Infusion & Chemotherapy最新文献

{"title":"Efficacy and safety of decamethoxin in complex treatment of patients with group III viral-bacterial community-acquired pneumonia","authors":"O. Bororova","doi":"10.32902/2663-0338-2021-1-15-21","DOIUrl":"https://doi.org/10.32902/2663-0338-2021-1-15-21","url":null,"abstract":"BACKGROUND. There are many unsolved medical problems and, of course, pneumonia is one of them. Communityacquired pneumonia (CAP) is a multifactorial disease, but the role of viruses as causative agents is constantly growing. Specific antiviral therapy for CAP is limited. Therefore, the search for drugs with virucidal activity remains relevant. An antimicrobial agent with a broad spectrum of action – decamethoxin – is successfully used today for treatment of patients with infectious exacerbations of bronchial asthma and chronic bronchitis. At the same time efficacy of decamethoxin in CAP patients was not studied. \u0000OBJECTIVE. To evaluate the effectiveness and safety of the inhaled antimicrobial drug decamethoxin in the complex treatment of patients with group III viral-bacterial CAP. \u0000MATERIALS AND METHODS. There was enrolled 62 patients with group III viral-bacterial CAP. All patients received the same sequential antibiotic therapy: protected aminopenicillin with macrolide or III generation cephalosporin with macrolide. Patients of the main group were prescribed inhalations through a nebulizer of the antiseptic drug decamethoxin in addition to antibacterial therapy from the first day of treatment for 5-7 days. \u0000RESULTS AND DISCUSSION. No adverse events were detected in any of the patients during treatment. In all cases, recovery was diagnosed. At the same time, the term of achieving positive results in the main group was 12.2±0.7 days, and in the control – 17.2±0.7 (р <0,05). The average duration of antibiotic use was different in main and control groups: respectively 9.4±0.4 and 10.7±0.4 days (р <0,05). There were no infectious complications in the patients of the main group, while 24 (72 %) patients of the control group were diagnosed with acute rhinopharyngitis (47.0 % of cases), lateral pharyngitis (13 %) and sinusitis (9 %), other complications (otitis, infectious exudative pericarditis). In 22 (66 %) cases there was one complication and in 2 (6 %) cases there were two complications. \u0000CONCLUSIONS. For patients with group III viral-bacterial CAP additional inclusion in the empirical sequential antibiotic therapy of inhaled decamethoxin can significantly reduce the frequency of infectious complications, duration of antibiotic therapy, as well as the duration of positive treatment results.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83203248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a free radical scavenger edaravone in patients with hemorrhagic stroke","authors":"O. Halushko","doi":"10.32902/2663-0338-2021-1-28-36","DOIUrl":"https://doi.org/10.32902/2663-0338-2021-1-28-36","url":null,"abstract":"BACKGROUND. The free radical scavenger edaravone helps to reduce the area of ischemic injury and improve the longterm effects of stroke, and is therefore widely used in the treatment of ischemic stroke. However, the role of edaravone in the treatment of hemorrhagic stroke patients has not yet been clarified. \u0000OBJECTIVE. To investigate the feasibility and effectiveness of the use of the free radical scavenger edaravone in the treatment of patients with acute hemorrhagic stroke. \u0000MATERIALS AND METHODS. A search was conducted for studies and systematic reviews for the keywords “acute stroke”, “intracerebral hemorrhage”, “subarachnoid hemorrhage”, “hemorrhagic transformation”, “edaravone” in the Google Scholar database published between 2003 and 2020. \u0000RESULTS. The use of edaravone in patients with intracerebral hemorrhage was accompanied by activation of anti-inflammatory and reduction of pro-inflammatory peptides, activation of anti-apoptotic mechanisms, reduction of lipid peroxidation and oxidative trauma, reduction of permeability of the hematocenosis. \u0000CONCLUSIONS. The main effects of edaravone have been to reduce neurological deficits, accelerate the rate of recovery of neurological disorders, and improve functional outcomes. Thus, the introduction of edaravone in patients with hemorrhagic stroke has proven to be reliably effective and safe.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"59 32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76528318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Інформаційний бюлетень до Всесвітнього та Всеукраїнського дня боротьби з туберкульозом «Боротьба з туберкульозом – невід’ємна складова Глобального плану \"Зупинити ТБ\"»","authors":"Ю.І. Фещенко, В.