To describe the frequency and type of EMS analgesic administration to burned children; to describe pain after PICU admission used specific score FLACC and Wong-Baker FACES factors associated with the administration of analgesia by EMS. This was a retrospective study of children (age < 18 years) who were transported by EMS between January 2013 and December 2014 and had a final hospital diagnosis of major burns (20% and more). Receipt of and time of parenteral analgesia were recorded and statistical studied. 232 children met the inclusion criteria. The mean (range) age of this sample was 3.7 (0.1-17) years. Only 201 patients received prehospital analgesia (87%). Opioids received analgesia in the EMS (53.23%). Tramadol received analgesia in the EMS (83.36%). Non-opioids received (nurofen, ketorol) analgesia in the EMS (65.28%). On painful scores, prehospital opioids analgesia was associated with no pain or little bit pain (2.11 ± 1.13), tramadol was associated with banging pain (5.84 ± 1.2), non-opioids group and group without analgesia was associated with really hurts (8.55 ± 0.92 and 8.83 ± 0.69). Statistically significant association was between opioids analgesia group and tramadol, non-opioids and group without analgesia (p ≤ 0.01). The need for strict guidelines for administration of opioids in children with severe burn injury, which ensures an adequate level of analgesia. Parenteral Tramadol can ensure only partial removal of pain. Unacceptable use of only non-narcotic analgesics or start transportation to hospital without analgesia. Key words: burns, pediatric, pain, prehospital.>< 18 years) who were transported by EMS between January 2013 and December 2014 and had a final hospital diagnosis of major burns (20% and more). Receipt of and time of parenteral analgesia were recorded and statistical studied. 232 children met the inclusion criteria. The mean (range) age of this sample was 3.7 (0.1-17) years. Only 201 patients received prehospital analgesia (87%). Opioids received analgesia in the EMS (53.23%). Tramadol received analgesia in the EMS (83.36%). Non-opioids received (nurofen, ketorol) analgesia in the EMS (65.28%). On painful scores, prehospital opioids analgesia was associated with no pain or little bit pain (2.11 ± 1.13), tramadol was associated with banging pain (5.84 ± 1.2), non-opioids group and group without analgesia was associated with really hurts (8.55 ± 0.92 and 8.83 ± 0.69). Statistically significant association was between opioids analgesia group and tramadol, non-opioids and group without analgesia (p ≤ 0.01). The need for strict guidelines for administration of opioids in children with severe burn injury, which ensures an adequate level of analgesia. Parenteral Tramadol can ensure only partial removal of pain. Unacceptable use of only non-narcotic analgesics or start transportation to hospital without analgesia.

On the basis clinical and microbiological studies are revealed differences in the pathogenesis of burn injury during the hypodermic introduction to the rabbits of the species «chinchilla» of the cultivated and uncultivated bacteria P.aeruginosa and S.aureus. Infection by the uncultivated bacteria S.aureus and P.aeruginosa in 87.5% causes the loss of laboratory animals on the average on 3.43 ± 0.94 day after putting of thermal injury, which is accompanied by the phenomena of the defeat of brain s 1 on 4 the twenty-four hours in each second individual. Infection by the cultivated bacteria causes the generalization infection by gram-negative bacteria with the colonization of internal organs with the subsequent development of sepsis and loss 80% of animals on 13.58 ± 0.63 day.

The activation of membrane lipid peroxidation, circulatory and tissue hypoxia are crucial triggers for membrane destroying events in acute pancreatitis. The use of anti-oxidant therapy in acute experimental pancreatitis reduces the intensity of lipid peroxidation (the level of diethenoid conjugates statistically confidently reduces by 30.4-32.5%) and restores the tissue respiration (oxidation-reduction potential is above the control one by 10-15%). Such therapy provides less effect on the microcirculation.

To study burnout syndrome in anesthesiologists, we conducted a survey study in 48 doctors working in Arkhangelsk region. It was found that 62.5% of them have a high level of burnout, characterized by emotional exhaustion and stress in work, deterioration of health and social adaptation. More than half of the anesthesiologists have a high index of organizational stress and Behavioral type A, use maladaptive coping strategies in dealing with intractable situations arising during work. These results led to preparation of recommendations for prevention and correction of burnout in anesthesiologists.

This review continues to investigate the management aspects of main physiological parameters during artificial blood circulation in the adult patients from the position of the evidence based medicine, and the first part of this review was published in the previous issue. This part is devoted to management of temperature, oxygen delivery and pulsation. The authors conclude that currently the majority of recommendations for artificial blood circulation are not based on the relevant evidences. In order to achieve best clinical results it has been offered to review the published data and relate them with the personal experience evaluating benefits and risks. It has been shown that the majority of complications related to artificial blood circulation have various causes and it demands the multi-disciplinary approach to their prevention.

Drug-induced sleep endoscopy occupies the important place in the diagnostic procedure of obstructive sleep apnea – sleep hypopnea and often defines the further treatment tactics. The review presents the main aspects of this manipulation and its anesthetic provision. Despite the long term experience of using drug-induced sleep endoscopy, the phenomenon of the increased and individual sensitivity of the inspiratory center to the hypnotic agent in those suffering from obstructive sleep apnea – sleep hypopnea has not been interpreted yet from research point of view. The issue of defining individual pharmacological threshold for induced apnea and personal level of sedation depth still remains important.

Severe cerebral ischemia of newborns remains to be the main cause of children disability and mortality and neuroprotection is the main way to reduce them. Therapeutic hypothermia being widely introduced into clinical practice nowadays has the number of limitations. It requires searching for effective pharmacological neuroprotection providing impact on numerous pathogenic mechanisms of neuronal damage. These promising neuroprotective agents include melatonin, erythropoietin, topiramate, cannabinoids, barbiturates and magnesium sulfate. Promising neuroprotection in newborns can include antenatal use in case of fetal distress or potentation and/or postponed use of therapeutic hypothermia with their post-natal administration. Data currently available from clinical studies do not allow recommending any of the above drugs for routine clinical use. However in future clinical studies now in progress will allow finding the effective neuroprotection and optimal mode for its use in newborns with severe cerebral ischemia.

The article describes the follow-up over the development of atypical hemolytic-uremic syndrome in the female patient suffering menometrorrhagia which manifested with concurrent metrorrhagia and was accompanied with acute renal failure.

Basing on the existing data about the positive impact of inhalation induction and anesthetic support (IIAS) and levosimendan it is planned to study and compare within framework of the coming study the impact of IIAS and pre-operative preparation through administration of levosimendan on the rates of myocardial contractility during intra and early post-operative periods, the need in inotropic agents, and 30-day and 1 year mortality of the patients with lower ejection fraction of left ventricular during surgery on infrarenal part of aorta.