Annals of pulmonary and critical care medicine最新文献

{"title":"What treatment really make sense for critically ill patients with COVID-19: single-center retrospective cohort study","authors":"L. Ermokhina, A.S. Mityashov, S. Perekhodov, N. Chaus, N. Karpun, A. Baeva, K. Kadantseva, M. Yadgarov, A. Kuzovlev, V. Likhvantsev","doi":"10.21320/1818-474x-2021-3-69-79","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-3-69-79","url":null,"abstract":"Introduction. Even now — a year after the pandemic announcement by WHO, there is lack of clinical evidence to confirm the efficacy of the majority of anti-COVID drugs, evenly for general and critically ill patients. Objective. To estimate the efficacy and safety of some anti-COVID-19 drugs as well as the impact of the demographic data and comorbidity on clinical outcomes of critically ill patients. Materials and methods. The single-center retrospective cohort study was performed on critically ill patients admitted to the ICU of Moscow Municipal Hospital No. 68 from March 6 to June 3, 2020. Anthropometric parameters, severity of the condition and comorbidities, as well as CT data, treatment in the ICU, duration of mechanical ventilation and the patients’ length of staying the ICU were taken into account and analyzed. Results. Overall, 403 patients (231 male, average age: 62.4 ± 15.3 years, range from 21 to 97 years) were enrolled into the study. In hospital mortality rate appeared to be 44.9 % (181/403) and was equal for men and for women (p = 1,000). The application of low molecular weight heparin was the single one significant predictor of mortality reduction according to the results of multivariate analysis — HR = 0.742 (0.545–0.991), p = 0.045. The main unmodifiable predictors for mortality elevation in the ICU were: age 65+ (RR 2.116 [1.680–2.664], p < 0.001) and Charlson’s comorbidity index (HR 1.136 [1.087–1.188], p < 0.001). The group of patients with a fatal outcome had a higher comorbidity index, the number of points on the SOFA scale (p < 0.001), as well as a larger median number of days in the ICU (p = 0.012). Conclusions. Current study has convincingly proved that low molecular weight heparin to be used for while treating severe acute respiratory syndrome coronavirus 2 patients in intensive care settings. © 2021, Practical Medicine Publishing House LLC. All rights reserved.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87169102","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":"Anesthesiologists-reanimatologists of Russia: a professional portrait of the community. A survey","authors":"A. Volkov, A. Ilyin, K. M. Lebedinskii, I. Zabolotskikh, V. V. Lazarev, V. Mazurok, A. Ovezov, E. Shifman, A. Shchegolev, G.N. Vasilyeva","doi":"10.21320/1818-474x-2021-4-21-32","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-4-21-32","url":null,"abstract":"Introduction. In different countries, the number, training, field of activity and social status of anesthesiologists vary greatly, as well as the exact professional scope of the specialty. To develop work plans and develop the professional community, the Federation of Anesthesiologists and Resuscitators of Russia conducted a questionnaire survey on the actual situation of the professional activities of anesthesiologists and resuscitators. Objectives. To characterize the professional component of the sociological portrait of the Russian doctor-anesthesiologist-resuscitator based on the results of a mass survey. Materials and methods. The questionnaire survey (paper forms and online questionnaires) was carried out in 83 regions of Russia; 3108 anesthesiologists and resuscitators participated in the study. Results. The main type of professional activity is: practical work - 96.3 %, teaching - 2.8 %, scientific activity - 0.9 %. It was found that 60 % of the survey participants devote all their working time to practical work, 71.3 % and 74 % of the respondents are not at all engaged in teaching and scientific work, respectively. The positions of respondents, their job responsibilities, categories of organizations, length of service and qualification categories of doctors, self-assessment of the level of professional skill, and ways of improving their qualifications were analyzed. Satisfaction with various aspects of their work, reasons for dissatisfaction with their work, issues of social protection, the desire to change jobs or the nature of work were also assessed. Conclusions. The sample of the survey is skewed, uniting specialists with a high status in the profession and young active colleagues. The need for continuing medical education is not yet sufficiently met. Information about professional vacancies on the website of the Federation of Anesthesiologists and Resuscitators may be a popular information resource.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81663913","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":"A prospective randomized pilot study: The impact of the depth of neuromuscular blockade and modes of mechanical ventilation on surgical conditions during laparoscopic and robotic surgery","authors":"A. Klimov, A. Malakhova, S. A. Kamnev, S. Rudnitsky, V. Subbotin","doi":"10.21320/1818-474x-2021-2-115-127","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-2-115-127","url":null,"abstract":"","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87938583","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":"Assessment of xenon effect on postoperative pain syndrome severity in oncological patients: a randomized