On some aspects of furosemide routine prescription at acute respiratory distress syndrome at the prehospital stage

We studied the effect of furosemide application at the pre-hospital stage on survival rate and mortality risk in patients with acute respiratory distress syndrome. It was found that out of 665 patients admitted to intensive care units, 90 have been diagnosed with acute respiratory distress syndrome, of which 75 have noted decreased preload. Those patients were divided into two groups: group 1 (n = 28) received furosemide on the first day, group 2 (n = 47) did not receive furosemide. The patients of both groups matched by age, the severity of the condition and the severity of organ dysfunction. The 10-day survival rate in the patients with acute respiratory distress syndrome and reduced preload received furosemide at the pre-hospital stage made 11 % and was significantly lower than in the patients without furosemide - 43 % (p = 0.031). The frequency of multiple organ dysfunction syndrome in group 1 the was statistically higher than in patients without furosemide (93 % and 75 % respectively; p = 0.048). Furosemide administration in patients with acute respiratory distress syndrome and reduced preload 1.8 times increases the relative mortality risk (p = 0.032)

CLINICAL NUTRITION INVOLVING A SPECIALIZED PROTEINAND CALORIE-RICH PEDIATRIC MILK PRODUCT FOR ENTERAL FEEDING OF INFANTS WITH PROTEIN-CALORIE DEFICIENCY

Background: Premature infants with extremely low and very low birth weight with a severe overlapping perinatal pathology often feature slower growth rate within the first year of life and require special nutritional support.Objective: Our aim was to study physical development of infants with protein-calorie deficiency in the setting of using a specialized protein- and calorie-rich pediatric milk product for enteral feeding.Methods: We analyzed tolerability and efficacy of clinical nutrition within the framework of a prospective two-month-long case series. We assessed actual children’s diets and the chemical composition thereof. We determined body weight and length, body mass index (BMI), adipodermal flap thickness over the triceps. Anabolic effect of clinical nutrition was assessed on the basis of transthyretin concentration dynamics.Results: The study involved 30 infants with protein-calorie deficiency (7 term infants and 23 premature infants) with a severe perinatal pathology. High tolerability of the formula under analysis was registered in most patients. Termination of functional gastrointestinal tract disorders (posseting, colics, flatulence, constipations) was observed in 23 (87%) patients. In most cases, the use of a protein- and calorie-rich formula as a part of a therapeutic diet helped to satisfy children’s protein demand and improve their weight/length parameters: BMI increased in 19 (72%) children, body weight — in 16 (63%), body length — in 24 (92%), adipodermal flap thickness over the triceps — in all the children (100%). We observed transthyretin concentration increase from 162 (157; 171) in the beginning of the study to 187 (170; 208) mg/l in the end thereof (p = 0.028).Conclusion: A specialized protein- and calorie-rich product for enteral feeding may be used for feeding infants with protein-calorie deficiency born with a severe a perinatal pathology, including premature infants

ЛЕЧЕБНОЕ ПИТАНИЕ С ПРИМЕНЕНИЕМ СПЕЦИАЛИЗИРОВАННОГО ДЕТСКОГО МОЛОЧНОГО ПРОДУКТА ДЛЯ ЭНТЕРАЛЬНОГО ПИТАНИЯ С ПОВЫШЕННЫМ СОДЕРЖАНИЕМ БЕЛКА И ЭНЕРГИИ У ДЕТЕЙ ПЕРВОГО ГОДА ЖИЗНИ С БЕЛКОВО-ЭНЕРГЕТИЧЕСКОЙ НЕДОСТАТОЧНОСТЬЮ

