The article describes the impact of the targeted therapy with colloid and crystalloid infusion solutions on renal function and fluid balance during the surgery and early post-surgery period in the patients who underwent aortocoronary bypass under cardio-pulmonary bypass. No differences have been found in the frequency of acute renal lesion as per AKI and the need in the substitution renal therapy. During one stage of the study the lower rates of urine neutrophil gelatinase-associated lipocalin have been observed in the group of crystalloids. The lack of confident differences in the clinical course of the post-surgery period makes the use of the balanced crystalloid solution more preferable compared to colloid solutions.

Inhalation anesthetics of desflurane and sevoflurane when used in aortocoronary bypass with cardio-pulmonary bypass can reduce the frequency of post-perfusion heart weakness t h rough supporting stable hemodynamic profile of the patients undergoing cardiac surgery. 11 owever the choice between these two medications is often disputable. 43 patients with coronary disease who underwent direct myocardial revasculization with artificial cardio-pulmonary bypass were examined. Desflurane was used as a general anesthetic for 28 patients: sevoflurane was used for 15 patients. During surgery expanded hemodynamic profile data of all patients were evaluated (cardiac index - Cl. stroke volume index - SVI. medium blood pressure - МНР. index of general peripheral resistance - IGPR, index of systolic operation of the left anti right ventricles, pulmonary artery wedge pressure, index of pulmonary resistance) as well as oxygen transporting blood function (delivery, consumption and oxygen extraction co-efficient. oxygen arteriovenous difference) and arterial blood lactate level. The investigated data were recorded before artificial cardio-pulmonary bypass, after reperfusion of myocardium and upon anesthesia completion. Results. Both groups did not have any confident differences in МНР. pulmonary artery pressure, heart rate. In all examined patients С I increased significantly compared to pre-perfusion period due to the increase of stroke volume and systolic discharge of the heart ventricles. And sevoflurane caused more persistent reduction of IGPR after artificial cardio-pulmonary bypass compared to desflurane which required using angiotonic support in 41.1% of patients versus 3.4% of patients in the group where desflurane was used (²criterion with credibility correction, p< 0.01). The bigger need in oxygen when sevoflurane was used during the surgery (p < 0.01) was accompanied by the bigger activation of anaerobic metabolism with increase of lactate concentration in post-perfusion period (p < 0.01) which can be explained by less depression of the global metabolism by sevoflurane compared to desflurane.

67 elderly patients with physical status of Class III as per ASA, had their sensitivity of peripheral chemoreflex tested with the help of modified timed inspiratory capacity test and compared with parameters of central hemodynamics in laparoscopic cholecystectomy. High peripheral chemoreflex sensitivity is related to more signified hypotension due to heart index reduction and general peripheral vascular resistance.

The article presents the experience of use and efficiency of pre-operative carbohydrate administration of 20% glucose intravenously during anasthesiological support of thorax cancer surgery. The article shows the parameters of hemodynamics, results of intra and post-operative laboratory monitoring of glycemia, albumin levels, time of the enteral feeding start, duration of patients’ stay in the intensive care department and duration of the general hospital stay, basing on the above parameters the conclusion has been made about reduction in significance of metabolic stress response to surgical aggression in this category of the patients.

The wide surgery on hip joint is followed by the blood loss, local and systematic inflammatory response. Tranexamic acid is widely used in surgery for conservative homeostasis and its anti-inflammatory effect is also well known. The purpose: to justify the dosing regimen of tranexamic acid from the position of minimum blood loss and inflammatory response. Materials and methods: 32 patients from the control group received standard therapy with tranexamic acid at the dose of 20 mg/kg intravenously twice a day: 30 minutes prior to the surgery and in 6 hours since the 1st administration; in the main group (29 patients) the standard regimen was supplemented by intra-operative administration – 10 mg per kg-1 ∙ h-1. Results. The volume of the intra-surgery, drainage, general and estimated peri-operative blood loss was not statistically different between two groups. The level of pro-inflammatory and anti-inflammatory cytokines was higher in the drainage blood compared to the peripheral one (p < 0.001). The concentration of soluble receptors to IL-6 and FNO-α was statistically and clinically confidently higher in the control group compared to the main one at the majority stages of the study (p < 0.05). Conclusion. Tranexamic acid possesses anti-inflammatory action regardless of the dose.

During the prospective non-randomized study 340 patients were operated due to bone tumors in the volume of tumor removal with consequent defect replacement with megaprothesis of the hip (n = 52), knee (n = 254), ankle (n = 11) joints and total endoprosthesis of femur (n = 23). The combination of spinal or superficial general anesthesia with epidural (n = 101) or conduction (n = 239) analgesia was used for pain relief. The regional pain relief after surgery continued for 3-4 days. The level of pain, need for additional pain relief, frequency of failures and complications were studied as per the digit rating scale. The following nonparametric analysis methods were used for statistical processing: U-Mann-Whitney test or Fisher’s exact test. The number of patients with acceptable pain level after surgery and the need for additional pain relief were non statistically different in the groups with epidural or conduction pain relief. With post-surgery epidural pain relief compared to conduction analgesia arterial hypotension (12% versus 5%, p = 0.035) and dysuric disorders (5% versus 0.4%, p = 0.010) developed more often. The conduction analgesia turned out to be more complicated from technical point of view. Conclusion: given the similar efficiency of pain relief the conduction analgesia compared to epidural one has been followed by the less number of the side effects.

The study was conducted in order to investigate the informativeness of testing the changes in sepsis laboratory markers – procalcitonin, S-reactive protein and cholesterol. The prospective study included 27 patients (15 men, 12 women, age 55.7 ± 17.0 years old) with sepsis and syndrome of multi-organ failure. During the admission to anesthesiology and intensive care department the patients suffering from sepsis and multi-organ failure syndrome have elevated levels of procalcitonin and S-reactive protein. The reduction of procalcitonin by the 4-5th day and S-reactive protein on the 9th day is a favorable prognostic sign. Patients with sepsis and multi-organ failure syndrome manifest reduction of cholesterol level. The cholesterol value on the 4-5th day is statistically significantly higher in the group of patients with recovery 3.84 (3.03; 4.48) mM per lt. compared to the group of patients with lethal outcome 3.0 (2.64; 3.31) mM per lt.

The article presents the data from literature on using the analysis technique on the heart rhythm variability in anasthesiological practice.

The articles describes the clinical follow-up and the data of one-year prospective follow-up of the patient suffering from the Brugada syndrome complicated by clinical death.

Moderate therapeutic hypothermia is a promising technique for cerebral damage management aimed at the reduction of mortality and disability after hypoxic ischaemic encephalopathy. The article describes the experience of using therapeutic hypothermia in the newborn who had suffered from asphyxia. This case is special due to using hypothermia at the stages in the maternity hospital, neonatal transportation crew and special medical unit, and also using low-technology cooling technique (switching off the heating, cooled water packages, wiping with cold water). This case confirms the efficiency of this technique for achieving stable targeted temperature corridor. The key factor of the successful and safe use of low-technology hypothermia is the use of the hospital protocol. The availability of this technique can assist the wider dissemination of therapeutic hypothermia and reduction of mortality and disability in children after hypoxic ischaemic encephalopathy.