60 research outputs found
Diagnostics of wound infections in patients with burns
The article systematizes data on the clinical and microbiological diagnosis of burn wound infections, and presents the concept of sepsis diagnostics from the position of the American Burn Association Consensus Conference (2007)Π ΡΡΠ°ΡΡΠ΅ ΡΠΈΡΡΠ΅ΠΌΠ°ΡΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ Π΄Π°Π½Π½ΡΠ΅ ΠΏΠΎ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΈ ΠΌΠΈΠΊΡΠΎΠ±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΉ ΠΎΠΆΠΎΠ³ΠΎΠ²ΠΎΠΉ ΡΠ°Π½Ρ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΠΊΠΎΠ½ΡΠ΅ΠΏΡΠΈΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ΅ΠΏΡΠΈΡΠ° Ρ ΠΏΠΎΠ·ΠΈΡΠΈΠΈ American Burn Association Consensus Conference (2007
Using of lactate for the prediction of adverse outcomes in septic and hypovolemic shock
The purpose of the study was to estimate the lactate level as an outcome predictor in patients with septic and hypovolemic shock. Hospital mortality was considered as a primary outcome in patients with burn shock and mortality within 72 hours β in patients with septic shock. The lactate level AUROC in the prediction of mortality in patients with septic shock was 0.716 (95% CI 0.529-0.903), which defines the lactate level as a good predictor. The lactate level AUROC in the prediction of mortality in patients with burn shock was 0.812 (95% CI 0.587-1.000), it indicates the lactate level as a very good predictor. Small sample size and a shift of patients with septic shock to more severe cases are limitations of our study, because of which we could not display significant relation between the lactate level and mortality in patients with septic shockΠ¦Π΅Π»ΡΡ Π΄Π°Π½Π½ΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Π±ΡΠ»ΠΎ ΠΈΠ·ΡΡΠΈΡΡ ΡΠΎΠ»Ρ Π»Π°ΠΊΡΠ°ΡΠ° ΠΊΠ°ΠΊ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠ° Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΈ Π³ΠΈΠΏΠΎΠ²ΠΎΠ»Π΅ΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ (ΠΎΠΆΠΎΠ³ΠΎΠ²ΡΠΌ) ΡΠΎΠΊΠΎΠΌ. ΠΡΠ½ΠΎΠ²Π½ΡΠΌ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΡΠ΅ΠΌΡΠΌ ΠΈΡΡ
ΠΎΠ΄ΠΎΠΌ Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΠΆΠΎΠ³ΠΎΠ²ΡΠΌ ΡΠΎΠΊΠΎΠΌ ΡΡΠΈΡΠ°Π»Π°ΡΡ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΡΠ½Π°Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ, Π° Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΎΠΊΠΎΠΌ β 72-ΡΠ°ΡΠΎΠ²Π°Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ. ΠΠ»ΠΎΡΠ°Π΄Ρ ΠΏΠΎΠ΄ ROC-ΠΊΡΠΈΠ²ΠΎΠΉ Π΄Π»Ρ Π»Π°ΠΊΡΠ°ΡΠ° Π² ΠΏΡΠΎΠ³Π½ΠΎΠ·Π΅ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΎΠΊΠΎΠΌ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 0.716 (95%ΠΠ 0.529-0.903), ΡΡΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π»Π°ΠΊΡΠ°Ρ ΠΊΠ°ΠΊ ΠΏΡΠΈΠ΅ΠΌΠ»Π΅ΠΌΡΠΉ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡ ΠΈΠ·ΡΡΠ°Π΅ΠΌΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π°, Π° Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΎΠΆΠΎΠ³ΠΎΠ²ΡΠΌ ΡΠΎΠΊΠΎΠΌ - 0.812 (95%ΠΠ 0.587-1.000), ΡΡΠΎ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ΅Ρ Π»Π°ΠΊΡΠ°Ρ ΠΊΠ°ΠΊ Π±ΠΎΠ»Π΅Π΅ Π²Π΅ΡΠΎΠΌΡΠΉ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡ ΠΈΠ·ΡΡΠ°Π΅ΠΌΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π°. ΠΠ΄Π½Π°ΠΊΠΎ, Π² ΡΠ²ΡΠ·ΠΈ Ρ ΠΌΠ°Π»ΠΎΠΉ Π²ΡΠ±ΠΎΡΠΊΠΎΠΉ ΠΈ ΠΎΡΠ΅Π²ΠΈΠ΄Π½ΡΠΌ ΡΠΌΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΎΠΊΠΎΠΌ Π² ΡΡΠΎΡΠΎΠ½Ρ Π±ΠΎΠ»Π΅Π΅ ΡΡΠΆΠ΅Π»ΡΡ
