Annals of pulmonary and critical care medicine最新文献

{"title":"Comparison of ultrasound signs, computed tomography data and morphological examination of the lungs in patients with coronavirus infection: post hoc analysis","authors":"R. E. Lakhin, E. A. Zhirnova, A. V. Shchegolev, I. Zheleznyak, V. S. Chirsky, D. Y. Pluminsky","doi":"10.21320/1818-474x-2023-3-82-96","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-82-96","url":null,"abstract":"INTRODUCTION: Ultrasound examination (US) of the lungs has shown high efficiency in the diagnosis of COVID-19 pneumonia. The aim of the research was studying the correspondence of computed tomography (CT) US signs of the lungs and morphological data in patients with COVID-19 pneumonia. MATERIALS AND METHODS: The post hoc analysis included 388 patients who simultaneously underwent ultrasound and CT of the lungs. Lung ultrasound was performed according to the 16-zone “Russian Protocol”. Morphological data were obtained from the results of pathoanatomic examination of deceased patients. RESULTS: The comparison of signs detected by CT and ultrasound of the lungs was performed during a multidimensional correspondence analysis. The analysis was carried out using a three-dimensional solution that explained 64.9 % of inertia (p < 0.001). CT signs of “ground glass opacity” (100 %) corresponded to the B-line at ultrasound (100 %), CT of the consolidation sign (44.8 %) — ultrasound signs of consolidation (46.9 %), aerobronchogram of CT (34 %) — aerobronchogram of ultrasound (36.9 %), free liquid CT (11.1 %) — free liquid Ultrasound (13.9 %). CT signs of reticular changes (29.6 %) and “cobblestone pavement” (12.4 %) corresponded to various combinations of ultrasound signs of subpleural consolidation and B-lines. The B-lines were caused by the exudation of fluid and protein molecules into the intraalveolar space against the background of massive death of alveolocytes and formed by the development of intraalveolar edema and the formation of hyaline membranes. The ultrasonic sign of consolidation appeared in the airless zone of the lungs. Subpleural consolidation are caused by thickening and inflammatory infiltration of the pleura, diffuse alveolar damage, with intraalveolar edema, death and decay of alveolocytes, perivascular inflammatory cell reaction/ During treatment for more than 7 days, consolidation in the lung tissue developed due to the disorganization of the organ structure due to the progression of fibrosis. CONCLUSION: Multivariate correspondence analysis showed correlation of CT signs and US signs of the lungs. Morphological analysis showed polymorphism of histological data that caused the formation of ultrasound signs.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83257212","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":"Structure and frequency of comorbidities and associated postoperative complications: a national observational multicenter study STOPRISK","authors":"I. Zabolotskikh, N. Trembach, M. Magomedov, A. S. Popov, Yu. P. Malyshev, A. A. Dmitriev, E. V. Grigoryev, V. V. Fisher, V. Khoronenko, V. N. Kokhno, A. P. Spasova, V. R. Davydova, A. Gritsan, K. M. Lebedinskii, P. Dunts, A. Bayalieva, A. Ovezov, D. Martynov, N. G. Arikan, M. Kirov, V. I. Ershov, I. Pasechnik, A. Kuzovlev, D. E. Fedunets","doi":"10.21320/1818-474x-2023-3-43-57","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-43-57","url":null,"abstract":"INTRODUCTION: Risk assessment and identification of a group of patients with a high probability of developing an unfavorable outcome is the basis for effective prevention of postoperative adverse events. OBJECTIVE: The purpose of the study was to determine the structure and frequency of co-existing diseases in the preoperative period and associated adverse postoperative outcomes. MATERIALS AND METHODS: The analysis of the parameters of 8,241 patients of the STOPRISK database operated on abdominal and pelvic organs for the period from July 1, 2019 to April 30, 2022 was carried out. RESULTS: Co-existing diseases occurred in 4,638 patients (56.3 %), while one disease was observed in 1,872 patients (22.7 %), a combination of two diseases — in 1,383 patients (16.8 %), three diseases — in 814 patients (9.9 %), four diseases — in 395 patients (4.8 %), and more than 4 — in 170 patients (2.0 %). The most common were arterial hypertension — 48.2 %, chronic heart failure (20.7 %), coronary heart disease (19.3 %). The presence of one or more complications was recorded in 285 patients (3.5 %), fatal outcome — in 36 patients (0.43 %). 