The article covers modern concepts of mulfi-sfage compensation of fraumafic blood loss. Based on authors' experience and literature dafa, various aspects of fhe infusion and transfusion components of intensive care are highlighted.

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.

The aim of the study was to assess in experiment the effect of infusion solution on fat globules in the blood of patients with severe combined trauma. Material and methods. 0.9- and 7.5 per cent NaCl solutions, Ringer s solution, Sterofundin iso, Sterofundin G5, Reamberin, Remaxol, Confumin were introduced into the blood in a ratio of 1 : 20, 1 : 10, 1 : 5, 1 : 3 and 1 : 2 with an estimate of the amount of fat globules. The results: 0.9- and 7.5 per cent NaCl solution, Ringer s solution and Confumin change the parameters of fat globlemia in proportion to the degree of dilution. Infusion preparations Sterofundin iso, Sterofundin G5, Remaxol and Reamberin have an independent emulsifying effect on fat globules. Conclusion. The obtained results open up the prospect of further clinical use of Sterofundin iso, Sterofundin G5, Remaxol and Reamberin in the treatment and prevention of fat embolism syndrome.

Seventy three patients who underwent on-pump CABG surgery were examined. in 33 patients (group 1), perioperative blood loss of 10 or more ml/kg was noted, in other cases (n = 40, group 2) it was less than 10 ml/kg. in group 1, compared with group 2, the antiplatelet effect of aspirin measured by optical transmission aggregometry (570 ± 77; 620 ± 55 ARU; p = 0.0009), the total dosages of heparin (594 ± 110; 520 ± 54 U/ kg; p = 0.002) and protamine sulfate (4.7 ± 1.0; 3.9 ± 0.5 mg/ kg; p = 0.0005). Thus, the antiplatelet effect of aspirin administered before the operation, and the total dose of heparin, despite the calculated neutralization with protamine sulfate, are significant risk factors for an increase in perioperative blood loss during CABG-surgery.

The risk factors for development of infectious complications were identified in victims with thoracoabdominal injuries. 299 medical cards were analyzed. Risk factors were confirmed humoral shifts occurring in the perioperative period. These factors were combined into a scale of risk assessment of infectious complications.

The article presents a study of the effect of early and balanced artificial therapeutic nutrition on the correction of water and protein metabolism, as well as the frequency of development and nature of purulent-septic complications in patients with severe combined trauma in the early post-traumatic period. The study involved 19 patients with severe concomitant injury. According to the SAPS ii scale, the probability of mortality was on average 50 % (from 45 to 60 points). in terms of energy supply, patients were divided into three groups: nutritional support less than 30 % (7 patients), 30-70 % (7 patients), more than 70 % of the calculated energy needs (5 patients). The control group i included patients who received hospital meals or who could not have early enteral nutrition due to intestinal paralysis (about 1,000 kcal per day). Group ii consisted of patients who, for various reasons, had a late onset of enteral feeding or had been incomplete. Total caloric content was up to 2,000 kcal per day. The third group consisted of patients who received artificial nutritional therapy, including intravenous infusions of glucose and amino acid solutions, as well as enteral polysubstrate mixtures. The total calories amount was 3,000 kcal per day. it is confirmed that the development of catabolic hypermetabolism is characteristic of severe traumatic illness in the acute period. Among patients who received early artificial medical nutrition in the hyperelementation mode, there was an improvement in albumin binding capacity, frequency and severity of pneumonia and multiorgan failure at 10-14 days after injury.

The emergence of local anesthetic levobupivacaine in the Russian pharmaceutical variety causes lots of questions among anesthesiologists concerning the differences amid this drug and bupivacaine and ropivacaine, which are widely used in clinical practice. To compare the effectiveness and safety of the use of this anesthetic in daily routine practice during spinal anesthesia in a multidisciplinary hospital, a randomized prospective study was conducted. Surveyed 163 patients who underwent planned surgical interventions under subarachnoid anesthesia.

The article provides an analytical review of the literature according to the pubmed.com database. The historical aspects of the development of diagnostic and therapeutic measures in pregnant women in the case of PE are shown. The development of understanding of the need for both medical, including thrombolysis, PE interventions, and the need for thromboprophylaxis are shown.

The problem of medical error is multi-faceted, and besides an analysis of clinical cases it also requires proper methodological prerequisites to identify it. Existing definitions of medical error have several constructive contradictions, which should be examined from a viewpoint of interaction within «physician - patient - lawyer» triangle. Laws of dialectics point out the causality in development of any problem, and it is productive to overview it not only from a perspective of binary formal logic, but also in a format of multiple logic.

The article presents the problem of creating digital intensive care unit (ICU). This is associated with a significant increase in the amount of heterogeneous medical data required for a clinical decision by a specialist in a shortage of time. The authors present a modern information and analytical complex of the anesthesiology and intensive care unit. The complex includes: a tracking monitor system with a central station, a dedicated server, an electronic medical history. For the operation of the complex, Big Data technologies and CDS algorithms were applied, which made it possible to create integral indicators characterizing the operation of a number of body systems. Using Arden Knowledge Engine software tools allows authors to assert about the transition to the next stage of development of digital resuscitation, the use of artificial intelligence.