Ann, Pontén, Emma, Bruelisauer, Thoma, Erdoes, Gabor, Kaiser, Heiko, Marchon, Mathia, Seiler, Stefan, Bögli, Yann, Dolci, Mirko, Marcucci, Carine, Pichon, Isabelle, Vutskits, Laszlo, Casutt, Mattia, Hölzle, Martin, Hurni, Thoma, Jöhr, Martin, Malär, Anna-Ursina, Mauch, Jacqueline, Erb, Thoma, Oeinck, Karin, Akin, Mine, Keskin, Gulsen, Senayli, Yesim, Kaya, Guner, Kendigelen, Pinar, Tutuncu, Ayse Çiğdem, Hatipoğlu, Zehra, Özcengiz, Dilek, Erdost, Hale Aksu, Öçmen, Elvan, Olguner, Çimen, Ayanoglu, Hilmi, Dincer, Pelin Corman, Umuroglu, Tumay, Azizoglu, Mustafa, Birbiçer, Handan, Doruk, Nurcan, Sagun, Aslı, Baris, Sibel, Dmytriiev, Dmytro, Kuchi, Sridevi, Masip, Nuria, Brooks, Peter, Hare, Alison, Ahmad, Nargi, Casey, Michelle, De Silva, Sam, Dobby, Nadine, Krishnan, Prakash, Sogbodjor, L. Amaki, Walker, Ellie, Walker, Suellen, King, Stephanie, Nicholson, Katy, Quinney, Michelle, Stevens, Paul, Blevin, Andrew, Giombini, Mariangela, Goonasekera, Chulananda, Adil, Sadia, Bew, Stephanie, Bodlani, Carol, Gilpin, Dan, Jinks, Stephanie, Malarkkan, Nalini, Miskovic, Alice, Pad, Rebecca, Wolfe Barry, Juliet, Abbott, Joy, Armstrong, Jame, Cooper, Natalie, Crate, Lindsay, Emery, John, James, Kathryn, King, Hannah, Martin, Paul, Scalia Catenacci, Stefano, Bomont, Rob, Smith, Paul, Mele, Sara, Verzelloni, Alessandra, Dix, Philippa, Bell, Graham, Gordeva, Elena, McKee, Lesley, Ngan, Esther, Scheffczik, Jutta, Tan, Li-En, Worrall, Mark, Cassar, Carmel, Goddard, Kevin, Barlow, Victoria, Oshan, Vimmi, Shah, Khairi, Bell, Sarah, Daniels, Lisa, Gandhi, Monica, Pachter, David, Perry, Chri, Robertson, Andrew, Scott, Carmen, Waring, Lynne, Barnes, David, Childs, Sophie, Norman, Joanne, Sunderland, Robin, Julia, Dowell, Prisca, Feijten, Pierre, Harlet, Sarah, Herbineaux, Brigitte, Leva, Benoît, Plichon, Katalin, Virág, IOO, ACS - Microcirculation, APH - Quality of Care, and ANS - Neuroinfection & -inflammation
Subjects: Male, Time Factors, paediatric, medicine.medical_treatment, morbidity, Severity of Illness Index, 0302 clinical medicine, 030202 anesthesiology, Risk Factors, Clinical endpoint, Anesthesia, Prospective Studies, 610 Medicine & health, Hypoxia, Medical Audit, medicine.diagnostic_test, ddc:617, infants, Incidence (epidemiology), Incidence, Age Factors, anaesthesia, respiratory system, Europe, Treatment Outcome, Cohort, Female, medicine.symptom, Bradycardia, Laryngoscopy, Anesthesia/adverse effects/mortality, Risk Assessment, Europe/epidemiology, 03 medical and health sciences, Laryngoscopy/adverse effects/mortality, Hypoxia/diagnosis/epidemiology/mortality, medicine, Intubation, Intratracheal, Humans, difficult intubation, business.industry, Tracheal intubation, Infant, Newborn, Infant, Perioperative, Newborn, 3126 Surgery, anesthesiology, intensive care, radiology, mortality, neonates, Clinical trial, Intratracheal, Anesthesiology and Pain Medicine, airway, Intubation, Intratracheal/adverse effects/mortality, neonate, Intubation, business, airways
Abstract: Background: Neonates and infants are susceptible to hypoxaemia in the perioperative period. The aim of this study was to analyse interventions related to anaesthesia tracheal intubations in this European cohort and identify their clinical consequences. Methods: We performed a secondary analysis of tracheal intubations of the European multicentre observational trial (NEonate and Children audiT of Anaesthesia pRactice IN Europe [NECTARINE]) in neonates and small infants with difficult tracheal intubation. The primary endpoint was the incidence of difficult intubation and the related complications. The secondary endpoints were the risk factors for severe hypoxaemia attributed to difficult airway management, and 30 and 90 day outcomes. Results: Tracheal intubation was planned in 4683 procedures. Difficult tracheal intubation, defined as two failed attempts of direct laryngoscopy, occurred in 266 children (271 procedures) with an incidence (95% confidence interval [CI]) of 5.8% (95% CI, 5.1e6.5). Bradycardia occurred in 8% of the cases with difficult intubation, whereas a significant decrease in oxygen saturation (SpO2
Published: 2021
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42. Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

Author: Fuchs A., Disma N., Virag K., Ulmer F., Habre W., de Graaff J. C., Riva T., NECTARINE Group of the European Society of Anaesthesiology and Intensive Care Clinical Trial Network: Christian Breschan, Rudolf Likar, Manuela Platzer, Isole Edelman, Johanes Eger, Stefan Heschl, Brigitte Messerer, Maria Vittinghof, Ruth Kroess, Martina Stichlberger, David Kahn, Thierry Pirotte, Caroline Pregardien, Francis Veyckemans, France Stevens, Johan Berghmans, Annemie Bauters, Luc De Baerdemaeker, Stefan De Hert, Koen Lapage, Aliaksandra Parashchanka, Jurgen Van Limmen, Piet Wyffels, Nadia Najafi, Joris Vundelinckx, Diana Butković, Ivana Kerovec Sorić, Sandra Kralik, Ana Markić, Josip Azman, Josko Markic, Daniela Pupacic, Michal Frelich, Petr Reimer, René Urbanec, Petra