The review presents the history of establishing the Institute, studies and achievements of employees of the V. A. Negovsky Research Institute of General Reanimatology' former regional campus in the city Novokuznetsk.

Purpose: to identify gender peculiarities of postresuscitation shifts in BDNF expression and neuronal death.

Materials and Methods. At different points of the postresuscitation period (days 1-, 4-, 7-, and 14), the condition of highly sensitive to hypoxia neuronal populations (pyramidal neurons of hippocampus and Purkinje cells of cerebellum) were studied in white mature female rats exposed to a 10-minute stop of systemic blood circulation (compression of vascular fascicle of the heart). Sham operated animals were used as the control. Immunohistochemical detection of BDNF-immunoreactive neurons followed with determination of optical density, number of cells with different levels of BDNF expression, and total count of neurons per 1 mm of the length of their layer was carried out. The work was done using the image analysis system (computer Intel, microscope Olympus BX-41, software ImadgeScopeM, ImageJ 1,48v, Excel 2007). Statistic processing of data was performed with the aid of Statistica 7.0 using Kolmogorov-Smirnov λ test, Mann-Whitney U test, and Student's t-test.

Results. The dynamics of postresuscitation shifts in BDNF-immunoreactivity of neuronal populations highly sensitive to hypoxia was studied in rats. Purkinje cells population in tissue slides from brain specimens harvested from female rats the alterations in BDNF expression became evident. This pattern was accompanied by the death of neurons. Those shifts in female animals were found to develop later than in male rats — by day 7 of the postresuscitation. Only BDNF-negative and BDNF-weakly positive neurons not survived postresuscitation. In the population of pyramidal cells of hippocampus in females, in contrast to males, there were no quantitative changes in BDNF molecules as revealed by immunohistochemistry and neuronal death process did not develop.

Conclusion. Gender peculiarities in the development of postresuscitation shifts in BDNF expression and associated therewith death of neurons were revealed. It was shown that after cardiac arrest of the same duration, the postresuscitation shifts in BDNF expression and neuronal death manifested mostly in males compared to females. At the same time, animals of both genders demonstrate common postresuscitation brain alterations evidencing connection between the level of BDNF expression in neurons and their resistance to ischemia-reperfusion. Gender-specific patterns of brain damage and their importance for understanding the mechanisms of post-hypoxic encephalopathies are discussed. 

Investigation of mechanical properties of erythrocyte membranes is a pressing issue in practical reanimatology and rehabilitation, because erythrocyte's ability to deform determines the possibility of their passage through capillary network and blood rheology in general.

The purpose of the work: to study the process of nonlinear deformation of membranes of normal erythrocytes by the method of atomic force spectroscopy.

Materials and Methods. The local stiffness of erythrocyte membranes was studied: that of diskocytes — on the torus and on the depression, that of planocytes — on the cell surface. Аtomic force spectroscopy was used for cell membrane study.

Results. The nonlinear deformation process was described by functions h(z), h/z (h), and μ(h). This set of functions describes in full the process of probe incorporation (submergence) into membranes. It has been shown that stepwise dependencies of the stiffness coefficient of membrane segments differ significantly and depend on its condition.

Conclusion. The suggested approach may be used in fundamental and clinical studies of blood cells' properties in the norm and different diseases. The method of recording nonlinear deformations may be especially efficient in the reanimatology and rehabilitation practice. 

Nosocomial pneumonia is the second most common nosocomial infection in critical care units and most common in ALV patients (9—27%). The purpose of this literature review is to discuss the latest domestic and foreign body of evidence concerning the use of inhaled antibiotics в critical care. Search for domestic publications (literature reviews, observation studies, double blind randomized studies) was carried out in elibrary.ru database, for foreign — in PubMed. Database for the period of yrs. 2005—2017. The following search enquiries were used: «inhaled antibiotics», «nosocomial pneumonia», «inhaled tobramycin», «inhaled colistin». The analysis includes 67 publications of yrs. 2007—2017 and 1 publication of yr. 2000. The literature review includes drug descriptions, contemporary capabilities of inhaled antibiotic therapy for nosocomial pneumonia, the advantages and drawbacks of this method of treatment. Special attention is focused on the use of inhaled aminoglycosides and inhaled colistin during nosocomial pneumonia in critical care units.

Endogenous intoxication as a typical pathological process has always been one of the key issues in all areas of medicine, especially in intensive care. Accumulation of endogenous toxic substances is an integral component of any critical condition. It accompanies severe trauma, generalized infections and destructive diseases of the cavity organs. The loss of the function of detoxification systems in multi-organ failure causes the progression of endotoxicosis and the disruption of oxygen transport (in the organs of detoxification as well), hence closing the vicious cycle of thanatogenesis.

Endogenous intoxication is a multidisciplinary problem being a matter of interest in different areas of modern medical science, experimental pathophysiology and biomedical technology. As a result new effective methods of efferent treatments of critical conditions are introduced into clinical practice. For many years theoretical and applied issues aimed at solving the problem of endotoxicosis have been the focus of studies in the V. A. Negovsky Research Institute of General Reanimatology of the Russian Academy of Medical Sciences (now the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology). In the presented review we have tried to generalize the main results of the Institute's activities in this direction. 

Dedicated to reviewing the methods for detecting bacterial endotoxin in aqueous solutions and biological fluids, this review is focused on determining the content of endotoxin as a clinically relevant biomarker of sepsis caused by Gram-negative bacteria. The advantages and disadvantages of each method are described, and the characteristics of test systems currently used in clinical practice are listed and compared.

International studies demonstrate an annual increase in the frequency and impact of sepsis in intensive care units (ICU). Cerebral dysfunction, or so-called sepsis-associated encephalopathy (SAE), is one of the earliest signs of sepsis, as well as its common complication. Up to 70% of patients with sepsis have symptoms of encephalopathy [1, 2]. A direct link between the SAE and an increased mortality rate is a major concern; more than a half of sepsis survivors experience continuous memory and concentration impairment [3—5]. Diagnosis of the cerebral dysfunction in sepsis is often difficult because of lack of specific biomarkers and frequent prescription of sedatives to critically ill patients. Clinical manifestations of SAE are diverse, may vary from simple malaise and lack of concentration to deep coma. The literature discusses probable mechanisms of formation and development of septic encephalopathy, such as oxidative stress, inflammation, mitochondrial and endothelial dysfunction, increased permeability of the blood-brain barrier, impairment of macro- and microcirculation, changes in neirotransmission, activation of microglia. The lack of clear data and consensus about the etiology and mechanisms of SAE at present does not permit predicting its development and prescribing a specific therapy. The review discusses current understanding of the causes of septic encephalopathy, methods of diagnosis, the main clinical manifestations, key mediators, and pathophysiological mechanisms. A hypothesis is proposed that poses a contribution of aromatic microbial metabolites (AMM) of phenol and indole nature (products of bacterial biodegradation of tyrosine and tryptophan) to the development of brain dysfunction. The fields of exploratory studies, which might open perspectives in the diagnosis, as well as new approaches in the treatment of SAE are outlined.