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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medalphabet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский алфавит</journal-title><trans-title-group xml:lang="en"><trans-title>Medical alphabet</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-5631</issn><issn pub-type="epub">2949-2807</issn><publisher><publisher-name>ООО «Альфмед»</publisher-name></publisher></journal-meta><article-meta><article-id custom-type="elpub" pub-id-type="custom">medalphabet-919</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>Статьи</subject></subj-group></article-categories><title-group><article-title>Целенаправленная инфузионная терапия критических состояний. Обзор литературы</article-title><trans-title-group xml:lang="en"><trans-title>Goal-directed fluid resuscitation in critically ill patients. Literature review</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хромачева</surname><given-names>Н. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Khromacheva</surname><given-names>N. O.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьменко</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzmenko</surname><given-names>A. A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Фот</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Fot</surname><given-names>E. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кузьков</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuzkov</surname><given-names>V. V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Киров</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Kirov</surname><given-names>M. Y.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северный государственный медицинский университет» Минздрава России; ГБУЗ АО «Первая городская клиническая больница имени Е. Е. Волосевич»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Northern State Medical University; First City Clinical Hospital n.a. E. E. Volosevich</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северный государственный медицинский университет» Минздрава России; ГБУЗ ЛО «Токсовская районная больница»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Northern State Medical University; Regional Hospital, Toksovo</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>09</day><month>12</month><year>2018</year></pub-date><volume>4</volume><issue>38</issue><issue-title>Неотложная медицина</issue-title><fpage>10</fpage><lpage>16</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Хромачева Н.О., Кузьменко А.А., Фот Е.В., Кузьков В.В., Киров М.Ю., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Хромачева Н.О., Кузьменко А.А., Фот Е.В., Кузьков В.В., Киров М.Ю.</copyright-holder><copyright-holder xml:lang="en">Khromacheva N.O., Kuzmenko A.A., Fot E.V., Kuzkov V.V., Kirov M.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-alphabet.com/jour/article/view/919">https://www.med-alphabet.com/jour/article/view/919</self-uri><abstract><p>Неотъемлемым компонентом лечения пациентов, находящихся в критических состояниях, является инфузионная терапия, которая направлена на увеличение сердечного выброса, улучшение тканевой перфузии и предупреждение органной дисфункции. Вместе с тем данные недавних исследований показывают, что более чем в 20 % случаев инфузионной терапии возникают проблемы в связи с ее нерациональным применением. Чрезмерная регидратация приводит к тканевому отеку, электролитным нарушениям, развитию острого респираторного дистресс-синдрома и острого повреждения почек. При сепсисе положительный кумулятивный гидробаланс, начиная со вторых суток от момента поступления в отделение интенсивной терапии (ОИТ), ассоциируется с увеличением продолжительности искусственной вентиляции легких, длительности пребывания в ОИТ, а также ростом летальности. В настоящее время большое значение придается не только адекватному заполнению емкости сосудистого русла и интерстициального пространства, но и своевременной дегидратации или дересусцитации под контролем инвазивного мониторинга гемодинамики.</p></abstract><trans-abstract xml:lang="en"><p>An important part of treating critically ill patients is infusion therapy that is aimed at cardiac output increase, tissue perfusion improvement and organ failure prevention. Herewith, recent research data show that more than 20 % of infusion therapy cases are associated with problems related with its irrational application. Excessive rehydration causes tissue edema, electrolyte disorders, development of acute respiratory distress syndrome and kidney injury. in case of sepsis, starting from the second day after intensive care unit (iCU) admission, the positive cumulative fluid balance is accompanied by increased duration of mechanical ventilation, longer iCU stay and increased mortality. Nowadays, much attention is paid not only to the adequate filling of vascular capacity and interstitial space but also to the in-time dehydration or deresuscitation under control of invasive monitoring of hemodynamics.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>инфузионная терапия</kwd><kwd>кумулятивный гидробаланс</kwd><kwd>дегидратация</kwd><kwd>инвазивный мониторинг гемодинамики</kwd></kwd-group><kwd-group xml:lang="en"><kwd>infusion therapy</kwd><kwd>cumulative flui balance</kwd><kwd>dehydratation</kwd><kwd>invasive monitoring of hemodynamics</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Багненко С. Ф., Ермолов А. С., Стожаров В. В., Чикин А. Е. Основные принципы диагностики и лечения тяжелой сочетанной травмы // Скорая медицинская помощь. 2008. № 3: 3-10.</mixed-citation><mixed-citation xml:lang="en">Багненко С. Ф., Ермолов А. С., Стожаров В. В., Чикин А. 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