Г. Матусевич","doi":"10.32902/2663-0338-2021-1-63-64","DOIUrl":"https://doi.org/10.32902/2663-0338-2021-1-63-64","url":null,"abstract":"Інформаційний бюлетень до Всесвітнього та Всеукраїнського дня боротьби з туберкульозом «Боротьба з туберкульозом – невід’ємна складова Глобального плану \"Зупинити ТБ\"»","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83140373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapy of patients with COVID-19: clinical studies and recommendations in different countries","authors":"S. Zaikov","doi":"10.32902/2663-0338-2020-4-5-12","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-4-5-12","url":null,"abstract":"BACKGROUND. During 2020 coronavirus disease (COVID-19) is at the focus of many scientific studies. National approaches to the management of conditions associated with the SARS-CoV-2 can differ significantly due to socio-economic characteristics, capabilities of the health care system in different regions of the world, inertion in making regulatory decisions, as well as the variability and limitations of evidence base regarding effectiveness of various therapeutic approaches. \u0000OBJECTIVE. To review guidelines and clinical experience in the management of patients with COVID-19 around the world. \u0000RESULTS. National guidelines for COVID-19 management can vary significantly in different regions of the world. The governments of each country, in cooperation with leading experts and taking into account global experience, choose and constantly adjust the best ways to overcome COVID-19 epidemic in local population. \u0000CONCLUSIONS. The choice of methods for prevention and treatment of COVID-19 is associated with the capabilities of the healthcare system, regional level of antibiotic resistance, current epidemiological conditions, socio-economic factors, etc. Over the past 5-6 months the epidemiological conditions in different regions of the world have varied significantly, which could create unequal conditions for conducting high-quality clinical trials with a large number of participants. Even within one country the conclusions and recommendations for the treatment of COVID-19 developed by different medical associations and expert groups may differ significantly. Expert organizations conduct an independent evaluation of emerging clinical experience in the treatment of COVID-19 and come to different conclusions. This phenomenon is quite normal and desirable to minimize systematic error in the context of rapidly updating clinical evidence.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83373010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse reactions to anti-tuberculous drugs in patients with pulmonary tuberculosis and ways to eliminate them","authors":"M. Kuzhko, V. Melnyk, М. Gumeniuk, T. Tlustova, T. Sprynsian","doi":"10.32902/2663-0338-2020-4-13-16","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-4-13-16","url":null,"abstract":"ABSTRACT. Here we present the results of retrospective analysis of medical records of 2292 patients with all forms of pulmonary tuberculosis aged 20 to 65 years, who were treated at the National Institute of Tuberculosis and Pulmonology named after F.G. Yanovsky of National Academy of Medical Sciences of Ukraine in 2000-2018. We analyzed the most common side effects of anti-tuberculous drugs and their impact on treatment effectiveness. Practical recommendations for the elimination of adverse reactions to anti-tuberculous drugs in order to increase the effectiveness of treatment of patients with pulmonary tuberculosis are given here.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"2006 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78646047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microcirculation as a goal of correction in macroangiopathy (atherogenesis)","authors":"O. Dynnyk","doi":"10.32902/2663-0338-2020-3.2-80-81","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-3.2-80-81","url":null,"abstract":"Background. The microcirculatory system (MCS) is a network of blood vessels that includes arterioles, capillaries, venules, and terminal lymphatic vessels. Microcirculation is characterized by the constant variability. Factors of atherogenesis development due to MCS dysfunction include shear stress, hyperglycemia, dyslipidemia, systemic and local inflammation, hypoxia and endothelial dysfunction mediated by oxidative stress. Laser Doppler flowmetry (LDF) is used to study microcirculation in the clinical settings. The advantages of LDF include simplicity, accessibility and non-invasiveness. \u0000Objective. To describe the features of microcirculation disorders and their elimination. \u0000Materials and methods. Analysis of literature data on this topic; own study. The study involved 98 patients (59 females; 39 males) with a mean age of 52.0 years. The first group consisted of patients with coronary heart disease (CHD) and chronic heart failure of I-IIA grades, the second – of relatively healthy individuals. All patients underwent LDF, ultrasound examination of the carotid arteries, and determination of anthropometric parameters. \u0000Results and discussion. MCS dysfunction is not only a risk factor for atherogenesis, but also a trigger for its acute complications (myocardial infarction, stroke, sudden death). Nitric oxide (NO) deficiency plays an important role in this. A potential target of therapeutic