74.0 % of patients had a single complication, 14.0 % had a combination of two complications, and 12.0 % had a combination of three or more complications. The structure of complications was dominated by paralytic ileus (25.57 %), pneumonia (12.1 %), wound infection (12.1 %). Both mortality and the frequency of complications increased with an increase in the number of co-existing diseases. CONCLUSIONS: The most common co-existing diseases in abdominal surgery are arterial hypertension, chronic heart failure, coronary heart disease, diabetes mellitus and cardiac arrhythmia. The frequency of postoperative complications was 3.5 %, mortality was 0.43 %; the most frequent complications were paralytic ileus, wound infection and pneumonia.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84825227","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":"Comparison of noninvasive respiratory support methods in the postoperative period in cardiac surgery patients: a prospective randomized trial","authors":"A. A. Eremenko, D. V. Fomina, R. D. Komnov, L. Sorokina, A. Urbanov, Aleksandr A. Eremenko — Dr, Med. Sci","doi":"10.21320/1818-474x-2023-3-97-107","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-97-107","url":null,"abstract":"INTRODUCTION: The frequency of respiratory failure in the postoperative period is 17–22 % [1–3]. The most commonly used methods: noninvasive positive pressure mask ventilation (NIPPMV), high-flow nasal cannula (HFNС), noninvasive positive pressure helmet ventilation (NIPPHV). OBJECTIVE: Comparison of the effectiveness of respiratory support methods depending on their effect on gas exchange in patients with mild to moderate respiratory failure in the early period after cardiac surgery. MATERIALS AND METHODS: The study included 42 cardiac surgery patients with 200 < P/F < 300 who were divided into 3 groups depending on the methods of respiratory support used (NIPPMV, HFNС, NIPPHV). The main point of the study is to assess the dynamics of the gas exchange indicators before, during and after their use. RESULTS: All three methods of NIVL contribute to a statistically significant improvement in gas exchange during NIVL, which persisted after the end of therapy (SpO2, PaO2, P/F, Qsp/Qt). In the group with the use of NIPPMV and HFNС an increase in the oxyhemoglobin fraction. In the course of this study, no data were revealed on changes in PaCO2. The largest increase in SpO2 was revealed in groups using a mask and helmet, but at the end of the NIVL session there were no statistically significant differences between the groups. A decrease in the proportion of patients with P/F < 300 after a single session in the NIPPMV group by 2 times, in the HFNC group — by 1.6 times, in the NIPPHV group — by 3.5 times. CONCLUSIONS: Conducting noninvasive respiratory support significantly improves the indicators of oxygenating lung function in the early postoperative period in cardiac surgery patients. NIPPHV and NIPPMV are more effective compared to HFNC. When using a helmet, a higher level of support is required.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79248628","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":"Clinical and laboratory signs of multiple organ dysfunction in newborns with intraamniotic infection: prospective observational study","authors":"Y. Aleksandrovich, D. Ivanov, E. Pavlovskaia, K. V. Pshenisnov, D. A. Zemlyanoy","doi":"10.21320/1818-474x-2023-3-137-148","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-137-148","url":null,"abstract":"INTRODUCTION: Assessment of the severity of the condition of newborns with intra-amniotic infection is extremely important for neonatal intensive care. OBJECTIVE: To study signs of multi-organ dysfunction in newborns with intra-amniotic infection. MATERIALS AND METHODS: 165 newborns who are being treated in the NICU were examined. The weight of the children was 1870 (1480–2550) g, the Apgar score at the first minute was 7 (6–7), at the fifth — 8 (7–8) points. Depending on the gestation period, the children were divided into 4 groups: I — 26–29, II — 30–33, III — 34–37 and IV — 38–40 weeks. In groups I–III, children with respiratory distress syndrome and intraamniotic infection prevailed, and in groups IV — with asphyxia. RESULTS: The maximum score on the NEOMOD scale of the ball is typical for children of groups I and IV: 4 (3–5) and 3 (1–4) points, respectively. The number of leukocytes in group IV newborns on the first day of treatment was statistically significantly higher than in groups II and III: 19.6 (8.5–43.7) vs 12.4 (5.8–33.1) and 12.5 (6.4–32.5), respectively (p = 0.003). Вase excess indicators in group I were statistically significantly lower than in group IV: −7.2 vs −4.2 (p < 0.001). The minimum concentration of C-reactive protein was typical for group I children — 1.7 (1.3–2.2) mg/l, which was significant compared to the indicators of other groups (p < 0.001). CONCLUSIONS: The most pronounced multiple organ dysfunction was observed in newborns with a gestation period of 26–29 and 38–40 weeks, which is confirmed by high scores on the NEOMOD scale, an increase in the number of leukocytes and neutrophil index indicators. Hemodynamic disorders in newborns with a gestation period of 26–29 weeks are the main factor determining the severity of the child's condition and the NEOMOD score.