The purpose of the study was to asses changes in cerebral macrocirculation and metabolism parameters in patients with concomitant cerebral injury during infusions of ethylmethylhydroxypyridine succinate at a dose of 12.5 to 100 mg/h depending on a source pattern of the cerebral blood flow.

Materials and methods. The study included 25 patients with severe concomitant cerebral injury who administered ethylmethylhydroxypyridine succinate (EMHPS) intravenously in addition to the standard therapy at a dose of 12.5 mg/h for 1 hour, then the dose was increased up to 25 mg/h within 1 hour, then up to 50 mg/h within 1 hour followed by an infusion at a dose of 100 mg/h for 1 hour. Cerebral macrocirculation parameters were analyzed every hour before each dose increase. Transcranial dopplerography (TDG) was used to assess the following linear blood flow velocity (LBFV) parameters: systolic (Vmax), diastolic (Vmin), medium (Vm) LBFV, pulsation index (PI) and resistance index (RI), as well as glucose and lactate levels, lactate dehydrogenase (LDH) activity and the pH level in venous blood from a jugular vein.

Results. Positive changes of LBFV parameters in the form of cerebral perfusion increase were recorded in patients with hindered perfusion and hypoperfusion patterns after EMHPS infusions at a dose of 12.5 to 100 mg/h. Patients with a mild vasospasm pattern presented favorable changes in LBFV parameters including a decrease in velocity parameters, normalization of the pulsation index and the resistance index which confirmed normalization of the vascular tone and vasospasm elimination. Positive changes in LBFV parameters in patients with a hyperperfusion pattern were noticed in the form of the reduction of hyperemia manifestations and normalization of the vascular tone. Patients with a severe vasospasm pattern presented normalization of the vascular tone. Normalization of LBFV parameters was accompanied by normalization of the lactate level, lactate dehydrogenase activity and the pH level in venous blood. Optimal values were found in infusions at a dose of 50—100 mg/h.

Conclusion. Infusions of EMHPS at a dose of 12.5—100 mg/h to patients with concomitant cerebral trauma resulted in normalization of LBFV and metabolism parameters in patients with all kinds of CBF patterns. 

The purpose of the study: a comprehensive assessment of the effectiveness of the treatment of newborns with transient myocardial ischemia in the intensive care unit.

Materials and methods. 102 newborns with transient myocardial ischemia, with a history of ante- and/or intranatal hypoxia, at the age of 1 to 7 days, with a gestational age from 29 to 42 weeks, underwent a clinical and instrumental examination of the heart before and during the treatment. The Group 1 consisted of 30 infants with 1 degree circulatory failure (CF); the Group 2 was comprised of 39 infants with 2A degree of CF, and the Group 3 included 33 infants with the 2B degree of CF. All children received cardiotropic drugs; infants from Groups 2 and 3 received cardiotonic drugs.

Results. The study demonstrated an increase in biochemical parameters of blood (myocardial CPK, lactate dehydrogenase, aspartate aminotransferase, de Ritis ratio), manifestations of subendocardial ischemia in the electrocardiogram (depression of ST segment in one or more leads in combination with a T-wave defect), changes in systolic cardiac function during echocardiography (stroke volume, ejection and shortening factions, left ventricular TEI index, cardiac output, and cardiac index) that correlated with the severity of myocardial ischemia and circulatory failure and their reverse development during the treatment. Various correlative links between parameters of left ventricular systolic function and blood biochemistry before and during the treatment reflecting the myocardial dysfunction with a gradual reverse development have been found.

Conclusion. Infants with transient myocardial ischemia suffered from disorders of the clinical and functional state of the heart depending on the degree of ischemia and circulatory failure. Most infants exebited gradual reverse development during a complex intensive therapy. 

A public-access defibrillation is one of key techniques for improvement of the pre-hospital and in-hospital resuscitation success and survival rates of resuscitated patients in the case of a sudden cardiac arrest caused by ventricular fibrillation and ventricular tachycardia. The short review discusses the relation between the type of a sudden cardiac arrest and the survival rate, the 'chain of survival' concept and the role of early defibrillation, as well as the function of public-access defibrillation programs and the contribution of automated external defibrillators in prehospital and in-hospital resuscitation. In conclusion, the perspectives of introduction of the public-access defibrillation in Russia are discussed. 

Modifiers of membranes cause local defects on the cell surface. Measurement of the rigidity at the sites of local defects can provide further information about the structure of defects and mechanical properties of altered membranes.

The purpose of the study: a step-by-step study of the process of a nonlinear deformation of red blood cells membranes under the effect of modifiers of different physico-chemical nature.

Materials and methods. The membrane deformation of a viscoelastic composite erythrocyte construction inside a cell was studied by the atomic force spectroscopy. Nonlinear deformations formed under the effect of hemin, Zn2+ ions, and verapamil were studied.

Results. The process of elastic deformation of the membrane with the indentation of a probe at the sites of local defects caused by modifiers was demonstrated. The probe was inserted during the same step of the piezo scanner z displacement; the probe indentation occured at the different discrete values of h, which are the functions of the membrane structure. At the sites of domains, under the effect of the hemin, tension areas and plasticity areas appeared. A mathematical model of probe indentation at the site of membrane defects is presented.