influence in the treatment of coronary heart disease is not only macrovascular system, but also vasa vasorum. The condition of the latter determines the course of atherosclerosis. According to the results of our own study, patients with CHD demonstrated a muscle mass decrease, an increase in waist and hip circumference, and in body mass index. In addition, the groups differed in thickness of the intima-media complex of both common carotid arteries (right common carotid artery: CHD group – 0.79±0.18 mm; group of relatively healthy individuals – 0.69±0.13 mm, p<0,05; left common carotid artery: CHD group – 0.81±0.19 mm, group of relatively healthy individuals – 0.70±0.14 mm, p<0,05). When assessing the indicators of wavelet analysis of LDF, a significant decrease in the rate of microcirculation and capillary blood flow reserve is revealed in the CHD group, as well as an increase in peripheral vascular resistance. According to previous own studies, sorbitol (Reosorbilact, “Yuria-Pharm”) and pentoxifylline (Latren, “Yuria-Pharm”) can be used to correct microcirculation disorders. The use of these drugs leads to vasodilation of precapillary sphincters and improvement of regional microperfusion. \u0000Conclusions. 1. Disorders of MCS are the pathogenetic factors of the atherogenesis. 2. Laser Doppler flowmetry is used to study microcirculation in the clinical settings. 3. In patients with CHD there is an increase in neuro- and myotonus of the MCS, which is associated with the impaired release of nitric oxide. 4. Changes in microcirculation contribute to the development of","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"254 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73541260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peculiarities of penetration of anti-tuberculosis drugs into the foci of infection in patients with tuberculosis of the central nervous system and the choice of pharmacotherapy","authors":"R. Ruslami","doi":"10.32902/2663-0338-2020-3.2-252-253","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-3.2-252-253","url":null,"abstract":"Background. Tuberculosis (TB) of the central nervous system (CNS) is the most severe and life-threatening form of TB. Diagnosis of TB of CNS is difficult, and treatment is suboptimal. At present, the treatment of tuberculous meningitis (TBM) involves the same drugs and doses as for pulmonary TB, however, the problem is that not all the drugs cross the blood-brain barrier. \u0000Objective. To describe the penetration of anti-TB drugs (ATBD) into the foci of infection in patients with TB of CNS and the choice of pharmacotherapy. \u0000Materials and methods. Analysis of literature sources on this issue. \u0000Results and discussion. Options for optimizing the TBM treatment include a non-pharmacological approach, treatment prolongation, and increasing the residence time of ATBD at the infection site. A meta-analysis of 17 observational studies found no significant benefits of 9-month treatment over 6-month regimens. To increase the residence time of the drug in CNS, you can increase the dose of drugs that poorly penetrate the CNS, add drugs with better brain penetration characteristics, modify drug delivery systems and physical and chemical properties of drugs. The optimal dose provides the maximum effectiveness of the active substance on the background of the minimum number of side effects, so increase of the dose without taking into account the risks of side effects is not advisable. One of the main ATBD rifampicin is characterized by poor penetration into the cerebrospinal fluid. The killer activity of rifampicin depends on its concentration. In our own study, it was found that the administration of a high dose of rifampicin (600 mg) intravenously for 14 days was characterized by lower mortality in patients with TBM than treatment with oral rifampicin (standardized risk ratio was 0.42). Intravenous high-dose treatment was safe and well tolerated by patients. The disadvantages of this treatment include its high cost, invasiveness and poor availability. A meta-analysis of Indonesian patient data confirmed that high doses of rifampicin were associated with lower mortality (Svensson E. et al., 2019). Other drugs that need research in TBM include a new drug bedaquiline, fluoroquinolones (levofloxacin), linezolid. Isoniazid, pyrazinamide, cycloserine, ethionamide, prothionamide are also characterized by the good permeability to cerebrospinal fluid. Therefore, in a strategy to optimize the TBM treatment high-dose rifampicin, high-dose isoniazid and pyrazinamide (?) are the first line, and cycloserine, ethionamide, linezolid, delamanide, pretomanide – the second line. \u0000Conclusions. 1. Diagnosis of TB of CNS is difficult, and treatment is suboptimal. 2. Not all the drugs cross the blood-brain barrier. 3. Options for optimization of the TBM treatment include a non-pharmacological approach, prolongation of therapy and increasing the residence time of ATBD in the infection focus. 