Cajková, Vladimír Mixa, Yvona Sedláčková, Lenka Knoppová, Alena Zlámalová, Martin Vavřina, Jiří Žurek, Tom Hansen, Arash Afshari, Anders Bastholm Bille, Marguerite Ellekvist, Mari-Liis Ilmoja, Reet Moor, Reet Kikas, Merle Väli, Kariantti Kallio, Elisa Reponen, Pertti Suominen, Sami Suvanto, Raisa Vähätalo, Hannu Kokki, Merja Kokki, Jarkko Harju, Miia Kokkonen, Jenni Vieri, Tuula Manner, Catherine Amory, Hugues Ludot, Dina Bert, Juliette Godart, Anne Laffargue, Hervé Dupont, Benjamin Urbina, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Maryline Bordes, Karine Nouette Gaulain, Yann Hamonic, François Semjen, Olivier Jacqmarcq, Caroline Lejus-Bourdeau, Cécile Magne, Léa Petry, Lilica Ros, Aurélien Zang, Mehdi Bennis, Bernard Coustets, Rose Fesseau, Isabelle Constant, Eliane Khalil, Nada Sabourdin, Noemie Audren, Thomas Descarpentries, Fanny Fabre, Aurélien Legrand, Emilie Druot, Gilles Orliaguet, Lucie Sabau, Lynn Uhrig, François de la Brière, Karin Jonckheer, Jean-Paul Mission, Lucia Scordo, Caroline Couchepin, Christophe Dadure, Pablo De la Arena, Laurent Hertz, Philippe Pirat, Chrystelle Sola, Myriam Bellon, Souhayl Dahmani, Florence Julien-Marsollier, Daphne Michelet, Veronique Depret-Donatien, Anne Lesage, Jost Kaufmann, Michael Laschat, Frank Wappler, Karin Becke, Lena Brunner, Karin Oppenrieder, Gregor Badelt, Karin Hochmuth, Bernhard Koller, Anita Reil, Sebastian Richter, Thomas Fischer, Anja Diers, Clemens Schorer, Andreas Weyland, Ruth Cohausz, Franz-Josef Kretz, Michaela Löffler, Markus Wilbs, Claudia Hoehne, Johanna Ulrici, Christiane Goeters, Armin Flinspach, Matthias Klages, Simone Lindau, Leila Messroghli, Kai Zacharowski, Christoph Eisner, Thomas Mueller, Daniel Richter, Melanie Schäfer, Markus Weigand, Sebastian Weiterer, Miriam Ochsenreiter, Michael Schöler, Tom Terboven, Isabel Eggemann, Sascha Haussmann, Nicolas Leister, Christoph Menzel, Uwe Trieschmann, Sirin Yücetepe, Susanna Keilig, Peter Kranke, Yvonne Jelting, Torsten Baehner, Richard Ellerkmann, Shahab Ghamari, Claudia Neumann, Martin Söhle, Pelagia Chloropoulou, Vagia Ntritsou, Pinelopi Papagiannopoulou, Eleana Garini, Afroditi Karafotia, Panagoula Mammi, Evangelia Bali, Despoina Iordanidou, Anna Malisiova, Artemis Polyzoi, Adelais Tsiotou, Erzsebet Sapi, Edgar Székely, Nandor Kosik, Veronika Maráczi, Janos Schnur, Judit Csillag, János Gál, Gergely Göbl, Balázs Hauser, András Petróczy, Gyula Tövisházi, Stuart Blain, Sarah Gallagher, Sinead Harte, Mandy Jackson, Emma Meehan, Zeenat Nawoor, Brendan O'Hare, Mark Ross, Daniela Lerro, Marinella Astuto, Chiara Grasso, Rita Scalisi, Giulia Frasacco, Elena Lenares, Roberto Leone, Maurizia Grazzini, Carmelo Minardi, Nicola Zadra, Gilda Cinnella, Antonella Cotoia, Dario Galante, Brita De Lorenzo, Beate Kuppers, Giulia Bottazzi, Fabio Caramelli, Maria Cristina Mondardini, Emanuele Rossetti, Sergio Picardo, Alessandro Vittori, Anna Camporesi, Andrea Wolfler, Edoardo Calderini, Laura Brigitta Colantonio, Simona Anna Finamore, Giuliana Anna Porro, Rachele Bonfiglio, Svetlana Kotzeva, Leila Mameli, Girolamo Mattioli, Camilla Micalizzi, Alessia Montaguti, Angela Pistorio, Clelia Zanaboni, Anna Guddo, Gerald Rogan Neba, Moreno Favarato, Bruno Guido Locatelli, Micol Maffioletti, Valter Sonzogni, Rossella Garra, Maria Sammartino, Fabio Sbaraglia, Andrea Cortegiani, Alessandra Moscarelli, Elena Attanasi, Simonetta Tesoro, Cristina Agapiti, Francesca Pinzoni, Cesare Vezzoli, Federico Bilotta, Arta Barzdina, Zane Straume, Anda Zundane, Laura Lukosiene, Irena Maraulaite, Ilona Razlevice, Bernd Schmitz, Stephanie Mifsud, Carolin Aehling, Celia Allison, Rients De Boer, Dina Emal, Markus Stevens, Marielle Buitenhuis, Inge De Liefde, Andreas Machotta, Gail Scoones, Lonneke Staals, Jeremy Tomas, Anouk Van der Knijff-van Dortmont, Marianne Veldhuizen, David Alders, Wolfgang Buhre, Eva Schafrat, Jan Schreiber, Petronella Mari Vermeulen, Mark Hendriks, Sandra Lako, Marieke Voet-Lindner, Barbe Pieters, Gert-Jan Scheffer, Luc Tielens, Anthony R Absalom, Margot Bergsma, Joke De Ruiter, Sascha Meier, Martin Volkers, Tjerk Zweers, Anne M Beukers, Christa Boer, Jurgen Dertinger, Sandra Numan, Bas Van Zaane, Wenche B Boerk, Nil Ekiz, Kristoffer Stensrud, Inger Marie Drage, Erik Ramon Isern, Alicja Bartkowska-Sniatkowska, Malgorzata Grzeskowiak, Magdalena Juzwa-Sobieraj, Jowita Rosada-Kurasińska, Artur Baranowski, Karina Jakubowska, Dorota Lewandowska, Magdalena Mierzewska-Schmidt, Piotr Sawicki, Magdalena Urban-Lechowicz, Pomianek Przemyslaw, Marzena Zielinska, Teresa Leal, Maria Soares, Pedro Pina, Sílvia Pinho, Maria Domingas Patuleia, Catarina Cruz Esteves, Helena Salgado, Maria João Santos, Rodica Badeti, Iulia Cindea, Loredana Oana, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Radu Tabacaru, Irina Trante, Valentin Munteanu, Mihai Morariu, Emese Nyíri, Ivana Budic, Vesna Marjanovic, Biljana Drašković, Marina Pandurov, Jordanka Ilic, Ana Mandras, Zdenka Rados, Nikola Stankovic, Maja Suica, Sladjana Vasiljevic, Mirjana Knezevic, Irina Milojevic, Ivana