study","authors":"V. I. Potievskaya, F. Shvetskiy, D. Sidorov, M. Lozhkin, M. Potievskiy, G. Abuzarova, R. R. Sarmanaeva, S. Kuznetsov, G. S. Alekseeva","doi":"10.21320/1818-474x-2021-3-140-150","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-3-140-150","url":null,"abstract":"","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86698920","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":"Differential diagnostic capabilities of calculating the level of neutrophil extracellular traps in the venous blood of pregnant women: a comparative prospective study","authors":"N. B. Kuzina, E. N. Plakhotina, A. Kuzovlev, T. N. Belousova, E. V. Bryantsev, D. V. Kasina","doi":"10.21320/1818-474x-2021-4-79-87","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-4-79-87","url":null,"abstract":"Introduction. Severe preeclampsia in early stages can be detected by isolated thrombocytopenia, which makes it difficult to diagnose it in time and carry out the necessary therapeutic measures. As a rule, the diagnosis of severe preeclampsia can be declared with a detailed clinical and laboratory researches, and it increases the risks for the mother and the embryo. However, if there are no clinical symptoms of preeclampsia except of thrombocytopenia, there is a problem of differential diagnosis between thrombocytopenia, which has the same symptoms as preeclampsia and gestational thrombocytopenia, which is a physiological peculiarity and does not require any medical interventions and restrictions. Nowadays there are no screening methods for differential diagnosis of these conditions. Objectives. To estimate the possibilities of determing the level of neutrophil extracellular traps (NETs) during the differential diagnosis of preeclampsia and gestational thrombocytopenia. Materials and methods. The comparative analysis of the level of NETs was carried out in three groups of pregnant women. Group 1 included patients with severe preeclampsia (n = 45), group 2-patients with gestational thrombocytopenia (n = 44) and group 3 consisted of healthy pregnant women (n = 44). Results. The research revealed significant increase in the level of NETs in the group of patients with preeclampsia (15.26 %,) compared with the groups of healthy patients (7.65 %, p = 0.001) and patients with gestational thrombocytopenia (7.04 %, р = 0.002). There were no significant differences in the level of NETs between the groups of healthy patients and patients with gestational thrombocytopenia. Conclusions. A significant increase of the level of NETs among the patients with severe preeclampsia allows us to consider the method of calculating the level of NETs among patients with thrombocytopenia which can be detected after the 20th week of pregnancy, if there are no other laboratory and clinical signs of preeclampsia as a screening method for early diagnosis of this complication.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90766941","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 REMS, NEWS, qSOFA scales and SIRS criteria in sepsis prediction for patients with confirmed SARS-CoV-2 infection: retrospective observational study","authors":"K. Zybin, A. A. Noskov, T. Musaeva, M. Kuznetsova, S. Goncharenko, O. Vysotsky, P.I. Danilyuk, E. S. Petrushenko, M.I. Veselenko, A. Potapova, S. V. Sinkov, V. M. Durleshter","doi":"10.21320/1818-474X-2021-1-48-56","DOIUrl":"https://doi.org/10.21320/1818-474X-2021-1-48-56","url":null,"abstract":"Introduction. Novel coronavirus disease is often accompanied by sepsis. This leads us to search of sepsis prediction tools. Objectives. Comparison of REMS, NEWS, qSOFA scales and SIRS criteria in sepsis prediction for patients with confirmed SARS-CoV-2 infection. Materials and methods. 167 medical cards retrospective analysis of patients with confirmed SARS-CoV-2 infection on admission to ICU. Results. In sepsis prediction only NEWS (0,819 [95% CI 0.738–0,884]) showed resolution high enough to serve as supplemental clinical information. REMS (0.798 [95% CI 0.715–0.866]), qSOFA (0.716 [95% CI 0.626–0.795]) and SIRS criteria (0.710 [95% CI 0.620–0.790]) showed insufficient resolution in sepsis prediction for patients with SARS-CoV-2. NEWS in pairwise comparison showed significantly better resolution than qSOFA (p = 0.002) and SIRS criteria (p = 0.013). All scales showed good calibration. Conclusions. Only NEWS scale showed good resolution and calibration and can be used as supplemental clinical information in sepsis prediction for patients with SARSCoV-2 infection.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89153358","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":"The prognostic value of changes in the plasma cytokine profile of neuroresuscitation patients with ventilator-associated pneumonia: two center observational study","authors":"E. Zinina, S. V. Tsarenko, D. Logunov, A. Tukhvatulin, M. Magomedov, A. Babayants, A. Avramov","doi":"10.21320/1818-474x-2021-4-48-58","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-4-48-58","url":null,"abstract":"Objectives. This study was performed to find changes in the plasma cytokine profile of neuroresuscitation patients with ventilator-associated pneumonia, and to search for prognostic markers of effectiveness of antibacterial treatment of ventilator-associated pneumonia. Materials and methods. A two-center clinical study, that included 73 patients aged 19 to 82 years with neurosurgical and neurological pathology and signs of ventilator-associated pneumonia (VAP) was conducted. On the 1st and 3rd days of antibiotic therapy, plasma samples were taken from patients, in which the concentration of 59 cytokines was determined. Retrospectively, patients were divided into groups of favorable and unfavorable clinical course of VAP. Predictors of the clinical course of the disease were identified using statistical methods, ROC analysis, and logistic regression. Results. Matrix metalloproteinase-2 (MMP-2) was the