The aim of this study was to assess the incidence of cardiovascular complications (CVC) within 12 months after vascular surgery and to analyze inpatient perioperative examination data to identify potential predictors.

   Materials and Methods. A prospective cohort study included 103 patients aged 66 years [61–70] who underwent vascular surgery. Clinical outcomes within 12 months after surgery, including CVC and/or other cardiac events (composite outcome) and cardiac death, were assessed by telephone interviews with patients or their relatives. Patient physiological parameters, comorbidities, cardiac risk indices (CRI), platelet-lymphocyte ratio (PLR), concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and other parameters were obtained and analyzed from medical records. Logistic regression and ROC analysis were used to assess the predictive power of the investigated indicators.

   Results. The composite outcome was recorded in 33 % of cases and cardiac death occurred in 6.8 %. The risk of the composite outcome was associated with ASA class (OR 2.7413; 95 % CI 1.1126–6.7541), whereas the risk of perioperative myocardial infarction or cardiac arrest was associated with CRI (OR 1. 6051; 95 % CI 0.6645–2.0215), American University of Beirut (AUB) CRI (OR 2.1106; 95 % CI 1.0260–4.3414), PLR (1.0120; 95 % CI 1.0018–1.0222), and NT-proBNP concentration during hospitalization. Concurrent congestive heart failure (OR 5.0658; 95 % CI 1.2400–20.6956), revised CRI (OR 2.1024; 95 % CI 1.0572–4.1813), Khoronenko CRI (OR 103.76; 95 % CI 1.8752–5796.55), AUB CRI (OR 3.1902; 95 % CI 1.1040–9.2181), and NT-proBNP concentration all increased the risk of cardiac death. Predischarge NT-proBNP levels < 179 pg/mL (OR 1.0071; 95 % CI 1.0038–1.0104; AUC 0.795) and maximum postoperative NT-proBNP levels were reliable predictors of the composite outcome. The most effective predictor of postoperative mortality was a maximum NT-proBNP concentration > 303 pg/mL after surgery (OR 1.0039; 95 % CI 1.0015–1.0063; AUC 0.836).

   Conclusion. CVC developed in 33 % of patients within 12 months after vascular surgery, with cardiac death occurring in 6.8 % of cases. An NT-proBNP concentration > 179 pg/mL before hospital discharge or a maximum NT-proBNP concentration > 248 pg/mL in the postoperative period predicted CVC within one year. Postoperative NT-proBNP concentration > 303 pg/mL was a strong predictor of one-year cardiac mortality. Other factors associated with the risk of postoperative CVC did not provide an accurate prognosis.

   The aim of this study was to investigate the changes in caspase-9 and p53 levels as biomarkers of pro- and anti-apoptotic pathways in the early postoperative period in patients who underwent lung surgery for malig-nant tumors under different types of multimodal or inhalation-intravenous anesthesia.

   Material and Methods. A single-center prospective study of 22 patients aged 45–64 years was conducted at the Omsk Clinical Oncology Early Treatment and Prevention Center from January to April 2020. The participants were divided into two groups. Group 1 patients received multimodal anesthesia, which included sympathetic nerve block and prolonged epidural analgesia in the postoperative period. Group 2 patients received inhalational and intravenous anesthesia followed by systemic morphine analgesia. Serum caspase-9 and  p53 protein levels were measured at four time points: before anesthesia, one, twelve, and twenty-four hours after surgery. Statistical hypotheses were tested using nonparametric (rank) analysis methods. Friedman's ANOVA was used to compare multiple time points, while the Wilcoxon test was used to compare variables between two time points in dependent samples. The Mann-Whitney test was used to assess differences between groups in independent samples. P-values < 0.05 were considered statistically significant. Results are expressed as median ± half interquartile range (Me ± (LQ – UQ) / 2).

   Results. At time point 2, caspase-9 levels were significantly higher in group 2 patients than in group 1 (P = 0.045). There were no significant differences between the groups at any other time points.

   Conclusion. The lack of a significant difference in serum levels of caspase-9 and p53 protein at most time points between the groups demonstrates the efficacy of the anesthesia and analgesia methods used. Mean-while, a significantly higher level of caspase-9 one hour after surgery demonstrates a greater susceptibility of patients without sympathetic blockade to activation of the apoptotic cell death program.

   Aim. To evaluate the predictive value of cerebral oximetry for functional recovery in patients undergoing reperfusion therapy for ischemic stroke.

   Materials and Methods. A post hoc analysis was performed using data from a single-center, open-label, randomized controlled trial. The study included 45 patients with ischemic stroke who received systemic thrombolysis. Primary outcomes included functional recovery as assessed by modified Rankin Scale and mortality. Serial cerebral oximetry was performed within the first 24 hours after thrombolysis. The interhemispheric difference (IHD) in cerebral oximetry was used to determine a cutoff point for predicting functional recovery using ROC curve analysis. Associations between IHD and outcomes were analyzed using univariate and multivariate logistic regression models.

   Results. The IHD in cerebral oxygenation between the unaffected and affected hemispheres was 4 % (3–5 %) before thrombolysis and dropped to 3 % (1–4 %) 24 hours after thrombolysis (P = 0.024). An IHD of less than 4 % was identified as an independent predictor of favorable functional outcome with an adjusted odds ratio of 12 (95 % CI: 1.6–93.7; P = 0.017). However, IHD less than 4 % was not predictive of mortality (P = 0.301).

   Conclusion. Systemic thrombolysis in ischemic stroke is associated with improved cerebral oxygenation. An IHD in cerebral oxygenation of less than 4 % serves as an independent predictor of favorable functional recovery in ischemic stroke patients but does not correlate with reduced mortality.