Petrov, Selena Puric Racic, Dusica Simic, Irena Simic, Marija Stevic, Irena Vulicevic, Barbora Cabanová, Miloslav Hanula, Jelena Berger, Darja Janjatovic, Špela Pirtovšek Štupnik, Dolores Méndez, Gema Pino, Paloma Rubio, Alberto Izquierdo, Silvia López, Cristina González Serrano, Jesús Cebrián, Ana Peleteiro, Pilar Del Rey de Diego, Ernesto Martínez García, Carolina Tormo de Las Heras, Pablo Troncoso Montero, Celia Arbona, David Artés, Alicia Chamizo, Silvia Serrano, Montserrat Suarez Comas, Francisco Escribá, Cristina Auli, Osvaldo Pérez Pardo, Natalia Sierra Biddle, Ceferina Suárez Castaño, María Isabel Villalobos Rico, Susana Manrique Muñoz, Irene García Martínez, Nuria Montferrer Estruch, Elena Vilardell Ortíz, Rodrigo Poves-Álvarez, Ivan Kohn, Ulf Lindestam, Jarl Reinhard, Albert Castellheim, Kerstin Sandström, Sporre Bengt, Rainer Dörenberg, Peter Frykholm, Maria Garcia, Ann Kvarnström, Emma Pontén, Thomas Bruelisauer, Gabor Erdoes, Heiko Kaiser, Mathias Marchon, Stefan Seiler, Yann Bögli, Mirko Dolci, Carine Marcucci, Isabelle Pichon, Laszlo Vutskits, Mattias Casutt, Martin Hölzle, Thomas Hurni, Martin Jöhr, Anna-Ursina Malär, Jacqueline Mauch, Thomas Erb, Karin Oeinck, Mine Akin, Gulsen Keskin, Yesim Senayli, Guner Kaya, Pinar Kendigelen, Ayse Çiğdem Tutuncu, Zehra Hatipoğlu, Dilek Özcengiz, Hale Aksu Erdost, Elvan Öçmen, Çimen Olguner, Hilmi Ayanoglu, Pelin Corman Dincer, Tumay Umuroglu, Mustafa Azizoglu, Handan Birbiçer, Nurcan Doruk, Aslı Sagun, Sibel Baris, Dmytro Dmytriiev, Sridevi Kuchi, Nuria Masip, Peter Brooks, Alison Hare, Nargis Ahmad, Michelle Casey, Sam De Silva, Nadine Dobby, Prakash Krishnan, L Amaki Sogbodjor, Ellie Walker, Suellen Walker, Stephanie King, Katy Nicholson, Michelle Quinney, Paul Stevens, Andrew Blevin, Mariangela Giombini, Chulananda Goonasekera, Sadia Adil, Stephanie Bew, Carol Bodlani, Dan Gilpin, Stephanie Jinks, Nalini Malarkkan, Alice Miskovic, Rebecca Pad, Juliet Wolfe Barry, Joy Abbott, James Armstrong, Natalie Cooper, Lindsay Crate, John Emery, Kathryn James, Hannah King, Paul Martin, Stefano Scalia Catenacci, Rob Bomont, Paul Smith, Sara Mele, Alessandra Verzelloni, Philippa Dix, Graham Bell, Elena Gordeva, Lesley McKee, Esther Ngan, Jutta Scheffczik, Li-En Tan, Mark Worrall, Carmel Cassar, Kevin Goddard, Victoria Barlow, Vimmi Oshan, Khairi Shah, Sarah Bell, Lisa Daniels, Monica Gandhi, David Pachter, Chris Perry, Andrew Robertson, Carmen Scott, Lynne Waring, David Barnes, Sophie Childs, Joanne Norman, Robin Sunderland, Fuchs A., Disma N., Virag K., Ulmer F., Habre W., de Graaff J.C., Riva T., NECTARINE Group of the European Society of Anaesthesiology and Intensive Care Clinical Trial Network: Christian Breschan, Rudolf Likar, Manuela Platzer, Isole Edelman, Johanes Eger, Stefan Heschl, Brigitte Messerer, Maria Vittinghof, Ruth Kroess, Martina Stichlberger, David Kahn, Thierry Pirotte, Caroline Pregardien, Francis Veyckemans, France Stevens, Johan Berghmans, Annemie Bauters, Luc De Baerdemaeker, Stefan De Hert, Koen Lapage, Aliaksandra Parashchanka, Jurgen Van Limmen, Piet Wyffels, Nadia Najafi, Joris Vundelinckx, Diana Butković, Ivana Kerovec Sorić, Sandra Kralik, Ana Markić, Josip Azman, Josko Markic, Daniela Pupacic, Michal Frelich, Petr Reimer, René Urbanec, Petra Cajková, Vladimír Mixa, Yvona Sedláčková, Lenka Knoppová, Alena Zlámalová, Martin Vavřina, Jiří Žurek, Tom Hansen, Arash Afshari, Anders Bastholm Bille, Marguerite Ellekvist, Mari-Liis Ilmoja, Reet Moor, Reet Kikas, Merle Väli, Kariantti Kallio, Elisa Reponen, Pertti Suominen, Sami Suvanto, Raisa Vähätalo, Hannu Kokki, Merja Kokki, Jarkko Harju, Miia Kokkonen, Jenni Vieri, Tuula Manner, Catherine Amory, Hugues Ludot, Dina Bert, Juliette Godart, Anne Laffargue, Hervé Dupont, Benjamin Urbina, Catherine Baujard, Philippe Roulleau, Giuseppe Staiti, Maryline Bordes, Karine Nouette Gaulain, Yann Hamonic, François Semjen, Olivier Jacqmarcq, Caroline Lejus-Bourdeau, Cécile Magne, Léa Petry, Lilica Ros, Aurélien Zang, Mehdi Bennis, Bernard Coustets, Rose Fesseau, Isabelle Constant, Eliane Khalil, Nada Sabourdin, Noemie Audren, Thomas Descarpentries, Fanny Fabre, Aurélien Legrand, Emilie Druot, Gilles Orliaguet, Lucie Sabau, Lynn Uhrig, François de la Brière, Karin Jonckheer, Jean-Paul Mission, Lucia Scordo, Caroline Couchepin, Christophe Dadure, Pablo De la Arena, Laurent Hertz, Philippe Pirat, Chrystelle Sola, Myriam Bellon, Souhayl Dahmani, Florence Julien-Marsollier, Daphne Michelet, Veronique Depret-Donatien, Anne Lesage, Jost Kaufmann, Michael Laschat, Frank Wappler, Karin Becke, Lena Brunner, Karin Oppenrieder, Gregor Badelt, Karin Hochmuth, Bernhard Koller, Anita Reil, Sebastian Richter, Thomas Fischer, Anja Diers, Clemens Schorer, Andreas Weyland, Ruth Cohausz, Franz-Josef Kretz, Michaela Löffler, Markus Wilbs, Claudia Hoehne, Johanna Ulrici, Christiane Goeters, Armin Flinspach, Matthias Klages, Simone Lindau, Leila Messroghli, Kai Zacharowski, Christoph Eisner, Thomas Mueller, Daniel Richter, Melanie Schäfer, Markus