Background: Premature infants with extremely low and very low birth weight with a severe overlapping perinatal pathology often feature slower growth rate within the first year of life and require special nutritional support.Objective: Our aim was to study physical development of infants with protein-calorie deficiency in the setting of using a specialized protein- and calorie-rich pediatric milk product for enteral feeding.Methods: We analyzed tolerability and efficacy of clinical nutrition within the framework of a prospective two-month-long case series. We assessed actual children’s diets and the chemical composition thereof. We determined body weight and length, body mass index (BMI), adipodermal flap thickness over the triceps. Anabolic effect of clinical nutrition was assessed on the basis of transthyretin concentration dynamics.Results: The study involved 30 infants with protein-calorie deficiency (7 term infants and 23 premature infants) with a severe perinatal pathology. High tolerability of the formula under analysis was registered in most patients. Termination of functional gastrointestinal tract disorders (posseting, colics, flatulence, constipations) was observed in 23 (87%) patients. In most cases, the use of a protein- and calorie-rich formula as a part of a therapeutic diet helped to satisfy children’s protein demand and improve their weight/length parameters: BMI increased in 19 (72%) children, body weight — in 16 (63%), body length — in 24 (92%), adipodermal flap thickness over the triceps — in all the children (100%). We observed transthyretin concentration increase from 162 (157; 171) in the beginning of the study to 187 (170; 208) mg/l in the end thereof (p = 0.028).Conclusion: A specialized protein- and calorie-rich product for enteral feeding may be used for feeding infants with protein-calorie deficiency born with a severe a perinatal pathology, including premature infants.Дети, родившиеся недоношенными, с экстремальной и очень низкой массой тела, с тяжелой сочетанной перинатальной патологией нередко имеют сниженные темпы роста на протяжении первого года жизни и нуждаются в специальной нутритивной поддержке.Цель исследования: изучить физическое развитие младенцев с белково-энергетической недостаточностью при использовании специализированного детского молочного продукта для энтерального питания с повышенным содержанием белка и энергии.Методы: переносимость и эффективность лечебного питания изучали в проспективном двухмесячном наблюдении серии случаев. Оценивали фактическое питание и химиче- ский состав рационов детей. Определяли массу и длину тела, индекс массы тела (ИМТ), толщину кожно-жировой складки над трицепсом. Анаболический эффект лечебного питания оценивали по динамике содержания транстиретина.Результаты: в исследование были включены 30 младенцев с белково-энергетической недостаточностью, родившихся доношенными (n = 7) и недоношенными (n = 23), все с тяжелой перинатальной патологией. Хорошая переносимость изучаемой формулы зафиксирована у большинства пациентов. Купирование функциональных нарушений желудочно-кишечного тракта (срыгиваний, колик, метеоризма, запоров) отмечено у 23 (87%) пациентов. Использование формулы с повышенным содержанием белка и энергии в составе лечебной диеты в большинстве случаев позволяло удовлетворить потребности детей в белке и улучшить их массо-ростовые показатели: ИМТ увеличился у 19 (72%), масса тела — у 16 (63%), длина тела — у 24 (92%), толщина кожно-жировой складки над трицепсом — у всех (100%) детей. Установлено повышение концентрации транстиретина со 162 (157; 171) в начале исследования до 187 (170; 208) мг/л при его завершении (p = 0,028).Заключение: специализированный высокобелковый и высококалорийный продукт для энтерального питания может использоваться в питании младенцев с белково-энергетической недостаточностью, родившихся с тяжелой перинатальной патологией, в т. ч. недоношенными

Thrombin receptor agonist peptide immobilized in microspheres stimulates reparative processes in rats with gastric ulcer

The effect of synthetic thrombin receptor (PAR1) agonist peptide encapsulated in microspheres made of lactic and glycolic acid copolymer on tissue reparation was studied in rats with acetate-induced ulcer. PAR1 agonist peptide was immobilized in biodegraded lactic and glycolic acid microspheres by double emulgation, the kinetics of peptide release was analyzed, and the dynamics of ulcer healing was studied in experimental (administration of microspheres with the peptide into the stomach) and two control groups (administration of saline or spheres without peptide). Thrombin receptor agonist peptide gradually released from lactic and glycolic acid microspheres into the stomach shortened the inflammation phase and shifted the proliferation phase to the earlier period, thus accelerating healing of experimental ulcers in rats