Conclusion. The molecular mechanisms of various types of nonlinear deformations occurring under the effect of toxins are discussed. The results of the study may be of interest both for fundamental researchers of the blood cell properties and for practical reanimatology and rehabilitology. 

The purpose of the study was to assess the morphology of red blood cells (RBC) and the association of morphological parameters with lipid peroxidation processes and the content of organic phosphates in RBC when treating packed red blood cells with the ozonized saline solution (with an ozone concentration of 2 mg/l) after different storage periods.

Materials and methods. The morphology of human RBC, the concentration of malonic dialdehyde (MDA) in RBC, the catalase activity, the concentration of ATP and 2,3-diphosphoglycerate (2,3-DPG) were studied before and after treatment of RBC with the ozonized saline (with the ozone concentration of 2 mg/l) after 7, 14, 21 and 30 days of storage.

Results. The effect of ozone (2 ng/l) in vitro on the packed red blood cells after 7–21 days of storage contributed to the recovery of RBC shape, increased the concentration of ATP and 2,3-DPG, and optimized the lipid peroxidation. Ozone did not demonstrate a pronounced positive effect on these parameters when the packed RBCs were stored for 30 days.

Conclusion. The treatment of the packed RBCs with the ozonized saline solution (with the ozone concentration of 2 mg/l) contributed to the recovery of the discocyte count due to optimization of lipid peroxidation processes in cell membranes and enhanced the synthesis of organic phosphates in cells due to the activation of glycolysis and the pentose phosphate pathway. This can be used to improve the morphological and metabolic status of the packed RBCs before their transfusion. 

National Resuscitation Council: Work Results for 2004–2017 (in Rus).

Professor Vladimir T. Dolgikh is 70 (in Rus).

Purpose: improvement of the results of operative treatment in patients with emergency abdominal pathology by selecting the tactics of perioperative infusion therapy that would be optimum for postoperative bowel function recovery.

Materials and methods. 52 surgical patients (28 men, 24 women, mean age 57.5±14 years) subjected to various emergency abdominal surgeries were studied. The patients were split into 2 groups. It was a prospective study; group affiliation was determined by randomization. In group 1 (n=29), balanced ionic solutions were used for perioperative infusion therapy. In group 2 (n=23), balanced ionic solutions were combined with synthetic colloids. The infusion therapy volume during operation was 2359 ml on average. To determine the bowel function during the postoperative period, comprehensive dynamic assessment of the gastrointestinal tract (GIT) status was undertaken, which included physical examination, intra-abdominal pressure (IAP) measurement, and ultrasound visualization of the intestinal wall condition; the dynamics of intestinal absorptive function and common laboratory tests were monitored. The level of intestinal failure during the postoperative period was determined based on assessment of the GIT condition and recommendations of the National Guidelines for Parenteral and Enteral Nutrition.

Results. A strong significant correlation (r=1.000, P=0.01) between the volume of perioperative infusion therapy and the stage of postoperative intestinal failure was established.

Conclusion. During performance of emergency surgeries, the volume of intra-operative infusion therapy rendered a direct influence on the postoperative bowel function. Optimization and application of a targeted corrective infusion therapy during the perioperative period promote earlier resolution of postoperative intestinal failure. 

The purpose of this study was to evaluate the effectiveness of a succinic acid derivate, a substrate metabolic agent cytoflavin in patients with acute poisoning with synthetic psychoactive drugs.

Materials and methods. A retrospective evaluation of effectiveness of a combined intensive care treatment protocol for 622 patients with acute narcotic poisoning (methadone and synthetic cannabinoids) was carried out. All patients were divided into two groups. The main group (112 patients, median age 38.2±12.0 years) included patients who, in addition to the basic treatment, received cytoflavin by intravenous drop infusion, 20–40 ml diluted in 400–500 ml of 10% glucose, for 5 days. Patients of the reference group (510 subjects, median age 37.6±14.1 years) received treatment according to the «classical scheme». In addition to conventional examination, all patients underwent duplex scanning of cerebral vessels, examination of changes in the cerebral blood circulation and electroencephalogram findings. The severity of somatic disorders was assessed using criteria of the Glasgow coma scale. The severity of the asthenic syndrome was assessed according to the MFI-20 scale.

Results. Compared to patients who received a standard therapy, patients of the main group had a significantly more rapid recovery from coma (by 1.5-fold: 23.5±3.1 days, versus 15.1±3.0 days, respectively, P0.05); the duration of psychotic disorders was shorter (by 1.8-fold: 15.5±4.2 hours vs 8.3±2.5 hours., respectively, P0.05), and the intensity of asthenic syndrome (by 2.8-fold: 64.1±3.3 rel. units vs 23.0±4,9 rel. units, respectively, P0.05) was also lower.

Conclusion. Inclusion of cytoflavin in a protocol of a complex treatment of patients with synthetic drugs poisoning increased the effectiveness of the therapy. Data demonstrate that inclusion of the drug can be recommended for treatment of acute synthetic narcotic poisoning.