Weigand, Sebastian Weiterer, Miriam Ochsenreiter, Michael Schöler, Tom Terboven, Isabel Eggemann, Sascha Haussmann, Nicolas Leister, Christoph Menzel, Uwe Trieschmann, Sirin Yücetepe, Susanna Keilig, Peter Kranke, Yvonne Jelting, Torsten Baehner, Richard Ellerkmann, Shahab Ghamari, Claudia Neumann, Martin Söhle, Pelagia Chloropoulou, Vagia Ntritsou, Pinelopi Papagiannopoulou, Eleana Garini, Afroditi Karafotia, Panagoula Mammi, Evangelia Bali, Despoina Iordanidou, Anna Malisiova, Artemis Polyzoi, Adelais Tsiotou, Erzsebet Sapi, Edgar Székely, Nandor Kosik, Veronika Maráczi, Janos Schnur, Judit Csillag, János Gál, Gergely Göbl, Balázs Hauser, András Petróczy, Gyula Tövisházi, Stuart Blain, Sarah Gallagher, Sinead Harte, Mandy Jackson, Emma Meehan, Zeenat Nawoor, Brendan O'Hare, Mark Ross, Daniela Lerro, Marinella Astuto, Chiara Grasso, Rita Scalisi, Giulia Frasacco, Elena Lenares, Roberto Leone, Maurizia Grazzini, Carmelo Minardi, Nicola Zadra, Gilda Cinnella, Antonella Cotoia, Dario Galante, Brita De Lorenzo, Beate Kuppers, Giulia Bottazzi, Fabio Caramelli, Maria Cristina Mondardini, Emanuele Rossetti, Sergio Picardo, Alessandro Vittori, Anna Camporesi, Andrea Wolfler, Edoardo Calderini, Laura Brigitta Colantonio, Simona Anna Finamore, Giuliana Anna Porro, Rachele Bonfiglio, Svetlana Kotzeva, Leila Mameli, Girolamo Mattioli, Camilla Micalizzi, Alessia Montaguti, Angela Pistorio, Clelia Zanaboni, Anna Guddo, Gerald Rogan Neba, Moreno Favarato, Bruno Guido Locatelli, Micol Maffioletti, Valter Sonzogni, Rossella Garra, Maria Sammartino, Fabio Sbaraglia, Andrea Cortegiani, Alessandra Moscarelli, Elena Attanasi, Simonetta Tesoro, Cristina Agapiti, Francesca Pinzoni, Cesare Vezzoli, Federico Bilotta, Arta Barzdina, Zane Straume, Anda Zundane, Laura Lukosiene, Irena Maraulaite, Ilona Razlevice, Bernd Schmitz, Stephanie Mifsud, Carolin Aehling, Celia Allison, Rients De Boer, Dina Emal, Markus Stevens, Marielle Buitenhuis, Inge De Liefde, Andreas Machotta, Gail Scoones, Lonneke Staals, Jeremy Tomas, Anouk Van der Knijff-van Dortmont, Marianne Veldhuizen, David Alders, Wolfgang Buhre, Eva Schafrat, Jan Schreiber, Petronella Mari Vermeulen, Mark Hendriks, Sandra Lako, Marieke Voet-Lindner, Barbe Pieters, Gert-Jan Scheffer, Luc Tielens, Anthony R Absalom, Margot Bergsma, Joke De Ruiter, Sascha Meier, Martin Volkers, Tjerk Zweers, Anne M Beukers, Christa Boer, Jurgen Dertinger, Sandra Numan, Bas Van Zaane, Wenche B Boerk, Nil Ekiz, Kristoffer Stensrud, Inger Marie Drage, Erik Ramon Isern, Alicja Bartkowska-Sniatkowska, Malgorzata Grzeskowiak, Magdalena Juzwa-Sobieraj, Jowita Rosada-Kurasińska, Artur Baranowski, Karina Jakubowska, Dorota Lewandowska, Magdalena Mierzewska-Schmidt, Piotr Sawicki, Magdalena Urban-Lechowicz, Pomianek Przemyslaw, Marzena Zielinska, Teresa Leal, Maria Soares, Pedro Pina, Sílvia Pinho, Maria Domingas Patuleia, Catarina Cruz Esteves, Helena Salgado, Maria João Santos, Rodica Badeti, Iulia Cindea, Loredana Oana, Adriana Gurita, Luminita Ilie, Gabriel Mocioiu, Radu Tabacaru, Irina Trante, Valentin Munteanu, Mihai Morariu, Emese Nyíri, Ivana Budic, Vesna Marjanovic, Biljana Drašković, Marina Pandurov, Jordanka Ilic, Ana Mandras, Zdenka Rados, Nikola Stankovic, Maja Suica, Sladjana Vasiljevic, Mirjana Knezevic, Irina Milojevic, Ivana Petrov, Selena Puric Racic, Dusica Simic, Irena Simic, Marija Stevic, Irena Vulicevic, Barbora Cabanová, Miloslav Hanula, Jelena Berger, Darja Janjatovic, Špela Pirtovšek Štupnik, Dolores Méndez, Gema Pino, Paloma Rubio, Alberto Izquierdo, Silvia López, Cristina González Serrano, Jesús Cebrián, Ana Peleteiro, Pilar Del Rey de Diego, Ernesto Martínez García, Carolina Tormo de Las Heras, Pablo Troncoso Montero, Celia Arbona, David Artés, Alicia Chamizo, Silvia Serrano, Montserrat Suarez Comas, Francisco Escribá, Cristina Auli, Osvaldo Pérez Pardo, Natalia Sierra Biddle, Ceferina Suárez Castaño, María Isabel Villalobos Rico, Susana Manrique Muñoz, Irene García Martínez, Nuria Montferrer Estruch, Elena Vilardell Ortíz, Rodrigo Poves-Álvarez, Ivan Kohn, Ulf Lindestam, Jarl Reinhard, Albert Castellheim, Kerstin Sandström, Sporre Bengt, Rainer Dörenberg, Peter Frykholm, Maria Garcia, Ann Kvarnström, Emma Pontén, Thomas Bruelisauer, Gabor Erdoes, Heiko Kaiser, Mathias Marchon, Stefan Seiler, Yann Bögli, Mirko Dolci, Carine Marcucci, Isabelle Pichon, Laszlo Vutskits, Mattias Casutt, Martin Hölzle, Thomas Hurni, Martin Jöhr, Anna-Ursina Malär, Jacqueline Mauch, Thomas Erb, Karin Oeinck, Mine Akin, Gulsen Keskin, Yesim Senayli, Guner Kaya, Pinar Kendigelen, Ayse Çiğdem Tutuncu, Zehra Hatipoğlu, Dilek Özcengiz, Hale Aksu Erdost, Elvan Öçmen, Çimen Olguner, Hilmi Ayanoglu, Pelin Corman Dincer, Tumay Umuroglu, Mustafa Azizoglu, Handan Birbiçer, Nurcan Doruk, Aslı Sagun, Sibel Baris, Dmytro Dmytriiev, Sridevi Kuchi, Nuria Masip, Peter Brooks, Alison Hare, Nargis Ahmad, Michelle Casey, Sam De Silva, Nadine Dobby, Prakash Krishnan, L Amaki Sogbodjor, Ellie Walker, Suellen Walker, Stephanie King, Katy Nicholson, Michelle Quinney, Paul