[Respiratory support in elderly and senile victims with multiple traumas].

Studies of the specific features of acute posttraumatic respiratory failure in old age group victims with multiple traumas have provided an algorithm of mechanical ventilatory support. The advantage of early artificial ventilation with pressure monitoring is substantiated. There is evidence for the necessity of applying noninvasive ventilation in some cases. The proposed respiratory support tactics promoted a 12.1% reduction in mortality rates among elderly and senile victims in an intensive care unit.

[An anesthesiologist-resuscitator's differential tactics in acute traumatic disease].

The detection of four forms of the course of acute traumatic disease (traumatic shock, acute respiratory failure, acute heart failure, and traumatic coma) leads to the conclusion that the multi pathogenic mechanism responsible for progression of the disease generates a need for differentiating the tactics of an anesthesiologist-resuscitator, beginning from the first hours after injury. Therapeutic tactics may be standardized within each specific form of an acute period of traumatic disease. Implementation of specific tactic programs for anesthesiological and resuscitative care in acute traumatic disease has promoted a reduction in mortality from 8.2 to 3.2% in this period.

[Some disputable issues of transfusion therapy in wounded patients].

On the basis of an analysis of the tactics of transfusion therapy in 272 wounded persons and victims with acute massive blood loss, the authors conclude that it is necessary to strictly follow the principle of individual directionality during blood transfusions. By taking into account the high risk of development of iatrogenic complications in the postshock periods of traumatic disease, it is expedient to do away with hemotransfusions in the advancing mode.

[Organization of anesthesiological and resuscitative care delivered to the wounded and patients in the large specialized hospital].

On the basis of an analysis of the specific features of organization of anesthesiological and resuscitative care, the authors formulate a number of points that are of great importance for the quality of work. They give the optimal recommendations for organizing the professional activities of physicians of intensive care units and consultants. The paper presents conceptual sketches of the training of anesthesiologists working in a specialized center are presented. The authors show it necessary to follow the principle in the gradation of anesthesiological and resuscitative care.

[Restrictions on use of prolonged and long-term artificial ventilation of the lungs in the wounded and casualties]. / Ogranichenie pokazanii k prodlennoi i dlitel'noi iskusstvennoi ventiliatsii legkikh u ranennykh i postradavshikh.

On the basis of an analysis of results of treatment of two groups of the wounded and casualties the authors render concrete indications and contraindications for prolonged and long-lasting artificial ventilation of the lungs.

[The modern problems of intensive care in patients with wounds and traumas]. / Sovremennye problemy intensivnoi terapii u ranenykh i postradavshchikh.

The results of rendering the intensive care to 2244 patients with severe wounds and traumas were analyzed, which made it possible to define the most topical problems needed to be resolved, i.e. treatment schemes for patients with vegetative state (similar to coma) and with asthenic syndrome, perfection of intensive care for the elderly and absolutization of some intensive care techniques. Perspective solutions are suggested to cope with the above issues, which comprise a bigger quantity of rehabilitation centers, an elaboration of pathogenetic tactics of intensive care for the elderly patients and revising the feasibility of a long-term use of the intensive care methods with respect to the regulation and integration suppressed by such methods.