[Protein malnutrition in patient in the early postoperative period after uncomplicated removal of the brain tumors].

Malnutrition leads to adverse effects and may worsen clinical outcome. Surgery as a stress factor activates pathological reactions changing metabolism structure. The aim of this study was to evaluate changes of protein metabolism in patients after elective neurosurgical operation. 24 patients were prepared for elective surgery and were enrolled in this study. Evaluation of each patient included: measurement of anthropometric indices--height, weight, arm circumference and the triceps skinfold thickness, the definition of protein loss by determining the loss of nitrogen in the urine, assessment of protein catabolism, determining the violations of nutritional status upon the base of laboratory parameters. During the course of the conducted investigation significant (p < 0.05) decrease in the indices of total protein, albumin, transferrin and the absolute numbers of lymphocytes in the postoperative period was revealed. All the patients developed severe protein catabolism. It became clear that uncomplicated elective surgical intervention, together with the adopted scheme of the nutritional therapy leads to severe protein catabolism in all patients.

[Using ASV mode for respiratory support withdrawal in patients after posterior fossa surgery].

The study gives data on how to improve the way from mechanical to spontaneous breathing in patients with weakened respiratory drive after posterior fossa tumor removal. We compared the effectiveness of two methods of weaning from mechanical ventilation in these patients. The main group consisted of 6 patients weaned from ventilator with ASV mode. The control group was made up of 10 patients weaned from ventilator with SIMV or PS modes. The duration of weaning from ventilator using ASV mode was significantly shorter than with SIMV or PS modes. During ASV ventilation spontaneous breath rate gradually increased. In all patients the level of P0,1 index representing respiratory center activity was initially lower than normal. While spontaneous breath activity increased the level of P0,1 index also gradually normalized. Plmax index (respiratory effort index) measured once a day increased as well. Weakened respiratory drive is accompanied by P0,1 and Plmax indexes' decrease in patients after posterior fossa tumor removal. ASV mode in these patients allows quicker weaning from mechanical ventilation.

[Funtcional and morphological changes in nasal mucosa in patients presenting with septal deformation].

This study was designed to obtain morpho-functional characteristics of nasal mucosa associated with septal deformation. It has demonstrated disturbances in the mucociluary transport, compromised mucosal immunity, and morphological changes in the nasal cavity.

[Continuous mechanical ventilation in a neurosurgical intensive care unit (one-year analysis of results)].

This was a retrospective study. Its inclusion criterion was mechanical ventilation (MV) for more than 48 hours. One hundred and eighty-four case records of 184 neurosurgical intensive care unit patients were analyzed. Ventilation modes, upper airway cares and prosthetic replacement were chosen by the protocol accepted at the Institute. Great differences were found in the structure of indications for MV and in the duration of respiratory support in relation to the neurosurgical nosological entity and the site of a major process. The upper airway care protocols accepted at the Institute were shown to reduce the incidence of ventilator-associated pneumonia. Some risk factors for ventilator-associated pneumonia were identified.