4. Administration of high-dose rifampicin (600 mg) intravenously for 14 days was characterized ","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73228060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State sanitary and anti-epidemic rules and norms of medical waste management","authors":"O. M. Tsyganchuk","doi":"10.32902/2663-0338-2020-3.2-300-302","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-3.2-300-302","url":null,"abstract":"Background. Hands are a favorable environment for bacterial colonization. The microflora of skin is divided into resident and transient. The latter gets to the hands of healthcare workers (HCW) by the contact during professional activities during various diagnostic and treatment procedures, as well as by the contact with contaminated objects. General requirements for hand hygiene include short nails, absence of false nails, absence of infected skin injuries (or covered injuries) on the hands and forearms, absence of jewelry or watch. If there is visible dirt, the hands should be washed with usual soap. As for disinfection, it is divided into focal (current and final) and preventive (planned and according to the epidemic indications). Not only the hands of the HCW, medical devices, surfaces and furniture, but also medical waste (MW) should be disinfected. \u0000Objective. To describe the features of disinfection and MW management. \u0000Materials and methods. Analysis of the literature on this issue. \u0000Results and discussion. After use, the syringes are disinfected together with the needles without caps and collected in waterproof and puncture-proof containers. When using containers for sharp objects, it is allowed to fill them for 3 days. Medical devices should be immersed in a disinfectant solution immediately after use; the solution should cover the tools at least 1 cm above their surface. Containers with disinfectant solutions must be marked with the name of the solution, its concentration, purpose, exposure time, date of preparation and expiration date. Disinfectants are divided into halide-containing, alcohol-containing, aldehyde-containing, oxidizing, detergent and composite. Decamethoxine – an antiseptic and antifungal drug for topical use – is widely used for disinfection. The mechanism of action of this solution is to disrupt the permeability of the cytoplasmic membrane of bacteria and fungi by binding to phosphatide groups of membrane lipids. The problem of MW is a major problem in the domestic health care system. Ukraine annually produces about 400 thousand tons of MW, 100-120 thousand of which are dangerous. The risks caused by MW are divided into infectious, chemical and radiation-associated. Categories of MW include category A – epidemically safe MW, B – epidemically dangerous MW, C – toxicologically dangerous MW, D – radiologically dangerous MW. The waste management system includes its collection and sorting; marking; disinfection; transportation within the institution; utilization or disposal (category A only). For each type of waste there are special types of containers and markings regulated by normative documents. Category A waste include household waste of all departments of the hospital, except infectious; waste that have not had contact with biological fluids of the body; food waste of all departments of the hospital, except infectious. Food waste is collected separately from other waste. When collecting MW of B category (used medical ","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75526097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Principles and rationale of infusion therapy in tuberculosis","authors":"T. Petrenko","doi":"10.32902/2663-0338-2020-3.2-239-240","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-3.2-239-240","url":null,"abstract":"Background. In 2018 7 million new cases of tuberculosis (TB) were registered, which is more than in previous years. Undoubtedly, TB is one of the most important threats to the public health globally. In developing countries, where there are no new TB drugs (TBD) and modern medical services, this threat is even more serious. Intravenous administration is an option to optimize the existing drug regimens, as it is accompanied by increased bioavailability. \u0000Objective. To substantiate the rationality of infusion therapy in TB. \u0000Materials and methods. Analysis of literature data on this topic; own study involving 106 patients with newly diagnosed infiltrative and disseminated pulmonary TB with bacterial excretion. \u0000Results and discussion. The medical community is concerned not only about the increase in the TB incidence, but also about the increase in the number of drug resistance (DR) cases. Improper treatment is one of the causes of DR. In case of oral administration absorption disorders of the drug are possible in people with digestive system diseases, in addition, part of the drug is metabolized by passing through the liver. In contrast, intravenous drugs enter the superior vena cava system, right ventricle, and pulmonary arteries. In a number of patients’ subgroups, it is not possible to achieve