АНАЛІЗ РЕКОМЕНДАЦІЙ МСЕ-Т, ЩО НОРМУЮТЬ ЯКІСТЬ ЦИФРОВИХ ТРАКТІВ ЗВ’ЯЗКУ, І ОЦІНКА МОЖЛИВОСТІ ЇХ ЗАСТОСУВАННЯ ПРИ ЕКСПЛУАТАЦІЇ МЕРЕЖ ЗВ’ЯЗКУ СПЕЦІАЛЬНОГО ПРИЗНАЧЕННЯ

The authors attempted to systematize the changes in ITU-T related to the transfer of information standardization in digital paths at a constant rate.The purpose of the publication: initiate action to incorporate these requirements in the development and deployment requirements for special networks users. The main direction of development of telecommunications infrastructure is the integration of special users to communications networks operators in Ukraine. Law of Ukraine "On Telecommunications" obliges operators of Ukraine to create their segments of telecommunications networks that provide interaction with the public switched telephone network of Ukraine and international communication networks. Prerequisite for such integration is the regulation and control of the transmission quality in all segments of the network operators in accordance with the recommendations of the International Telecommunication Union (hereinafter - ITU-T ), which are currently in force and establish common rules and methodology for assessing the quality of information transmission lines and paths.В статье авторы попытались систематизировать изменения в рекомендациях МСЭ-Т, относящихся к нормированию качества передачи информации в цифровых трактах с постоянной скоростью передачи.Цель публикации: инициировать действия по учету этих требований при разработке требований по развертывания и сетей связи Специальных пользователей. Основным направлением развития инфраструктуры телекоммуникаций специальных пользователей является интеграция с сетями связи операторов Украины. Закон Украины “О телекоммуникациях” обязывает операторов Украины создавать свои сегменты телекоммуникационных сетей, которые обеспечивают взаимодействие с телефонной сетью общего пользования Украины и международными сетями связи. Обязательным условием такой интеграции является нормирование и контроль качества передачи в сегментах сетей всех операторов согласно рекомендациям Международного Союза Электросвязи (далее – МСЭ-Т), которые действуют в настоящее время и устанавливают общие правила и методики оценки качества передачи информации по линиям и трактах.У статті автори спробували систематизувати зміни в рекомендаціях МСЕ-Т, що відносяться до нормування якості передачі інформації в цифрових трактах з постійною швидкістю передачі.Мета публікації: ініціювати дії з цих вимог при розробці вимог по розгортанню мереж зв’язку спеціальних користувачів. Основним напрямом розвитку інфраструктури телекомунікацій спеціальних користувачів є інтеграція з мережами зв’язку операторів України. Закон України “Про телекомунікації” зобов’язує операторів України створювати свої сегменти телекомунікаційних мереж, які забезпечують взаємодію з телефонною мережею загального користування України і міжнародними мережами зв’язку. Обов’язковою умовою такої інтеграції є нормування і контроль якості передачі в сегментах мереж всіх операторів згідно з рекомендаціям Міжнародного Союзу Електрозв’язку (далі – МСЕ-Т), які діють на теперішній час і встановлюють загальні правила і методики оцінки якості передачі інформації по лініях і трактах

In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Background: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation. Methods: EuroECMO-COVID is a prospective, multicentre, observational study developed by the European Extracorporeal Life Support Organization. This study was based on data from patients aged 16 years or older who received ECMO support for refractory COVID-19 during the first wave of the pandemic—from March 1 to Sept 13, 2020—at 133 centres in 21 countries. In-hospital mortality and mortality 6 months after ECMO initiation were the primary outcomes. Mixed-Cox proportional hazards models were used to investigate associations between patient and management-related variables (eg, patient demographics, comorbidities, pre-ECMO status, and ECMO characteristics and complications) and in-hospital deaths. Survival status at 6 months was established through patient contact or institutional charts review. This study is registered with ClinicalTrials.gov, NCT04366921, and is ongoing. Findings: Between March 1 and Sept 13, 2020, 1215 patients (942 [78%] men and 267 [22%] women; median age 53 years [IQR 46–60]) were included in the study. Median ECMO duration was 15 days (IQR 8–27). 602 (50%) of 1215 patients died in hospital, and 852 (74%) patients had at least one complication. Multiorgan failure was the leading cause of death (192 [36%] of 528 patients who died with available data). In mixed-Cox analyses, age of 60 years or older, use of inotropes and vasopressors before ECMO initiation, chronic renal failure, and time from intubation to ECMO initiation of 4 days or more were associated with higher in-hospital mortality. 613 patients did not die in hospital, and 547 (95%) of 577 patients for whom data were available were alive at 6 months. 102 (24%) of 431 patients had returned to full-time work at 6 months, and 57 (13%) of 428 patients had returned to part-time work. At 6 months, respiratory rehabilitation was required in 88 (17%) of 522 patients with available data, and the most common residual symptoms included dyspnoea (185 [35%] of 523 patients) and cardiac (52 [10%] of 514 patients) or neurocognitive (66 [13%] of 512 patients) symptoms. Interpretation: Patient's age, timing of cannulation (<4 days vs ≥4 days from intubation), and use of inotropes and vasopressors are essential factors to consider when analysing the outcomes of patients receiving ECMO for COVID-19. Despite post-discharge survival being favourable, persisting long-term symptoms suggest that dedicated post-ECMO follow-up programmes are required. Funding: None

In-hospital and 6-month outcomes in patients with COVID-19 supported with extracorporeal membrane oxygenation (EuroECMO-COVID): a multicentre, prospective observational study

Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with COVID-19, but uncertainty remains about the determinants of in-hospital mortality and data on post-discharge outcomes are scarce. The aims of this study were to investigate the variables associated with in-hospital outcomes in patients who received ECMO during the first wave of COVID-19 and to describe the status of patients 6 months after ECMO initiation