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78086674","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":"Virtual reality therapy in patients after trauma surgery: prospective clinical trial","authors":"Grigory E. Lysenko, A. V. Shchegolev, B. N. Bogomolov, D. Meshakov","doi":"10.21320/1818-474x-2023-3-58-65","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-58-65","url":null,"abstract":"INTRODUCTION: Postoperative pain is a common problem. The use of non-drug treatments can reduce the need for medications. The use of Virtual Reality Therapy (VR-therapy) is being widely studied as a complementary treatment for acute and chronic pain. The lack of data on the effectiveness of the technique in patients after traumatological surgical interventions became the basis for this study. OBJECTIVE: To determine the effectiveness of VR-therapy as a method of additional treatment of postoperative pain in patients after traumatological surgical interventions. MATERIALS AND METHODS: A prospective clinical study included 70 patients admitted for elective trauma surgery. VR-therapy in combination with medicated analgesics was used in 35 patients. The control group included 35 patients who, after performing similar surgical interventions, were given pain relief only with medication. Virtual reality therapy was performed using an Oculus Quest 2 device. Sessions of 25 minutes were performed 3, 7, 12 hours after the operation. The effectiveness of pain therapy was assessed using a numerical rating scale. The response of the endocrine-metabolic response to pain was assessed by changes in the concentration of cortisol and adrenocorticotropic hormone (ACTH). RESULTS: Therapy based on drug analgesia in combination with virtual reality sessions led to a better quality of pain relief for patients after trauma surgery. After a session of VR, the decrease in scores on the pain self-assessment scale was 44 %. When compared with the results obtained the next day, the values in the main group were lower by 22 %. The need of patients of the main group for narcotic analgesics significantly decreased. The change in the concentration of ACTH, as an indicator of the endocrine-metabolic response, in the group with VR-therapy was 18 % less pronounced. CONCLUSIONS: The use of VR leads to a decrease in postoperative pain, endocrine-metabolic response and the need for opioid analgesics.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78147473","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":"Evaluation of the use of combined extracorporeal detoxification in patients with severe acute pancreatitis: a retrospective cohort study","authors":"S. V. Masolitin, D. N. Protsenko, I. N. Tyurin, T. G. Kim, M. Magomedov, L. A. Grishina, E. B. Gelfand, O. Ignatenko, A. Bykov, E. Y. Kalinin, A. V. Yaralyan","doi":"10.21320/1818-474x-2023-3-108-121","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-108-121","url":null,"abstract":"INTRODUCTION: Morbidity and mortality of severe acute pancreatitis (SAP) remains high. The most important direction of therapy is the relief of endotoxicosis. The use of extracorporeal detoxification (ECD) is a debatable problem. OBJECTIVE: Improving the results of treatment of patients with SAP, through the use of ECD methods. MATERIALS AND METHODS: The study included 25 patients. Group 1: ECD included 9 patients who used standard therapy with selective hemoperfusion (HP) and continuous veno-venous hemofiltration (CVVHF). Group 2 (control) 16 patients received standard therapy. We performed a comparative analysis of the main clinical and laboratory parameters and treatment outcomes between the groups. RESULTS: The use of ECD allowed to reduce the number of leukocytes from 14.9 to 8.6 × 109/l by 5 days of therapy in group 1, and from 17.6 to 16.1 × 109/l in group 2, respectively. The dynamics of CRP concentration from 1 to 5 days changed from 315.6 to 184.6 mg/ml and 274.2 to 352.9 mg/ml in groups 1 and 2, respectively. The level of PCT concentration on days 1–5 decreased from 4.5 to 2.1 ng/ml and 3.95 to 6.9 ng/ml in groups 1 and 2, respectively. The concentration of IL-6 decreased from 1624.3 to 914.3 pg/ml in group 1, and increased from 1529.8 to 1861.8 pg/ml in group 2, respectively. The dynamics of pH in group 1 was from 7.14 to 7.4 by the 5th day of therapy and 7.13 to 7.22 in group 2, respectively. SOFA by day 5 in group 1 was 4 points and 11 points in group 2, respectively. CONCLUSIONS: The use of HP and CVVHF in complex intensive care is accompanied by a significant regression of markers of endogenous intoxication, resolution of the acid-base state and reduces the severity of organ dysfunction and the risk of adverse outcomes, compared with standard treatment.