, Π½Π΅ ΡΠ΄Π°Π»ΠΎΡΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΡ Π΄ΠΎΡΡΠΎΠ²Π΅ΡΠ½ΠΎΠ΅ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΡΡΠΎΠ²Π½Ρ Π»Π°ΠΊΡΠ°ΡΠ° Π½Π° ΡΠ°ΡΡΠΎΡΡ Π»Π΅ΡΠ°Π»ΡΠ½ΡΡ
ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² Π² Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΎΠΊΠΎ
The course of Covid-19 in patients with chronic kidney disease and the role of renal replacement therapy in shaping the outcomes of a new coronavirus infection in intensive care
The aim of the study to determine the role of chronic kidney disease (CKD) as a risk factor for adverse outcomes in COVID-19, and to compare the effectiveness of hemodiafiltration (HDF) and hemodialysis (HD) in reducing the risk of death in patients with CKD requiring renal replacement therapy (RRT).Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ ΡΠΎΠ»Ρ Ρ
ΡΠΎΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΈΜ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠΎΡΠ΅ΠΊ (Π₯ΠΠ) ΠΊΠ°ΠΊ ΡΠ°ΠΊΡΠΎΡΠ° ΡΠΈΡΠΊΠ° Π½Π΅Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΡ
ΠΈΡΡ
ΠΎΠ΄ΠΎΠ² ΠΏΡΠΈ COVID-19, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΡΠ°Π²Π½ΠΈΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ°ΡΠΈΠ»ΡΡΡΠ°ΡΠΈΠΈ (ΠΠΠ€) ΠΈ Π³Π΅ΠΌΠΎΠ΄ΠΈΠ°Π»ΠΈΠ·Π° (ΠΠ) Π² ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΠΈ ΡΠΈΡΠΊΠ° Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π₯ΠΠ, ΡΡΠ΅Π±ΡΡΡΠΈΡ
ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ Π·Π°ΠΌΠ΅ΡΡΠΈΡΠ΅Π»ΡΠ½ΠΎΠΈΜ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΈΜ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ (ΠΠΠ’)
Epidemiology and outcomes of acute renal injury at patients with severe sepsis
86 patients with severe sepsis were examined. The most frequent reasons of a sepsis were peritonitis, acute necrotizing pancreatitis, skin and soft tissue infections. Frequency of acute renal failure was 75.6%, and attributive mortality was 28.2%. Risk factors of acute renal injury were age> 60 years and a septic shock. Risk factors of a lethal outcome were septic shock, respiratory failure, encephalopathy, duration of acute renal injury more than 4 days, AKIN III, oliguria, the expressed positive hydrobalance during intensive therapy, APACHE II score > 15, SOFA score > 6.Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΊΠ»ΡΡΠ΅Π½ΠΎ 86 ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΡΠΌ ΡΠ΅ΠΏΡΠΈΡΠΎΠΌ. ΠΡΠ½ΠΎΠ²Π½ΡΠΌΠΈ ΡΡΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌΠΈ ΠΏΡΠΈΡΠΈΠ½Π°ΠΌΠΈ ΡΠ΅ΠΏΡΠΈΡΠ° ΡΠ²Π»ΡΠ»ΠΈΡΡ ΠΏΠ΅ΡΠΈΡΠΎΠ½ΠΈΡ, Π½Π΅ΠΊΡΠΎΡΠΈΠ·ΠΈΡΡΡΡΠΈΠΉ ΠΏΠ°Π½ΠΊΡΠ΅Π°ΡΠΈΡ, ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ ΠΊΠΎΠΆΠΈ ΠΈ ΠΌΡΠ³ΠΊΠΈΡ