Stevens, Andrew Blevin, Mariangela Giombini, Chulananda Goonasekera, Sadia Adil, Stephanie Bew, Carol Bodlani, Dan Gilpin, Stephanie Jinks, Nalini Malarkkan, Alice Miskovic, Rebecca Pad, Juliet Wolfe Barry, Joy Abbott, James Armstrong, Natalie Cooper, Lindsay Crate, John Emery, Kathryn James, Hannah King, Paul Martin, Stefano Scalia Catenacci, Rob Bomont, Paul Smith, Sara Mele, Alessandra Verzelloni, Philippa Dix, Graham Bell, Elena Gordeva, Lesley McKee, Esther Ngan, Jutta Scheffczik, Li-En Tan, Mark Worrall, Carmel Cassar, Kevin Goddard, Victoria Barlow, Vimmi Oshan, Khairi Shah, Sarah Bell, Lisa Daniels, Monica Gandhi, David Pachter, Chris Perry, Andrew Robertson, Carmen Scott, Lynne Waring, David Barnes, Sophie Childs, Joanne Norman, Robin Sunderland, and Anesthesiology
Subjects: Red Blood Cell Transfusion, NEONATE, Haemoglobin levels, 610 Medicine & health, Peri-operative, red blood cell transfusion, neonates, infants, High morbidity, Hemoglobins, TRANSFUSION, medicine, Clinical endpoint, Humans, Anesthesia, Prospective Studies, business.industry, Postmenstrual Age, Infant, Newborn, Perioperative, Europe, Red blood cell, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Observational study, business, 610 Medizin und Gesundheit, Erythrocyte Transfusion
Abstract: BACKGROUND Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12��g��dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (��week 3) onwards. OBJECTIVE To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN A multicentre observational study. SETTING The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g��dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g��dl-1 in week 2 and 8.0 [7.3 to 9.0] g��dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml��kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g��dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02350348.
Published: 2021
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43. Use of ornidazole in the treatment of anaerobic infection in surgery

Author: Oleksandr Nazarchuk, Dmytro Dmytriiev, and Yu M Babina
Subjects: 0301 basic medicine, nitro-imidazole, medicine.medical_specialty, ornidazole, business.industry, Ornidazole, 030106 microbiology, 030206 dentistry, medicine.disease, Anaerobic infection, non-clostridial anaerobic infection, Surgery, 03 medical and health sciences, Metronidazole, 0302 clinical medicine, Infectious complication, medicine, Medicine, Combined therapy, Clinical efficacy, business, Surgical Infections, Complex problems, medicine.drug
Abstract: One of the most complex problems of modern surgery is the treatment and prevention of anaerobic infection. Main place in overcoming of this infectious complication is devoted to urgent surgical intervention and correct early empiric antibacterial therapy. Special place in the combined empiric antibacterial treatment is devoted to 5-nitroimidazoles. Modern data about clinical efficacy of ornidazole in the treatment of surgical infectious complications is presented in the article. We performed a comparison of therapeutic activity and physical-chemical properties, pharmacokinetic and pharmacodynamic features of ornidazole with the first representative of 5-nitroimidazole class – metronidazole. Taking into account antiprotozoal and antianaerobic activity of ornidazole, it is recommended to be used in the schemes of combined therapy of severe generalized anaerobic infections and purulent processes of different localization; treatment and prevention of surgical infections after intraabdominal, thoracic, proctological and dental surgical interventions.
Published: 2021
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44. Tobramycin: efficacy of intensive therapy

Author: Oleksandr Nazarchuk, Yu M Babina, Dmytro Dmytriiev, and O V Bankovskiy
Subjects: aminoglycosides, medicine.medical_specialty, business.industry, Pseudomonas aeruginosa, medicine.drug_class, Antibiotics, tobramycin, medicine.disease_cause, Clinical trial, Antibiotic resistance, Intensive care, Pharmacodynamics, Intensive therapy, Tobramycin, Medicine, business, Intensive care medicine, medicine.drug
Abstract: One of the leading cause of the decrease of treatment efficacy in patient with community-acquired infections in the intensive care department is a spread of antibiotic resistance in main causative agents. Among Gram-negative microorganisms Pseudomonas aeruginosa is one of the leading causative agents, that is related to health service. A review of foreign and domestic literature concerning tobramycin – systemic form use in the current medical practice in the conditions of increasing resistance of microorganisms to the most broad-spectrum antibiotics is presented in the article. Pharmacokinetic and pharmacodynamic characteristics of tobramycin are described, results of clinical trials, that demonstrate an efficacy of its use in the combination with other antibiotics in the life-threatening infections caused by Gram-negative microorganisms are presented in the article.
