The review analyzes possible epidemiological and molecular mechanisms responsible for hyperinflammation in patients with the severe course of COVID-19.

Results: it highlights the similarities between this condition and hyperferritinemic syndrome which allows considering pathogenesis of COVID-19 with the direct involvement of iron metabolism. In the case of COVID-19 infection of moderate severity and especially in its severe forms, it is indicated to use of iron chelators and other methods of free iron elimination.

The objective: based on publications to provide up-to-date information on the frequency, basic variants and predictive significance of cardiovascular complications of the coronavirus infection caused by SARS-CoV-2.

Results: the article identifies variants of cardiovascular disorders in COVID-19 caused by various comorbidities in particular hypertension, specific virus-associated myocardial damage, and side effects of medications. It analyzes the role of angiotensin-converting enzyme 2 type II receptors during infection with the coronavirus and potential changes in the renin–angiotensin–aldosterone system including in patients receiving angiotensin-converting enzyme inhibitors or blockers of angiotensin receptors. The data on the frequency and prognostic role of arrhythmias, virus-associated myocardial damage and heart failure, the risk of ischemia, and myocardial infarction are presented. The adverse cardiovascular events of drugs of different groups prescribed for treatment of COVID-19 and possible drug interactions are described. The current recommendations for cardiotonic and cardioprotective therapy in patients with cardiovascular complications are analyzed.

Conclusion. The SARS-Cov-2 virus has a pronounced cardiac tropic effect which requires maximum cardiac alertness in the treatment of patients in this category, timely use of electrocardiography, echocardiography, control of biomarkers of myocardial damage and tension, as well as a reasonable use of cardiotonic and cardioprotective drugs.

Currently, a certain amount of clinical data has been accumulated about the basics of lung ultrasound examination in the patients with pneumonia caused by COVID-19.

The use of ultrasound can be informative for assessing the state at the pre-hospital stage and triage, identifying patients with minor forms of the disease and their consequent routing. This review of literature has focused on the principles of the diagnosis of pneumonia using ultrasound in the context of the COVID-19 pandemic.

The objective: to provide pathogenetic justification for the need for extracorporeal blood purification in the new coronavirus infection.

Results: the article analyzes guidelines and the first experience of using extracorporeal methods in the new coronavirus infection in different countries. It has been demonstrated that methods of extracorporeal blood purification have complex pleiotropic (multiple) effects and can quickly normalize the level of cytokines and other pathogenic factors, thereby preventing/reducing the severity of organ disorders. The article specifies the criteria for choosing an extracorporeal method, as well as indications for its early and late use.

The objective: based on the analysis of published data and results of own research, to present scientifically valid procedures for respiratory support in acute respiratory distress syndrome of various origins.

Results: the article specifies approaches to escalation and de-escalation methods of optimizing positive end-expiratory pressure and duration of the inspiratory phase, the use of "lung opening", mechanical ventilation in the prone position, endotracheal administration of Surfactant BL, as well as the combination of these methods, their advantages, disadvantages, indications and contraindications, and potential complications.

It has been found out that methylation of nucleic acids, proteins and low-molecular substrates is necessary to renew cellular structures, their restoration and cytoprotection. Methionine plays the most important role in this process but whether its metabolism changes during anesthesia and how different anesthetics affect it, has not yet been studied.

The objective: to study the metabolism of methionine during cardiopulmonary bypass when the direct myocardial revascularization is performed and the impact of the anesthetics used (propofol, desflurane, and sevoflurane) on methionine metabolism.

Subjects and methods: 74 patients who underwent surgery due to coronary heart disease with cardiopulmonary bypass were enrolled in the study. The patients were divided into three groups by the anesthetic used (desflurane, sevoflurane, propofol). Levels of methionine, homocysteine, cysteine, and taurine were tested in the blood collected from veins and jugular vein before the aorta clamping and after the release of clamps.

Results. In all three groups, lower levels of methionine and a higher level of homocysteine were observed after the release of clamps from the aorta, especially in the jugular vein. The most significant consumption of methionine was noted when propofol was used. In the same group, the exocytic release of homocysteine into the blood and the formation of cysteine were significantly lower. No significant difference was observed in the effect of desflurane and sevoflurane on methylation.

Conclusion. During the anoxia, the consumption of methionine increases significantly but the intensity of demethylation/remethylation depends on the anesthetics used during anesthesia. The most significant decrease in the level of methionine as well as the remethylation of homocysteine into methionine occurs with the use of propofol, rather than inhalation anesthetics which may be a consequence of desflurane and sevoflurane cytoprotective properties.

It is very important to observe all the parameters of cardioplegia when protecting myocardium during cardiac surgery. To perform this task, it is necessary to have clear understanding of properties of the elements of the extracorporeal circuit of cardiopulmonary bypass.

The objective: to develop a test model and using it to evaluate technical capabilities of blood cardioplegic system reducing the filling volume of the heat exchange chamber and the system supplying solution to the myocardium.