ΡΠΊΠ°Π½Π΅ΠΉ. Π£ΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΡΠΎ Π² ΡΡΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΠ°ΡΡΠΎΡΠ° ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ (ΠΠΠ) Π»ΡΠ±ΠΎΠΉ ΡΡΠ΅ΠΏΠ΅Π½ΠΈ ΡΡΠΆΠ΅ΡΡΠΈ ΡΠΎΠ³Π»Π°ΡΠ½ΠΎ ΡΠΊΠ°Π»Π΅ AKIN ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 75.6%. ΠΡΡΠΈΠ±ΡΡΠΈΠ²Π½Π°Ρ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΡ ΠΏΡΠΈ ΡΠ°Π·Π²ΠΈΡΠΈΠΈ ΠΠΠ ΡΠΎΡΡΠ°Π²Π»ΡΠ΅Ρ 28.2%. Π€Π°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° ΡΠ°Π·Π²ΠΈΡΠΈΡ ΠΠΠ ΠΏΡΠΈ ΡΠ΅ΠΏΡΠΈΡΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ Π²ΠΎΠ·ΡΠ°ΡΡ >60 Π»Π΅Ρ ΠΈ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΎΠΊ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡΡ Π±ΠΎΠ»Π΅Π΅ 1 ΡΡΡΠΎΠΊ. Π€Π°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΈΡΡ
ΠΎΠ΄Π° ΠΏΡΠΈ ΠΠΠ ΡΠ²Π»ΡΡΡΡΡ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΎΠΊ, ΠΠΠ, ΡΠ½ΡΠ΅ΡΠ°Π»ΠΎΠΏΠ°ΡΠΈΡ, Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΠΠ Π±ΠΎΠ»Π΅Π΅ 4 ΡΡΡΠΎΠΊ, ΠΠΠ III ΡΡΠ°Π΄ΠΈΠΈ ΠΏΠΎ AKIN, ΠΎΠ»ΠΈΠ³ΡΡΠΈΡ, Π²ΡΡΠ°ΠΆΠ΅Π½Π½ΡΠΉ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½ΡΠΉ Π³ΠΈΠ΄ΡΠΎΠ±Π°Π»Π°Π½Ρ Π² Ρ
ΠΎΠ΄Π΅ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ, ΡΡΠΆΠ΅ΡΡΡ ΠΏΠΎ ΡΠΊΠ°Π»Π΅ APACHE II > 15 Π±Π°Π»Π»ΠΎΠ² ΠΈ ΠΏΠΎ ΡΠΊΠ°Π»Π΅ SOFA > 6 Π±Π°Π»Π»ΠΎΠ²
European Society Intensive Care Medicine ΠΈ Society Critical Care Medicine: 6 ΠΊΠ»ΡΡΠ΅Π²ΡΡ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΏΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΠ΅ΠΏΡΠΈΡΠΎΠΌ. ΠΡΠ΄Π° ΠΈΠ΄Π΅ΠΌ Π΄Π°Π»ΡΡΠ΅?
The objective: to analyze the validity of recommendations of the special research committee of the European Society of Intensive Care Medicine (ESICM) and Society of Critical Care Medicine (SCCM) concerning the most important provisions for the management of patients with sepsis and septic shock identifying predictors of long-term need for medical care and lethality.Subjects and methods. The article analyses the publications based on which experts in sepsis management identified the key provisions of theΒ above recommendations.Results. Attention is focused on six issues: empirical combined antibiotic therapy, individual infusion volume, express diagnosis of infection, assessment of organ and systemic dysfunction, identification of predictors of long-term need for medical care and lethality, and implementation attempts and prospects of precise/personalized medicine. It has been shown that the values of SOFA score, heart rate, syst. blood pressure, lactate and albumin levels should reflect the balance of the groups in these parameters. Molecular classification of patients with sepsis providing different endotypes allows better patients enrollment in clinical trials.Π¦Π΅Π»Ρ: Π°Π½Π°Π»ΠΈΠ· ΠΎΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½Π½ΠΎΡΡΠΈ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ ΡΠΏΠ΅ΡΠΈΠ°Π»ΡΠ½ΠΎΠ³ΠΎ Π½Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΈΡΠ΅ΡΠ° European Society Intensive Care Medicine (ESICM) ΠΈ Society Critical Care Medicine (SCCM), ΠΊΠ°ΡΠ°ΡΡΠΈΡ
ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π²Π°ΠΆΠ½ΡΡ
ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠΉ ΠΏΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² c ΡΠ΅ΠΏΡΠΈΡΠΎΠΌ ΠΈ ΡΠ΅ΠΏΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΎΠΊΠΎΠΌ, Ρ Π²ΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠ² Π΄ΠΎΠ»Π³ΠΎΡΡΠΎΡΠ½ΠΎΠΉ Π½ΡΠΆΠ΄Π°Π΅ΠΌΠΎΡΡΠΈ Π² ΠΎΠΊΠ°Π·Π°Π½ΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΠΈ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΏΠΎΠ»Π½Π΅Π½ Π°Π½Π°Π»ΠΈΠ· ΠΈΡΡΠΎΡΠ½ΠΈΠΊΠΎΠ² Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, Π½Π° ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΡΠΊΡΠΏΠ΅ΡΡΠ°ΠΌΠΈ ΠΏΠΎ Π²Π΅Π΄Π΅Π½ΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
ΡΠ΅ΠΏΡΠΈΡΠΎΠΌ Π²ΡΠ΄Π΅Π»Π΅Π½Ρ ΠΊΠ»ΡΡΠ΅Π²ΡΠ΅ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄Π°ΡΠΈΠΉ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΊΡΠ΅Π½ΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ Π½Π° ΡΠ΅ΡΡΠΈ ΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΡΡ
: ΡΠΌΠΏΠΈΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΊΠΎΠΌΠ±ΠΈΠ½ΠΈΡΠΎΠ²Π°Π½Π½Π°Ρ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠΎΡΠ΅ΡΠ°ΠΏΠΈΡ, ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½Π°Ρ ΠΏΠΎ ΠΎΠ±ΡΠ΅ΠΌΡ ΠΈΠ½ΡΡΠ·ΠΈΡ, Π±ΡΡΡΡΠ°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ, ΠΎΡΠ΅Π½ΠΊΠ° ΠΎΡΠ³Π°Π½Π½ΠΎ-ΡΠΈΡΡΠ΅ΠΌΠ½ΠΎΠΉ Π΄ΠΈΡΡΡΠ½ΠΊΡΠΈΠΈ, Π²ΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΏΡΠ΅Π΄ΠΈΠΊΡΠΎΡΠΎΠ² Π΄ΠΎΠ»Π³ΠΎΡΡΠΎΡΠ½ΠΎΠΉ Π½ΡΠΆΠ΄Π°Π΅ΠΌΠΎΡΡΠΈ Π² ΠΎΠΊΠ°Π·Π°Π½ΠΈΠΈ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΎΠΉ ΠΏΠΎΠΌΠΎΡΠΈ ΠΈ Π»Π΅ΡΠ°Π»ΡΠ½ΠΎΡΡΠΈ, ΠΏΠΎΠΏΡΡΠΊΠΈ Π²Π½Π΅Π΄ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Ρ ΡΠΎΡΠ½ΠΎΠΉ/ΠΏΠ΅ΡΡΠΎΠ½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½Ρ. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ Π·Π½Π°ΡΠ΅Π½ΠΈΡ ΡΠΊΠ°Π»Ρ SOFA, Π§Π‘Π‘, ΡΠΈΡΡ.ΠΠ, ΡΠΎΠ΄Π΅ΡΠΆΠ°Π½ΠΈΠ΅ Π»Π°ΠΊΡΠ°ΡΠ° ΠΈ Π°Π»ΡΠ±ΡΠΌΠΈΠ½Π° Π΄ΠΎΠ»ΠΆΠ½Ρ ΠΎΡΡΠ°ΠΆΠ°ΡΡ ΡΠ±Π°Π»Π°Π½ΡΠΈΡΠΎΠ²Π°Π½Π½ΠΎΡΡΡ Π³ΡΡΠΏΠΏ ΠΏΠΎ Π΄Π°Π½Π½ΡΠΌ ΠΏΠ°ΡΠ°ΠΌΠ΅ΡΡΠ°ΠΌ. ΠΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½Π°Ρ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ Π±ΠΎΠ»ΡΠ½ΡΡ
Ρ ΡΠ΅ΠΏΡΠΈΡΠΎΠΌ, ΠΏΡΠ΅Π΄ΡΡΠΌΠ°ΡΡΠΈΠ²Π°ΡΡΠ°Ρ Π½Π°Π»ΠΈΡΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ½Π΄ΠΎΡΠΈΠΏΠΎΠ², ΡΠΎΠ·Π΄Π°Π΅Ρ ΡΡΠ»ΠΎΠ²ΠΈΡ Π΄Π»Ρ Π»ΡΡΡΠ΅ΠΉ ΡΠ΅Π»Π΅ΠΊΡΠΈΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
Acute renal injury at patients with severe sepsis
The analysis of diagnostics and treatment of sepsis - associated acute renal injury/failure is made. Modern classifications RIFLE and AKIN, and also dialysis and no-dialysis methods of therapy acute renal injury/failure are discussed.Π ΡΡΠ°ΡΡΠ΅ Π°Π½Π°Π»ΠΈΠ·ΠΈΡΡΠ΅ΡΡΡ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΠ΅ ΡΠΎΡΡΠΎΡΠ½ΠΈΠ΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π² ΠΎΠ±Π»Π°ΡΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΈ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΎΡΡΡΠΎΠ³ΠΎ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½ΠΈΡ/Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΏΡΠΈ ΡΡΠΆΠ΅Π»ΠΎΠΌ ΡΠ΅ΠΏΡΠΈΡΠ΅. ΠΠ±ΡΡΠΆΠ΄Π΅Π½Ρ ΡΠΎΠ²ΡΠ΅ΠΌΠ΅Π½Π½ΡΠ΅ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ RIFLE ΠΈ AKIN, Π° ΡΠ°ΠΊΠΆΠ΅ Π΄ΠΈΠ°Π»ΠΈΠ·Π½ΡΠ΅ ΠΈ Π½Π΅Π΄ΠΈΠ°Π»ΠΈΠ·Π½ΡΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΡΠ΅ΡΠ½ΠΎΠΉ Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΎΡΠ½ΠΎΡΡΠΈ
Prevalence and attributive mortality in patients with hospital pneumonia in the ICU with severe burn injury