Published: 2021
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45. Ультразвук-контрольована блокада Quadratus Lumborum у порівнянні з каудальною блокадою для післяопера- ційного знеболення у дітей, які перенесли гострий апендицит: порівняльне дослідження

Author: E O Glazov, Kateryna Dmytriieva, B V Zaletskyi, and Dmytro Dmytriiev
Subjects: блокада Quadratus Lumborum Block (QLB) під контролем ультразвуку, us-guided quadratus lumborum block (qlb), гострий апендицит, острый аппендицит, acute appendicitis, Hemodynamics, Sevoflurane, Fentanyl, 03 medical and health sciences, caudal block, 0302 clinical medicine, каудальная блокада, Laryngeal mask airway, 030202 anesthesiology, Anesthesiology, Heart rate, Medicine, RD78.3-87.3, блокада Quadratus Lumborum Block (QLB) под контролем ультразвука, Bupivacaine, business.industry, каудальна блокада, Anesthesia, Airway, business, 030217 neurology & neurosurgery, Abdominal surgery, medicine.drug
Abstract: Background: ultrasound (US)-guided Quadratus Lumborum Block (QLB) is an effective technique in providing analgesia for abdominal surgery. This study was designed to evaluate the efficacy of a US-guided Quadratus Lumborum Block (QLB) compare it with a caudal block in children after acute appendicitis. Patients and methods. Forty eight (48) ASA 1–2, 1–5-year-old children scheduled for elective acute appendicites were studied. All patients received general anesthesia; sevoflurane was used for induction and maintenance of anesthesia and laryngeal mask airway (LMA) was used to secure the airway. After securing an intravenous cannula, patients were randomized to a US-guided Quadratus Lumborum Block (QLB) (n = 24) (group Q) using 0.5 ml/kg of 0.25 % bupivacaine, injected on the same side of surgery, and group C received a caudal block using 1 ml/kg of 0.2 % bupivacaine (n = 24). Surgery was allowed 15 min after administration of the block. Block failure was considered in case of gross movement or more than 20 % change in heart rate and/or ABP persisting more than 1 min after skin incision. Any adverse events were recorded. After surgery, patients remained for 4 h in the recovery room. Postoperative analgesia was evaluated using Children and Infants Postoperative Pain Scale (CHIPPS). An anesthesiologist, who was not part of the study team, evaluated the need for rescue analgesia in the intraoperative and postoperative period and a recovery nurse collected the data. If the CHIPPS score was greater than 4, a rescue analgesia of 20 mg/kg acetaminophen was administered. Results. No difference was found in hemodynamics in both groups. Also, intraoperative fentanyl consumption was not different and no rescue analgesia was required in the postanesthesia care unit. Conclusion. US-guided Quadratus Lumborum Block (QLB) is as effective as caudal block in providing immediate postoperative analgesia in acute appendicitis., Предпосылки. Ультразвук (УЗ)-контролированная блокада Quadratus Lumborum Block (QLB) – эффективная методика обеспечения обезболивания при операциях на брюшной полости. Это исследование было проведено для оценки эффективности блокады Quadratus Lumborum Block (QLB) под контролем ультразвука и сравнения его с каудальной блокадой при остром аппендиците у детей. Пациенты и методы. Было изучено сорок восемь (48) детей ASA 1–2, 1–5-летнего возраста, с диагнозом острого аппендицита и потребностью в оперативном вмешательстве. Все пациенты получали общий наркоз; севофлуран использовали для индукции и поддержания анестезии, а ларингеальную маску использовали для защиты дыхательных путей. После установки внутривенной канюли пациенты были рандомизированы в две группы: блокады Quadratus Lumborum Block (QLB) под контролем УЗ (n = 24) (группа Q) с использованием 0,5 мл/кг 0,25 % бупивакаина, введенного в одноименную сторону оперативного вмешательства, и группу С, получивших каудальную блокаду с использованием 1 мл/кг 0,2 % бупивакаина (n = 24). Операция была разрешена через 15 мин после введения анестетика. Недостаточность действия блокады рассматривали в случае возникновения значительного движения или изменения частоты сердечных сокращений более чем на 20 % и/или АД, сохранявшихся более 1 мин после разреза кожи. Любые неблагоприятные воздействия регистрировались. После хирургического вмешательства пациенты оставались на 4 часа в комнате для восстановления. Послеоперационную анальгезию оценивали с помощью шкалы послеоперационной боли у детей и младенцев (CHIPPS). Анестезиолог, который не был частью исследовательской группы, оценил необходимость проведения дополнительного обезболивания в интраоперационном и послеоперационном периоде, медсестра в комнате восстановления собирала данные. Если оценка CHIPPS была больше 4, вводили дополнительное обезболивание 20 мг/кг ацетаминофена. Результаты. Разницы в гемодинамике в обеих группах не выявлено. Кроме того, интраоперационные расходы фентанила не отличались в обеих группах, в отделении послеанестезиологической помощи дети не нуждались в дополнительном обезболивании. Вывод. Quadratus Lumborum Block (QLB) под контролем ультразвука столь же эффективна, как каудальная блокада, для немедленного послеоперационного обезболивания при остром аппендиците., Передумови. Ультразвуково(УЗ)-контрольована блокада Quadratus Lumborum Block (QLB) – ефективна методика забезпечення знеболення при операціях на черевній порожнині. Це дослідження було проведене для оцінки ефективності блокади Quadratus Lumborum Block (QLB) під контролем ультразвуку та порівняння його з каудальною блокадою при гострому апендициті у дітей. Пацієнти та методи. Було вивчено сорок вісім (48) дітей ASA 1–2, 1–5-річного віку, з діагнозом гострого апендициту та потребою в оперативному втручанні. Усі пацієнти отримували загальний наркоз; севофлуран використовували для індукції та підтримки анестезії, а ларингіальну маску використовували для захисту дихальних шляхів. Після встановлення внутрішньовенної канюлі пацієнти були рандомізовані у дві групи: блокади Quadratus Lumborum Block (QLB) під контролем УЗ (n = 24) (група Q) з використанням 0,5 мл/кг 0,25 % бупівакаїну, введеного в однойменну сторону оперативного втручання, та група С, що отримала каудальну блокаду з використанням 1 мл/кг 0,2 % бупівакаїну (n = 24). Операція була дозволена через 15 хв після введення анестетику. Недостатність дії блокади розглядали у разі виникнення значного руху або зміни частоти серцевих скорочень більше ніж на 20 % та/або АТ, що зберігається більше 1 хв після розрізу шкіри. Будь-які несприятливі дії реєструвались. Після хірургічного втручання пацієнти залишались на 4 години в кімнаті для відновлення. Післяопераційну аналгезію оцінювали за допомогою шкали післяопераційного болю у дітей та немовлят (CHIPPS). Анестезіолог, який не був частиною дослідницької групи, оцінив необхідність проведення додаткового знеболення в інтраопераційному та післяопераційному періоді, медсестра у кімнаті відновлення збирала дані. Якщо оцінка CHIPPS була більшою за 4, вводили додаткове знеболення 20 мг/кг ацетамінофену. Результати. Різниці в гемодинаміці в обох групах не виявлено. Крім того, інтраопераційні витрати фентанілу не відрізнялись в обох групах, у відділенні післяанестезіологічної допомоги діти не потребували додаткового знеболювання. Висновок. Quadratus Lumborum Block (QLB) під контролем ультразвуку настільки ж ефективна, як каудальна блокада, для негайного післяопераційного знеболення при гострому апендициті.