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80696312","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":"Transpyloric feeding with artificial lung ventilation in premature with pneumonia: an observational study","authors":"O. G. Smirnov, V. Gorbachev, V. A. Novozhilov","doi":"10.21320/1818-474x-2023-3-149-154","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-149-154","url":null,"abstract":"INTRODUCTION: Feeding critically ill patients on mechanical ventilation through a gastric tube can be challenging. Parenteral nutrition is often preferred when enteral feeding is problematic. Transpyloric feeding has been identified as an optimal method of nutrition for seriously ill premature infants. OBJECTIVE: This study aims to evaluate the advantages of transpyloric feeding combined with artificial ventilation compared to gastric feeding in premature neonatal patients. MATERIALS AND METHODS: The study included 64 patients with low tolerance to enteral feeding who required mechanical ventilation. The gestational age of the patients did not exceed 34 (32–35) weeks. Enteral feeding using a NAN® mixture was administered through a feeding tube placed outside the pylorus with an anti-reflux mechanism. The volume of enteral feeding was determined based on the requirement of 120 kcal/kg/day. RESULTS: The results of the study demonstrated that the group receiving transpyloric feeding had a significantly shorter hospital stay of 54 (41–67) days compared to the group receiving gastric feeding with 86 (64–94) days, p < 0.05. The weight gain in the group receiving gastric feeding was significantly lower at 89 (55–200) g compared to the group receiving transpyloric feeding with 161.5 (110–218) g. Similar findings were observed regarding a decrease in total protein levels on the 10th day of the study in the gastric feeding group with 36.5 (32–40) g/l compared to the transpyloric feeding group with 47 (42–50) g/l, p < 0.05. CONCLUSION: Transpyloric nutrition in premature infants on mechanical ventilation is a more efficient method compared to gastric feeding. The findings suggest positive effects including reduced hospitalization duration, prevention of hypoproteinemia, and significant increase in body weight.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82718478","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":"Chronic Disorders of Consciousness: guidelines of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists”","authors":"A. Belkin, E. V. Aleksandrova, T. V. Akhutina, V. Belkin, E. S. Berdnikovich, V. I. Bykova, N. Varako, I. A. Voznyuk, E. Gnedovskaya, V. N. Grigoryeva, O. Zaytsev, Yu. P. Zinchenko, G. E. Ivanova, N. E. Ivanova, M. S. Kovyazina, A. N. Kondratyev, E. Kondratyeva, S. Kondratyev, V. Krylov, Ya. A. Latyshev, K. M. Lebedinskii, L. Legostaeva, O. A. Maksakova, M. Martynov, Y. Mikadze, S. Petrikov, M. V. Petrova, M. Piradov, K. Popugaev, I. Pryanikov, Y. Ryabinkina, I. Savin, D. Sergeev, M. Sinkin, A. Skvortsov, E. Y. Skripay, A. Suvorov, N. Suponeva, D. Usachev, E. Fufaeva, N. Shamalov, A. V. Shchegolev, E. Iazeva, I. Zabolotskikh","doi":"10.21320/1818-474x-2023-3-7-42","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-7-42","url":null,"abstract":"Chronic disorders of consciousness (DOC) represent severe central nervous system damage resulting in long-term disability and a significant burden to healthcare institutions and patientsʼ families. DOC develop in patients after coma and are characterized by the presence of wakefulness with complete or almost complete absence of signs of awareness. DOC include vegetative state (VS) and minimally conscious state (MCS). The term prolonged disorders of consciousness (pDOC) is also used in the Russian literature to describe the initial stages of chronic DOC. Another clinical entity, exit from MCS, is used to characterize the stage of recovery of cognitive functions. Diagnosis of DOC is based on repeated structured clinical examination using specific scales, provided that reversible causes of impaired consciousness are excluded. Treatment of DOC patients includes maintenance of vital functions and optimal nutrition and control of typical complications and concomitant conditions (pressure sores, spasticity, pain, paroxysmal sympathetic hyperactivity, etc.). Rehabilitation of DOC patients should involve a multidisciplinary rehabilitation team, the extent of which is determined by the individual problems and capabilities of the patient. Rehabilitation is most effective if started early. To date, there is no robust evidence on the effectiveness of specific methods for restoring consciousness, while a number of pharmacological and non-pharmacological interventions are being studied; however, they should be applied provided that the maximum possible level of correction of the patientʼs somatic problems is achieved. The family plays a key role in rehabilitation. They need practical information about their loved oneʼs condition, guidance in rehabilitation, and psychological support.