[Method of biphasic defibrillation in modern electropulse therapy]. / Metod bifaznoi defibrilliatsii v sovremennoi élektroimpul'snoé terapii.

Cardiovascular diseases, primarily coronary disease, remain the leading cause of mortality in the majority of countries with well-developed economy. Electropulse therapy (defibrillation) is the main method helpful in life-threatening arrhythmias leading to heart arrest. The development of devices generating biphasic pulses is in progress now. Clinical trials confirmed the capacity of a bipolar pulse to arrest cardiac arrhythmia with current of lower strength in comparison with monopolar pulses. Due to low discharge energy, the degree of postresuscitation myocardial dysfunction is essentially decreased. New technology of biphasic pulses developed by Schiller AG Firm (Switzerland), based on the use of Multipulse Biowave device, is a new step in development of urgent care potentialities in severe cardiac arrhythmias in risk groups.

[Nosocomial pneumonia in patients with severe craniocerebral trauma in intensive care units]. / Nozokomial'naia pnevmoniia u bol'nykh s tiazheloi cherepno-mozgovoi travmoi v otdalenii reanimatsii i intensivnoi terapii.

Eighty-three patients with severe craniocerebral injuries (CCI) were treated at Institute of Neurosurgery in 1999. Pulmonary infectious complications occurred in 16 of 25 patients with severe CCI. Early nosocomial pneumonia (NP) was diagnosed in 18% and the so-called late NP (associated with artificial ventilation of the lungs) in 35%. Coma longer than 4 days increased the incidence of NP to 62%. The main pathogens of NP are gram-negative aerobic bacteria (61%), the predominant agent being Pseudomonas aeruginosa (18.9%). 76% isolated microorganisms were multiresistant. The most significant risk factors as regards NP in patients with severe CCI were coma combined with bulbar and pseudobulbar disorders.