most sensitive predictor of the clinical outcomes of VAP in neuroresuscitation patients. In the group of patients with an unfavorable VAP, the concentration of MMP-2 in plasma was initially increased, but significantly decreased by the 3rd day, in contrast to the group with good outcomes. The logistic regression model predicted the clinical course of VAP with an accuracy of 69.2 %. Less sensitive but significant predictors of the clinical course of the disease were cytokines: interleukin-1 receptor antagonist, interleukin-6, granulocyte colony-stimulating factor, tumor necrosis factor superfamily member 14, osteocalcin, pentraxin, thymic stromal lymphopoietin, element 12 of the tumour necrosis factor ligand superfamily, and interleukin-12. Conclusions. Measurement of plasma cytokine levels is a prospective method to determine the effectiveness of antibacterial therapy in VAP. Matrix metalloproteinase-2 is a sensitive predictor of the clinical course of VAP in neurosurgical patients.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79507559","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":"Current trends in management of hyperglycaemia in surgical patients with diabetes mellitus: a review","authors":"Ю. Матри, Н. П. Барлоу, Щ. Х. Твейт, Э.-М. Рингвольд, V. Kuklin, J. Matri, N. P. Barlow, S. Tveit, J. Kvernberg, E. Ringvold, V. Dahl","doi":"10.21320/1818-474x-2021-4-33-47","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-4-33-47","url":null,"abstract":"A large amount of clinical evidences demonstrates a clear association between long-term and/or stress-related hyperglycaemia, and development of complications after surgery. The incidences of perioperative hyperglycaemia are demonstrated in 20-80 % of all cases depending on the type of elective surgery, with the h ighest rate registered in cardiac surgery. The most studied pathophysiological complications of long-term hyperglycaemia in Diabetes Mellitus (DM) patients are; activation of the polyol pathway, diacylglycerol/protein kinase C and hexosamine pathways, advanced glycation product formation, and oxidative stress. The uncontrolled stress-related hyperglycaemia during and after surgery instigates: osmotic diuresis with further fluid and electrolyte imbalance, increased gluconeogenesis and glucogenolysis, breakdown of fats into free fatty acid and glycerol, proteins into amino acids, and increases generation of pro-inflammatory cytokines. All these changes may lead to development of diabetic ketoacidosis, immune deregulation and insulin resistance. Some clinical investigations seems to indicate that anaesthesia with propofol may have some advantages in keeping of stable blood sugar over inhalational agents. Two clinical trials comparing the influence of different anaesthetic agents on perioperative glycaemic status in diabetic patients are currently underway. For better management of perioperative hyperglycaemia in diabetic patients under surgery we have proposed several important practical principles.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80504953","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":"Value of combined lactate and central venous oxygen saturation measurement in patients with sepsis: a retrospective cohort study","authors":"K. Sitthikool, J. Boyd, J. Russell, K. Walley","doi":"10.21320/1818-474x-2021-4-59-68","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-4-59-68","url":null,"abstract":"Introduction. Lactate and central venous oxygen saturation (ScvO2) reflect tissue hypoperfusion but each measure is confounded by many additional factors. These confounding factors differ between lactate and ScvO2. Objectives. We postulated that combined assessment of lactate and ScvO2 may yield information beyond that of each measure alone. Specifically we sought to determine whether lactate has different characteristics and predictive value at different levels of ScvO2. Material and methods. We conducted a retrospective analysis of a Derivation cohort and a Validation Cohort of sepsis patients with lactate and ScvO2 measured within the first 4 hours of intensive care unit admission and 12 hours after resuscitation. Patients were grouped according to: 1) ScvO2 < 60 %; 2) 60 % < ScvO2 < 80 %; 3) ScvO2 > 80 %. Results. Lactate was negatively correlated with ScvO2 in the ScvO2 < 60 % group in both cohorts but was not correlated with ScvO2 in the other ScvO2 groups. Using receiver operator characteristic analysis in the Derivation Cohort, in the ScvO2 > 80 % group lactate was predictive of 28-day mortality with an area under the ROC curve (AUC) of 0.94 and an optimal threshold lactate of 3.0 mmol/L. Using this threshold in the ScvO2 > 80 % groups, 28-day mortality was 32.7 %. Conclusions. Lactate has different characteristics and predictive value at different levels of ScvO2. When ScvO2 < 60 % correlation between lactate and ScvO2 is consistent with a degree of oxygen supply limitation. When ScvO2 > 80 % lactate > 3.0 mmol/L is predictive of mortality.","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74034075","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":"Airway management in hospital. Methodological recommendations of the All-Russian public organization “Federation of Anesthesiologists and Reanimatologists” (third edition)","authors":"A. Andreenko, I. V. Bratishchev, S. Gavrilov, A. Zaitsev, V. Pikovsky, V. Stadler, V. Stamov","doi":"10.21320/1818-474x-2021-2-17-81","DOIUrl":"https://doi.org/10.21320/1818-474x-2021-2-17-81","url":null,"abstract":"","PeriodicalId":93261,"journal":{"name":"Annals of pulmonary and critical care medicine","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81773388","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}