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80339776","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":"Impact of multizonal decontamination of upper respiratory tract on incidence of ventilator-associated pneumonia: multicenter randomized pilot study","authors":"К. S. Lapin, Е. V. Fot, V. Kuzkov, М. Y. Кirov","doi":"10.21320/1818-474x-2023-3-66-81","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-66-81","url":null,"abstract":"INTRODUCTION: Ventilator-associated pneumonia (VAP) is the one of nosocomial infections in intensive care units. VAP can result in prolonged duration of hospitalization and invasive mechanical ventilation (MV) that is associated with attributive mortality. OBJECTIVE: The aim of our pilot multicenter randomized study was to assess effect of the multizonal decontamination of upper airway including subglottic space on the VAP incidence and time of onset, as well as colonization upper airway and clinical outcomes. MATERIALS AND METHODS: Sixty patients requiring the prolonged MV were included in the prospective study. All participants were randomized into three groups: the control, the local antiseptic (LA) and the bacteriophage (BP). All patients were managed using similar VAP protective bundle. Infection-related ventilator-associated complications (IVAC) were registered based on clinical, laboratory, and instrumental examination. Diagnosis of VAP was confirmed if CPIS was ≥ 6 points. RESULTS: A total incidence of IVAC did nоt differ between groups: 15 (75 %), 14 (70 %), and 17 (85 %) cases in the control, LA, and BP groups, respectively. The VAP incidence was lower in the LA and BP groups compared with the controls: 3 (15 %) and 3 (15 %) vs 10 (50 %) cases (χ2 = 8.35; p = 0.015). The overall mortality was 30 % and did not differ between the groups. Multi-selective decontamination resulted in a trend to increased ventilator-associated tracheobronchitis incidence in the BP group and to silent colonization in both LA and BP groups (p = 0.07). No differences in the duration of MV, ICU and hospital stay were observed. CONCLUSIONS: The combined multizonal upper airway decontamination involving subglottic space is associated with a reduction of the VAP incidence but did not change the overall IVAC rate. Multizonal decontamination based on subglottic bacteriophage instillation might have a potential to influence the microbial heterogeneity of upper airways.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89396952","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":"Effects of succinates on the inflammatory response: a review","authors":"V. V. Lazarev, P. E. Anchutin","doi":"10.21320/1818-474x-2023-3-155-165","DOIUrl":"https://doi.org/10.21320/1818-474x-2023-3-155-165","url":null,"abstract":"INTRODUCTION: Endogenous succinate functions as a pro-inflammatory factor, while exogenous succinate — as an anti-inflammatory factor. The mechanisms of effect of succinates on the inflammatory response are not fully understood. OBJECTIVE: Generalization of the current scientific knowledge on the use of exogenous succinate in inhibition of the inflammatory response. MATERIALS AND METHODS: The PubMed, Web of Science, Google Scholar, Scopus, and eLibrary international databases were used to search for relevant articles. The search keywords were: “succinic acid”, “amber acid”, “inflammation”, “meglumine sodium/solution”. The search was limited to articles published between 2012 and December 2022. The inclusion criteria were: 1) research focused on the cellular energy supply in inflammation; 2) effects of succinate on the inflammatory response intensity due to changes in the cellular energy supply; 3) correlation of the cellular energy supply with clinical and laboratory inflammatory indicators when succinate-containing drugs are used; 4) original studies. RESULTS: The initial identification analysis included over 200 published studies. After the screening, 84 full-text articles meeting the selection criteria were included in the final review: 31 literature reviews, 24 of which are dedicated to the pro-inflammatory effects of endogenous succinate, and 7 — to the anti-inflammatory effect of exogenous succinate in succinate-containing agents; and 53 original scientific articles: 27 articles are dedicated to the research of molecular mechanisms of endogenous succinate, and 26 articles are dedicated to the study of the clinical use of succinate-containing drugs. CONCLUSIONS: Endogenous succinate is defined as the most important pro-inflammatory factor. Exogenous succinate has a pronounced anti-inflammatory effect mediated by normalization of the immune cell energy supply in hypoxia. No studies have been found on the differences in the mechanism of action of endogenous and exogenous succinate.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89601767","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}