[Early fibrobronchoscopy and the microbial flora composition of bronchoalveolar lavage fluid in patients with concomitant injury during treatment in intensive care units].

Resuscitative bronchofibroscopy in victims with severe injury and aspiration has been shown to be both a method for diagnosing damages to the bronchus and lung and that for recovering airway patency in them. The most common involvement (47% of cases) in chest injury has been noted to be the lower lung with the development of pyoinflammatory processes caused by etiologically significant microorganisms, such as Staphylococcus aureus and types of Enterobacteriacea, in most cases (more than 50%).

[Syndrome of mutual aggravation of injuries in patients with a combined trauma].

An analysis of 1458 case histories of patients with a combined trauma has shown that 276 of the patients died, the lethality was 18.9%. The severity of each injury was estimated by the AIS scale, the severity of combined traumas--by the ISS scale. The syndrome of mutual aggravation of injuries manifested itself most brightly in the cases where one or more main injuries were dangerous for life. Of the greatest importance was an addition of the closed chest trauma to the dominating injury that resulted in a greater number of bronchial-pulmonary complications. Severe damages of the loco-motor system increased the number of thrombo- and fat embolism.

[Assessment of the immunological reactivity of the body using skin tests with bacterial antigens in patients suffering from severe trauma]. / Otsenka immunologicheskoi reaktivnosti organizma metodom kozhnykh prob s bakterial'nymi antigenami u postradavshikh s tiazheloi travmoi.

The dependence of cell-mediated reaction to antigens on circulation and respiration in traumatic shock has been established in two groups (60 patients each) during resuscitation, using skin tests with 5 bacterial antigens (Ps. aeruginosa, E. coli, Proteus, tuberculin, staphylococcus). Patients with trauma and decompensation of vital body functions are at high risk of infectious complications, as they are characterized by anergy, i.e. the absence of cell-mediated reactions to antigens, which leads to a higher incidence of infectious complications in them. Skin tests with bacterial antigens serve as a reliable and simple method for identification of patients at high risk of infectious complications in intensive care units.

[Routes of the transmission of Pseudomonas aeruginosa infection in resuscitation and intensive therapy departments]. / Puti peredachi sinegnoinoi infektsii v otdeleniiakh reanimatsii i intensivbnoi terapii.

To find out if the transfer of P. aeruginosa infection by droplet route is possible in resuscitation and intensive care units, the bacteriological study of air samples taken in different rooms of resuscitation units (altogether 234 air samples) was carried out with the subsequent identification and typing of isolated P. aeruginosa strains. In most cases (70.5%) the microbial contamination of the air in the main rooms of resuscitation units was found not to exceed 500 microbial cells per cu. m, and no P. aeruginosa strains were isolated. The identification and typing of six P. aeruginosa strains isolated from the air of an isolation ward for patients with infectious complications made it possible to find out intraspecific differences of these microorganisms, as all of them belonged to strains of different sero- and pyocinotypes. Thus, the results of these investigations indicate that the droplet route of the transfer of P. aeruginosa hospital infection is not characteristic of resuscitation and intensive care units, as no P. aeruginosa strains are isolated from the main rooms of such units; likewise, no circulation of this microorganism was observed in the air of an isolation ward for patients with infectious complications.

[Hospital infection due to Pseudomonas aeruginosa in resuscitation departments]. / Gospital'naia infektsiia, obuslovlennaia sinegnoinoi palochkoi, v otdeleniiakh reanimatsii.

The bacteriological survey of resuscitation and intensive care units has revealed the presence of P. aeruginosa strains in the microflora in 69.4% of cases. The circulation of 1-2 P. aeruginosa strains, identical in their serovar and pyocin type, is indicative of the presence of hospital infection and, therefore, the endogenous character of the contamination of patients. P. aeruginosa hospital strains are the main causative agents of infectious complications in the patients treated in resuscitation units.