The aim of the study to analyze and evaluate the clinical characteristics and risk factors of mortality in patients with severe pneumonia being treated in the intensive care unit of the burn center.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΠΈ ΠΎΡΠ΅Π½ΠΈΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ ΠΈ ΡΠ°ΠΊΡΠΎΡΡ ΡΠΈΡΠΊΠ° ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΡΡΠΆΠ΅Π»ΠΎΠΈΜ ΠΏΠ½Π΅Π²ΠΌΠΎΠ½ΠΈΠ΅ΠΈΜ, Π½Π°Ρ
ΠΎΠ΄ΡΡΠΈΡ
ΡΡ Π½Π° Π»Π΅ΡΠ΅Π½ΠΈΠΈ Π² ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠΈ ΡΠ΅Π°Π½ΠΈΠΌΠ°ΡΠΈΠΈ ΠΈ ΠΈΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΠΈΜ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΎΠΆΠΎΠ³ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅Π½ΡΡΠ°
Development of a technology for the preparation of a dry nutrient medium for anthrax vaccine production
Currently, submerged cultivation of the Bacillus anthracis STI-1 strain for live anthrax vaccine production requires liquid nutrient media, which have disadvantages of a short shelf life (no more than one month) and a narrow range of storage temperatures (2β8 Β°Π‘). Dry media, in contrast, have a number of indisputable advantages: such media are transportable and easy to use, have a standard capability to retain properties, and can be stored without preservatives at 2β30 Β°Π‘ for 2β5 years. The aim of this work was to develop a technology for the preparation of a dry nutrient medium for anthrax vaccine production. Materials and methods: The study used the Bacillus anthracis STI-1 vaccine strain and a nutrient medium for its cultivation, containing a 70:30 mixture of an enzymatic digest of casein and a pre-processed corn extract solution. Drying of the nutrient medium was carried out on a spray-drying unit. The authors evaluated physicochemical parameters of experimental medium batches. The shelf life was determined by an accelerated stability study. The dry nutrient medium was used to produce a live anthrax vaccine. Quality attributes of the vaccine were assessed for compliance with regulatory requirements. Results: The authors developed the dry media production technology. According to it, the liquid nutrient medium is fed to the drying unit at a rate of 20β25 dm3/h. The spray air pressure is 0.02 MPa. Temperatures at the drying chamber inlet and outlet are 118β122 Β°Π‘ and 85β90 Β°Π‘, respectively. The technology was used to obtain 3 experimental batches of the dry medium. The study results demonstrate that the technology is reproducible, and the tested quality attributes of experimental medium batches are consistent with the requirements. According to the accelerated stability study, the shelf life of the dry nutrient medium at 2β30 Β°Π‘ is at least 3 years. Experiments demonstrated the possibility of using the dry nutrient medium for live anthrax vaccine production. Critical quality attributes of the vaccine obtained with the medium met regulatory requirements. Conclusions: The developed technology allows for the production of a standard dry nutrient medium with a prolonged shelf life, which is convenient for live anthrax vaccine production
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