The results of long-term experimental studies and clinical observations have shown the pathophysiological and clinical significance of noncardiogenic pulmonary edema in the ARDS development. It was shown that the accumulation of the ex-travascular lung fluid is one of the leading mechanisms of the ARDS pathogenesis. Proven ability to use calculated index of the extravascular lungs fluid content as an early diagnostic criteria for ARDS. The effect of the extravascular lungs fluid accumulation on the effectiveness of certain respiratory, non-respiratory and pharmacological treatments ARDS was studied. The features of the noncardiogenic pulmonary edema development in ARDS caused by direct and indirect damaging factors was described. The algorithm for diagnosis and treatment an ARDS of different genesis based on these data was scientifically justified and developed.

The main principles of treatment of external postoperative pancreatic fistulas are viewed in the article. 36 patients recovered after the treatment. Complex conservative treatment of EPF allowed to close fistulas in all the patients with normal patency of the main pancreatic duct (MPD). The usage of octreotide 600-900 mcg daily intravenous infusion for at least 5 days to decrease pancreatic secretion was an important part of the conservative treatment in 80.5 % led to the elimination of fistula. Endoscopic papillotomy was performed in patients with major duodenal papilla obstruction and interruption of transporting of pancreatic secretion to duodenum. Stent of the main pancreatic duct was indicated in patients with extended pancreatic duct stenosis to normalize transport of pancreatic secretion to duodenum. Interruption of the MPD with diastasis between its ends or impossibility to fulfill endoscopic stenting of the pancreatic duct was an indication to surgical formation of anastomosis between distal part of the MPD and gastro-intestinal tract. Antisecretory treatment was carried out in all the cases of surgical interventions.

The aim of the study was to estimate the significance of an intra-operative natremia as an independent prognostic factor for results of surgical treatment of abdominal aortic aneurism rupture. The retrospective analysis of postoperative period of 38 emergency operated patients with the abdominal aortic aneurism rupture was carried out. It was established that the intraoperative natraemia is the independent predictive factor of lethal outcome after surgery and is connected with homeostasis and metabolic disorders after reperfusion. Natraemia depends on the volume of blood loss and characteristics of infusion and transfusion during surgery.

Diverticular disease of the colon is a fast spreading disease among the elderly population with a high incidence of purulent and septic complications (formation of pericolic infiltrates with abscesses and peritonitis). Although formed algorithm of examination of patients with suspected acute diverticulitis of the colon, including an ultrasound, computed tomography of the abdominal cavity, abdominal X-ray study and contrast enema, colonoscopy, in practice surgeons meet patients with atypical clinical and instrumental picture, which often leads to false positive or false negative results of diagnosis of acute diverticulitis. The authors analyzed these clinical cases, discussed the diagnosis and treatment errors, and recommendations to avoid similar difficulties in the future.

Emergency physicians come across patients with angioedema (AO) in their practice quite often. Depending on the mediator involved, various forms of AO forms can be recognized, calling for completely different therapeutic approaches. Despite of the similarity manifestations distinct AO caused by different mediators result in totally different prognosis for the patient. Prompt diagnosing is challenging for the emergency physician, but it is critical in patients’ outcomes. Low awareness of physicians in emergency department about rare bradykinin-mediated AO, which torpid to the standard regimens of therapy with adrenaline, systemic corficosteroids and antihistamines, adds to the problem. Lack of timely pathogenetic based therapeutic approaches can result in unjustified surgery, disability or death for patient.

The paper presents the evaluation of two methods of perioperative anesthetic management for nasal surgeries: a comparison of general anesthesia with tracheal intubation and combined anesthesia (general anesthesia with tracheal intubation and nerve blockade). The study found that the addition to general anesthesia with intubation local anesthesia was characterized by a more stable hemodynamics, decrease the need for anesthetics, the later pain emergence and reduction of pain intensity during postoperative period, reduction the stress response to surgical trauma.

The article discusses the possibility of therapeutic treatment of abnormal uterine bleeding in a general hospital. We describe the mechanism of action, indications and side effects of different pharmacological groups of drugs used in clinical practice for the treatment of abnormal uterine bleeding.

The authors conducted an analysis of the literature, MedLink and PubMed resources about the method of topical negative pressure (negative pressure wound therapy): its history, mechanisms of action and clinical effects, material support and applications.