Subjects and methods. A model of a neonatal cardiopulmonary bypass circuit was tested, it included an oxygenator and the cardioplegic system with a 7-ml heat exchange chamber; changes in the pressure and temperature in key nodes of the extracorporeal and cardioplegic circuits were assessed when the pump velocity, ambient temperature and fluid temperature in the main circuit were changed.

Results. This modification provides a wide range of liquid volumetric velocities. Maintaining the selected variant of blood cardioplegia and safe pressure within the cardioplegic circuit is ensured at the perfusion rate of up to 350 ml/min. With normothermal circulation and air temperature in the operating room of 23°C, parameters of the cardioplegic circuit and solution delivery system allows maintaining the solution temperature within the range from 16 to 19°C. When the solution is cooled in a heat exchanger down to 4°C, the temperature of the final cardioplegic solution is maintained within 12-17°C; and with normothermal perfusion, air temperature in the operating room of 15°C and the solution temperature in the heat exchange chamber of 4°C, the temperature of the final cardioplegic solution can be within 6‒13°C. With perfusion in the mode of moderate hypothermia (32°C), air temperature in the operating room 15°C and temperature in the heat exchange chamber 4°C, the final cardioplegic solution can be delivered at the temperature from 5 to 9°C.

Conclusions. The proposed test model allows investigating aimed to find out additional characteristics of the cardioplegic circuit.

Ambient air temperature, cardioplegic pump velocity and main circuit fluid temperature are the main factors influencing the final cardioplegic solution temperature.

When using the studied variant of the cardioplegic circuit assembly, the maintenance of the selected variant of blood cardioplegia and safe pressure inside the cardioplegic circuit are ensured at a perfusion rate of up to 350 ml/min.

The use of modern blood-saving technologies is one of the effective methods of preventing intra-operative bleeding in obstetric practice, however, the effect of local use of terlipressin to reduce blood loss is not sufficiently investigated.

The objective: to assess the efficacy of local preventive use of low doses of terlipressin to reduce of intra-operative blood loss in the cesarean section.

Subjects and methods. 105 women who underwent the cesarean section under spinal anesthesia were examined. They were divided into 3 groups depending on the administered dose of terlipressin: Group 1 (n = 35) ‒ 0.2 mg, Group II (n = 35) ‒ 0.4 mg, Group III (n = 35) ‒ control one. The swab-weighing method was used to assess blood loss.

Results. In Group I, the blood loss made 6.9% of the total blood volume, in Group II ‒ 7.7%, and in Group III ‒ 13.3%. The frequency of hemotransfusion in Group I was ‒ 0%, in II ‒ 2.9%, in III ‒ 14.3%. No complications and side effects associated with terlipressin use were observed.

Conclusion. The use of low doses of terlipressin for prevention purposes has a sufficiently pronounced clinical effect and is not accompanied by any complications.

Objective: analysis of the current pharmacological approaches to perioperative pain control, including in patients with chronic pain and opioid dependence

Results: An assessment of pregabalin, gabapentin, celecoxib, and other medications utilized in perioperative pain control as well as a characterization of methods used in pain control in opioid-dependent individuals, including chronic buprenorphine therapy. Detailing how multiple preparations are employed and their effectiveness in intraoperative and postoperative pain management. Also, addressing the increased role of pharmacogenomics in individualized pain management.

The objective: based on the literature review to demonstrate that when managing severe parenchymal acute respiratory failure, in addition to respiratory support it is necessary to use comprehensive non-respiratory and pharmacological methods of treatment, as well as various diagnostic and therapeutic measures including innovative medical technologies and involvement of specialists of different profiles.

Results: the article presents procedures of rational integrated and personalized therapy in patients with acute respiratory failure which are aimed to improve treatment outcomes.

The objective: to analyze the latest data on the management of patients with subarachnoid hemorrhage (SAH).

Results: nimodipine is the only drug that possesses evidence-based efficacy to prevent and treat vasospasm. However, there are cases of refractory vasospasm. Furthermore, there are cases of delayed cerebral ischemia without angiographically detected vasospasm. This article describes the diagnostic, classification of the severity of SAH, the dependence of outcomes on the timing of surgical interventions and intensive care (volemia, glycemia, sodium, hemoglobin level, and optimal values of systolic blood pressure), the results of research on the use of drugs and methods potentially effective for the prevention and treatment of cerebral vasospasm.

The objective of the review: analysis of innovations in the conceptual justification and methodological support of anesthetic protection of thoracic surgical interventions.

Results: optimization of methods of anesthetic protection should be aimed at solving both surgical requirements such as creating conditions for surgical comfort and at the same time, ensuring the maximum achievable level of protection efficiency and patient safety. When solving the problems of patient protection in thoracic surgery in general and thoracoscopic surgery in particular, the special attention is paid to ensuring effective gas exchange and optimal anesthesia methods corresponding to them within the framework of the multi-component concept. It is important to consider that weaning from mechanical ventilation and the careful collapse of the operated lung are absolute indications for thoracoscopic surgery. This approach is used due to the need to provide space in the pleural cavity for instrumental manipulations during surgery.