   Brain death diagnosis (BDD) remains a challenge for anesthesiologists and intensive care physicians despite existing regulatory frameworks.

   Objective. To evaluate the frequency of BDD procedure and identify factors limiting its implementation in a multidisciplinary hospital setting.

   Materials and Methods. A single-center retrospective study was conducted including 698 patients by total sampling. Of these, 98 (14 %) had brain injury and were selected for further analysis. From this cohort, patients who died within 15 days of hospital admission (N = 61) were identified. A subgroup of patients with a Glasgow Coma Scale (GCS) score of 3–5 was then selected (N = 38). For comparison, a literature search was performed in PubMed using the query «brain death criteria» and in eLibrary.ru using the keywords «brain death diagnosis».

   Results. BDD was initiated in 12 (31.6 %) cases within the GCS 3–5 subgroup, with brain death confirmed in 8 (21.1 %) patients, including 5 (63 %) women and 3 (37 %) men. Complete BDD procedures were performed
in 6 (75 %) patients with non-traumatic intracerebral hemorrhage (ICH), 1 with non-traumatic subarachnoid hemorrhageь (SAH), and 1 with traumatic brain injury (TBI) (12.5 % each). The median patient age was 59 [43; 65] years, the median GCS score was 3 [3; 3], and the median FOUR score was 0 [0; 0]. Median hospital length of stay was 1.5 [1; 2.5] days, and median intensive care unit (ICU) stay was 1 [1; 2] day.

   Conclusion. Insufficient pupil diameter (5 mm) is a limiting factor for the performance of BDD procedures in grade III coma patients.

   The heterogeneity of sepsis patient populations remains an unresolved issue, hindering the development of effective therapeutic strategies and disease prognostic tools. Classification of diverse sepsis patients by molecular endotypes, together with multi-omics profiling, enables a more personalized treatment approach. Studying the immune response, genomic, metabolomic and proteomic profiles of sepsis patients will enable clinical phenotyping of this diverse population and the development of a precision approach to the diagnosis, prognosis and treatment of sepsis and septic shock.

   The aim of the review was to discuss sepsis subtypes as identified by profiling of patient genomic, metabolic, and proteomic data and present the latest approaches addressing the heterogeneity of sepsis patient populations, such as multi-omics endotyping and clinical phenotyping, which may aid in targeted therapy and optimization of diagnosis and therapy.

   The keywords «sepsis omics», «sepsis endotypes», and «sepsis heterogeneity» were used to search PubMed databases without language restrictions. From over 300 sources, 120 were selected for analysis as being most relevant to the aim of the review. More than half of these were published within the last five years. Criteria for excluding sources were their inconsistency with the aims of the review and their low informativeness. This review discusses the different types of immune responses, the impact of patient population heterogeneity on therapeutic interventions, and current perspectives on phenotyping sepsis patients. Despite the limitations of centralized collection of clinical information, cluster analysis of large data sets and the role of immune response genomics, metabolomics, and proteomics are beginning to dominate the prognosis and treatment of sepsis. Establishing links between all these elements and attempting clinical phenotyping of sepsis, including subtype analysis, appear to be critical in the search for personalized treatment approaches in the near future.

   Conclusion. Currently, the widely accepted goal in sepsis management is early detection and initiation of therapy to prevent the development of irreversible septic shock and multiorgan failure syndrome. Personalized genetic, metabolomic and proteomic profiling of the patient seems to be an intriguing and promising avenue in the search for new treatment strategies in sepsis.

   James Bernat claimed that «the formulation of whole-brain death provides the most congruent map for our correct understanding of death». However, the author has recently proposed the categorization of another phrase: «brain as a whole (BAAW)». This is because patients with primary brainstem lesions who otherwise meet the clinical criteria for BD may still have EEG, CBF, evoked potentials, and hypothalamic-pituitary neurosecretion. Bernat and colleagues suggested «tightening the clinical tests for brain death or loosening the whole-brain criterion of death». They emphasize that the BAAW criterion is an intermediate standard between the whole-brain and brainstem views, tolerating the irreversible cessation of critical brain functions, whereas the BD/DNC determination does not require the cessation of all brain functions or the death of every neuron. In this paper, we have revised the concept of BAAW, which is intuitive and facilitates a conceptual and practical approach, but requires further refinement to specify precisely which brain functions must cease at brain death and which may continue.

   Hirsch-index, better known as, H-index is an important bibliometric index for Italian critical care physicians.

   Aim of our study was to collect the H-index of all Italian critical care academic physicians and compare it with the Italian Ministry of University and Research thresholds necessary to be eligible as Professor, and to investigate potential gender disparities in such bibliometric indices.

   Materials and Methods. We collected all the names of academic ICU physicians on June 24^th, 2023 from the official Italian Ministry of University and Research website. We added non-academic ICU physicians searching on Scopus or among academic physicians’ collaborators. Minimum thresholds to be eligible as Professor were identified through the official Italian Ministry of University and Research website. Median H-index of men and women were compared.

   Results. The total number of included physicians was 237 (46 Full Professors, 88 Associate Professors, 79 Researchers and 22 Non-academic physicians). Minimum threshold to be eligible as Associate Professor was 6 and to be eligible as Full Professor was 13. The median H-index in men versus women in every subgroup was: Full Professors (38 [27–49] vs 29 [21–34]), Associate Professors (25 [18–32] vs 22 [18–28]), Researchers (12 [7–21] vs 9 [6–16]) and Non-academic physicians (27 [25–37] vs 26 [25–29]).

   Conclusion. Current median H-index of Italian academic ICU physicians is considerably greater than minimum thresholds released by the Italian Ministry of University and Research to be eligible as Professor. Gender gap in bibliometric indices of academic ICU physicians remains.