Published: 2021

46. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author: Hassan M Ahmed, Benjamin P Atterton, Gillian G Crowe, Jaime L Barratta, Mark Johnson, Eugene Viscusi, Sanjib Adhikary, Eric Albrecht, Karen Boretsky, Jan Boublik, Dara S Breslin, Kelly Byrne, Alan Ch'ng, Alwin Chuan, Patrick Conroy, Craig Daniel, Andrzej Daszkiewicz, Alain Delbos, Dan Sebastian Dirzu, Dmytro Dmytriiev, Paul Fennessy, H Barrie J Fischer, Henry Frizelle, Jeff Gadsden, Philippe Gautier, Rajnish K Gupta, Yavuz Gürkan, Harold David Hardman, William Harrop-Griffiths, Peter Hebbard, Nadia Hernandez, Jakub Hlasny, Gabriella Iohom, Vivian H Y Ip, Christina L Jeng, Rebecca L Johnson, Hari Kalagara, Brian Kinirons, Andrew Kenneth Lansdown, Jody C Leng, Yean Chin Lim, Clara Lobo, Danielle B Ludwin, Alan James Robert Macfarlane, Anthony T Machi, Padraig Mahon, Stephen Mannion, David H McLeod, Peter Merjavy, Aleksejs Miscuks, Christopher H Mitchell, Eleni Moka, Peter Moran, Ann Ngui, Olga C Nin, Brian D O'Donnell, Amit Pawa, Anahi Perlas, Steven Porter, John-Paul Pozek, Humberto C Rebelo, Vicente Roqués, Kristopher M Schroeder, Gary Schwartz, Eric S Schwenk, Luc Sermeus, George Shorten, Karthikeyan Srinivasan, Markus F Stevens, Kassiani Theodoraki, Lloyd R Turbitt, Luis Fernando Valdés-Vilches, Thomas Volk, Katrina Webster, T Wiesmann, Sylvia H Wilson, Morné Wolmarans, Glenn Woodworth, Andrew K Worek, E M Louise Moran, Gürkan, Yavuz (ORCID 0000-0002-2307-6943 & YÖK ID 154129), Ahmed, Hassan M., Atterton, Benjamin P., Crowe, Gillian G., Barratta, Jaime L., Johnson, Mark, Viscusi, Eugene, Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S., Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H. Barrie J., Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K., Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H. Y., Jeng, Christina L. ., Johnson, Rebecca L., Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C., Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B., Macfarlane, Alan James Robert, Machi, Anthony T., Mahon, Padraig, Mannion, Stephen, McLeod, David H., Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H., Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C., O'Donnell, Brian D., Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C., Roques, Vicente, Schroeder, Kristopher M., Schwartz, Gary, Schwenk, Eric S., Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F., Theodoraki, Kassiani, Turbitt, Lloyd R., Valdes-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T., Wilson, Sylvia H., Wolmarans, Morne, Woodworth, Glenn, Worek, Andrew K., Moran, E. M. Louise, Koç University Hospital, School of Medicine, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Anesthesiology, APH - Quality of Care, and Amsterdam Neuroscience - Neuroinfection & -inflammation
Subjects: Consensus, neuraxial, Delphi Technique, education, General Medicine, Documentation, international consensus, anesthesia, documentation, nerve block, Anesthesiology and Pain Medicine, Anesthesiology, Anesthesia, Conduction, Nerve block, Regional anesthesia, Anesthesia, Neuraxial, Minimum standards, Delphi process, Humans, regional anesthesia, minimum standards
Abstract: Background and objectives: documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as >= 75% agreement and weak consensus as 50%-74% agreement. Results: seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: by means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia., European Society of Regional Anaesthesia and Pain Therapy (ESRA); ASRA Pain Medicine
Published: 2022

47. PROGNOSTIC PARAMETERS OF THE SUSCEPTIBILITY OF STAPHYLOCOCCUS SPP. TO AMINOGLYCOSIDES AND DOXYCYCLINE

Author: Neonila I. Osadchuk, Oleksandr Nazarchuk, Vasyl I. Nahaichuk, Dmytro Dmytriiev, Kostiantyn Dmytriiev, and Oksana S. Turzhanska
Subjects: Doxycycline, medicine.medical_specialty, business.industry, General Medicine, medicine.disease_cause, Antibiotic resistance, Amikacin, Internal medicine, Tobramycin, medicine, Severe burn, In patient, Gentamicin, business, Staphylococcus, medicine.drug
Abstract: OBJECTIVE The aim: To perform microbiological investigation and analytic mathematic prediction of clinical isolates of S. aureus to aminoglycosides in patients with severe burns. PATIENTS AND METHODS Materials and methods: We analyzed resistance of 199 S. aureus strains to aminoglycosides (gentamicin, tobramycin and amikacin) and doxycycline from 435 patients treated in the regional hospital due to burns for the period from 2011-2017. RESULTS Results: We created predictive curves for the prediction of susceptibility of S. aureus strains to aminoglycosides and doxycycline based on the changes in S. aureus resistance during the years of observation and expressed in mathematic equations. Susceptibility of S. aureus to gentamicin was 42.86 % at the end of observation and will decline in future. Despite tobramycin was efficient against 72.86 % of strains in 2017, mathematic modeling indicates rapid decline in its efficacy in future. Efficacy of amikacin was dropping during the last years, but according to the equation it efficacy will increase over 60 % in 2018. S. aureus susceptibility to doxycycline was 65.38 % in 2017 and mathematic modeling indicates its gradual decline in the nearest future. CONCLUSION Conclusions: Predicitive values of S. aureus susceptibility indicates not sufficient efficacy of these drugs in patients with infectious complications of burns. Tendency of the slight decline of S. aureus susceptibility to doxycycline still indicates sufficient levels of its efficacy in the nearest future. This justify its use as a second-line therapy with the causative agent in patients with burns.
Published: 2020
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48. Influence of different qualitative composition of infusion solutions on cerebral hemodynamics in patients with acute ischemic stroke

Author: Yuliia V Lomakina, Halyna I Khrebtii, Dmytro Dmytriiev, Mohammad Wathek O Alsalama, Lesia M Zheliba, Svetlana L Malyk, A. I. Semenenko, and Roksolana Ya Bodnar
Subjects: business.industry, Cerebral arteries, General Medicine, Blood flow, Cerebral circulation, Cerebral blood flow, Infusion therapy, Cerebral hemodynamics, Anesthesia, medicine, Mannitol, business, Perfusion, medicine.drug
Abstract: Objective The aim: Investigate the effect of 0.9% NaCl, HES 130, HAES-LX-5% and mannitol 15% on cerebral hemodynamics in patients with AIS. Patients and methods Materials and methods: The study included 100 patients with AIS. As the investigated solutions were used: isosmolar 0.9% NaCl, hyperosmolar mannitol 15%, colloid-isoosmolar HES 130, colloid-hyperosmolar HAES-LX-5%. The control group received only 0.9% NaCl compared: 0.9% NaCl+HES 130, 0.9% NaCl+HAES-LX-5%, 0.9% NaCl+mannitol 15%. Evaluation of cerebral hemodynamic (indexes of cerebral blood flow) was performed using doppler ultrasound of cerebral arteries. Results Results: The dynamics of specific volume velocity of blood flow per 100 grams of brain substance indicates that in the group of 0.9% NaCl and 0.9% NaCl+mannitol is the tendency to decrease the blood flow of the brain during 7 days of treatment, respectively: 2.8% and 7.5%. In patients with HES 130 solution cerebral blood flow increases by 14.2%, whereas when applied HAES-LX-5% during 7 days, it increases by 43.2% (p=0.004). Conclusion Conclusions: The analysis of the data of treatment the patients with AIS showed the best effect (p=0.004) of improvement of the cerebral circulation in the use of the polyfunctional infusion solution HAES-LX-5% unlike the 0.9% NaCl group and group of 0.9% NaCl+mannitol where was a decrease of the dynamics of cerebral blood flow, which could lead to hypoperfusion of the brain.