a sufficient concentration of drugs in serum when taken orally for various reasons. In particular, these reasons include host organism factors (features of drug metabolism (fast acetylators are more likely to have DR than slow ones), malabsorption, drug clearance, inability of the drug to reach lung tissue) and mycobacteria factors (biofilm formation, drug resistance due to efflux pumps, metabolic status of the bacterium – division phase or sleep phase). These factors are considered to be the consequences of continuous oral administration of TBD. Achieving a high concentration of TBD in the source of infection due to intravenous administration allows to overcome the DR of mycobacteria. In the own study, oral (n=33) and intravenous (n=73) modes of TBD administration were compared. The groups were identical in age, sex, and TB stage. In the intravenous treatment group there was a significantly higher proportion of complete closure of the decay cavities (90.5 % vs. 60.4 % in the oral treatment group; p=0.04), as well as the significantly lower number of toxic reactions (14.3 % vs. 57.9 %; p=0.001) and poor tolerability of treatment (31 % vs. 57.9 %; p=0.04). On the background of intravenous therapy less fluoroquinolone DR was observed. \u0000Conclusions. 1. Intravenous therapy in patients with pulmonary TB is more effective than standard in terms of closure of the decay cavities. 2. Intravenous therapy is accompanied by significantly less toxicity and better tolerability. 3. Intravenous TB therapy is less likely to provoke the development of DR.","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78419262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology of coagulation during bleeding","authors":"C. Fenger-Eriksen","doi":"10.32902/2663-0338-2020-3.2-294-295","DOIUrl":"https://doi.org/10.32902/2663-0338-2020-3.2-294-295","url":null,"abstract":"Background. Analysis of 99 studies found that the predictor properties of various tests to determine the blood coagulation condition, including the newest ones (thromboelastography, rotational thromboelastometry), regarding the risk of intra- and postoperative bleeding are low. The results of prothrombin time or activated partial thromboplastin time measurements can be very variable depending on the concentration of reagents and the characteristics of the analysis. That is why standard methods of screening to assess the condition of the coagulation system in all patients in the preoperative period are not recommended. \u0000Objective. To describe the features of perioperative blood clotting and management of patients. \u0000Materials and methods. Analysis of literature data on this topic. \u0000Results and discussion. Before performing invasive procedures, a careful history should be taken to determine the presence and severity of previous bleeding and to ask about antithrombotic medications. If the general hemorrhagic history is favorable, further determination of coagulographic parameters is not required. If the history is unfavorable or there is evidence of potential risk factors for bleeding (e. g., liver disease), a comprehensive coagulation study should be performed. Bleeding coagulopathy is a component of the so-called lethal triad, which also includes hypothermia and acidosis. Active administration of infusion solutions can deepen or provoke coagulopathy due to hemodilution. The use of balanced infusion solutions reduces the risk of this complication. According to some authors, the fibrinogen level <2 g/L is the predictor of bleeding probability. The causes of this condition include hyperfibrinolysis, dysfunctional fibrinogen in case of the administration of colloid solutions, increased decomposition of fibrinogen due to acidosis. Colloidal solutions (hydroxyethyl starch) increase the risk of reoperation and the need for transfusions, so their routine use is not currently recommended. Hyperfibrinolysis is a condition in which the rate of blood clot breakdown exceeds the rate of blood clot formation. As a result, hemorrhagic shock worsens and coagulopathy develops. Hyperfibrinolysis develops due to fibrinolytic agents and hypoperfusion. Tranexamic acid is used for heavy bleeding, in particular, postpartum. The WOMAN study involved 20,600 women with postpartum haemorrhage who received 1 g of tranexamic acid or placebo. Mortality due to bleeding in the tranexamic acid group was 1.2 %, and in the placebo group – 1.7 % (p=0.008). \u0000Conclusions. 1. Routine use of colloid solutions should be avoided during bleeding. 2. It is necessary to detect and eliminate anemia, hypothermia and acidosis. 3. Detection and elimination of deficiency or dysfunction of coagulation factors, hyperfibrinolysis, thrombocytopenia is an important component of bleeding prevention. 4. Reducing bleeding and improving blood clotting leads to the less need for transfusions and better outco","PeriodicalId":13681,"journal":{"name":"Infusion & Chemotherapy","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79170608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}