Published: 2020
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49. Choosing of drug for anesthesia in intensive therapy of traumatic disease for geriatric patients

Author: Kostaintyn D Dmytriiev, Yuliya V. Volkova, Kateryna Yu Sharlai, Dmytro Dmytriiev, and Olena V Boiko
Subjects: Drug, business.industry, media_common.quotation_subject, General Medicine, Disease, Perioperative, medicine.disease, Polytrauma, Intensive care, Concomitant, Anesthesia, medicine, Respiratory system, Adverse effect, business, media_common
Abstract: Objective The aim of the study was to find the most rational approach to postoperative pain relief in the complex of intensive care for the acute and early periods of traumatic diseasein elderly patients. Patients and methods Materials and methods: 132 gerontology patients with multiple trauma were included in the study. Respiratory and cardiovascular systems parameters were assessed, coagulogram and inflammatory response markers, pain severity and analgesia quality were assed. Results Results: According to the data obtained from the evaluation of VAS and Likerts scale, as well as other results, it was found that the use of NSAIDS and mu-opioid antagonists in the acute and early period of traumatic disease reduces significantly the severity of pain at a minimum daily dose (0.15 mg / kg), decreased the period of anaesthesia on demand, minimized negative respiratory and cardiovascular effects. Presence of sedative effect contributes to the improvement of emotional state of these patients. Conclusion Conclusions: Age-related changes and concomitant pathology in geriatric patients define the need for the safe pain relief in this patients, in order to decrease possible adverse events. Optimal combination in geriatric patients with perioperative pain syndrome due to polytrauma is NSAIDs with antagonists-agonists. This combination reduce the prevalence and severity of negative respiratory and cardiovascular.
Published: 2020
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50. Clinical case of postoperative anesthesia of a patient by using subanesthetic dose of ketamine in severe abdominal pathology

Author: B V Zaletskyi, Dmytro Dmytriiev, and V A Korobko
Subjects: кетамін, Dose, Gabapentin, ketamine, послеоперационное обезболивание, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, postoperative anesthesia, 030202 anesthesiology, medicine, Ketamine, abdominal surgical interventions in children, абдоминальные оперативные вмешательства у детей, business.industry, Acetaminophen, Allodynia, абдомінальні оперативні втручання у дітей, lcsh:Anesthesiology, Anesthesia, Anesthetic, Hyperalgesia, післяопераційне знеболення, medicine.symptom, business, кетамин, 030217 neurology & neurosurgery, medicine.drug, Abdominal surgery
Abstract: Pain is an inevitable consequence of surgical interventions in children, resulting in great stress and discomfort not only for patients but also for their parents. The intensity of the pain depends not only on the level of injury after the operation, but also on the localization and the nature of the procedure. Management of pain in children is best done through a multimodal approach: opioids, auxiliary drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, anti-neuroleptics such as gabapentin, and regional anesthetic methods. Postoperative anesthesia in abdominal surgery at present is a topical problem in anesthetic practice. In this clinical case, we would like to demonstrate the experience of applying post-operative anesthesia using subnormal dosages of ketamine. The patient was given anesthesia with prolonged infusion of a ketamine solution in a submorbid dose of 0.2 mg/kg/h IV. An assessment of the quality of anesthesia by assessing the level of stress markers, such as blood glucose, cortisol levels, and the assessment of the pain level on the NIPS scale was performed. Conclusion: The use of a ketamine solution in a dose of 0.2 mg/kg/h has a positive effect on treating postoperative pain in patients after severe abdominal surgical interventions. Applying a ketamine solution in a dose of 0.2 mg/kg/h reduces tolerance of the patient to opioid analgesics and the development of hyperalgesia and allodynia., Боль является неизбежным следствием хирургических вмешательств у детей, приводит к большому стрессу и дискомфорту не только для пациентов, но и для их родителей. Интенсивность боли зависит не только от уровня травмы после операции, но и от локализации и характера процедуры. Менеджмент боли у детей лучше осуществляется с помощью мультимодального подхода: опиоиды, вспомогательные средства, такие как нестероидные противовоспалительные препараты (НПВП) и ацетаминофен, антинейролептики – такие как габапентин, и методы региональной анестезии. Послеоперационное обезболивание в абдоминальной хирургии в настоящее время является актуальной проблемой в анестезиологической практике. В данном клиническом примере мы хотели бы продемонстрировать опыт применения послеоперационного обезболивания путем использования субнаркотических дозировок кетамина. Пациенту проводилось обезболивание длительной инфузией раствора кетамина в субнаркотической дозировке 0,2 мг/кг/ч в/в. Проводилась оценка качества обезболивания пациента путем определения уровня маркеров стресса, таких как уровень глюкозы крови, кортизола крови, и оценка уровня боли по шкале NIPS. Вывод: Использование раствора кетамина в дозе 0,2 мг/кг/ч имеет положительный эффект лечения послеоперационной боли у пациентов после тяжелых абдоминальных оперативных вмешательств. Применение раствора кетамина в дозе 0,2 мг/кг/ч уменьшает толерантность пациента к опиоидным анальгетикам и препятствует развитию гипералгезии и аллодинии., Біль є неминучим наслідком хірургічних втручань у дітей, що призводить до великого стресу і дискомфорту не тільки для пацієнтів, а й для їхніх батьків. Інтенсивність болю залежить не лише від рівня травми після операції, але й від локалізації та характеру процедури. Менеджмент болю у дітей найкраще здійснюється за допомогою мультимодального підходу: опіоїди, допоміжні засоби, такі як нестероїдні протизапальні препарати (НПЗП) та ацетамінофен, антинейролептики – такі як габапентин, і методи регіональної анестезії. Післяопераційне знеболення в абдомінальній хірургії на даний є час актуальною проблемою в анестезіологічній практиці. У даному клінічному прикладі ми хотіли б продемонструвати досвід застосування післяопераційного знеболення шляхом використання субнаркотичних дозувань кетаміну. Пацієнту проводилось знеболення тривалою інфузією розчину кетаміну у субнаркотичному дозуванні 0,2 мг/кг/год в/в. Проводилась оцінка якості знеболення пацієнта шляхом визначення рівня маркерів стресу, таких як рівень глюкози крові, кортизолу крові, та оцінка рівня болю за шкалою NIPS. Висновок: Використання розчину кетаміну в дозі 0,2 мг/кг/год має позитивний ефект лікування післяопераційного болю у пацієнтів після важких абдомінальних оперативних втручань. Застосування розчину кетаміну в дозі 0,2 мг/кг/год зменшує толерантність пацієнта до опіоїдних анальгетиків і розвитку гіпералгезії та алодинії.
Published: 2019

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