EXTRAVASCULAR LUNG WATER IS A PREDICTOR OF DEVELOPMENT OF MULTIPLE ORGAN FAILURE IN CHILDREN WITH SEVERE BURN INJURY.

The Aim: to determine if an increased extravascular lung water level (EVLW) would be a predictor of multiple organ failure in pediatric patients with severe burn injury.

Materials And Methods: a prospective study included 33 pediatric patients with burn surface from 30 to 90% of the total body surface area, admitted to PICU. All the patients were monitored with PICCO-technology advanced hemodynamic monitoring, that included an analysis ofEVLW level every 6 hours during first 48 hours after PICU admission.

[PRACTICE OF CLINICAL NUTRITION IN PEDIATRIC INTENSIVE CARE UNITS: RESULTS OF THE "NUTRIPED-2015" RESEARCH.].

The secondstudy of nutritional support in the pediatric intensive care unit in critical conditions in Russia "NutriPed-2015" were presented. The authors noted that modern clinical nutrition technologies were widely used among 167 critical patients aged 0 to 18 years in 31 PICU in Russia. The number ofpatients receiving all components of the preparations for parenteral nutrition has increased significantly in comparison with the study NutriPed-2013.

[RUSSIAN NATIONAL EPIDEMIOLOGICAL STUDY "RUVENT": THE USE OF ARTIFICIAL LUNG VENTILATION IN THE INTENSIVE THERAPY IN CHILDREN].

Unlabelled: Purpose of this part of the "RuVent" research is to study the real use of the various modes and parameters of prolonged respiratory support in children in Russia.

Materials And Methods: The study included 104 children from 29 ICUs (28 in Russian Federation, 1 in Ukraine) under the age of 15 years with ALV duration more than 12 hours in the period from February 7 to 11, 2011. The collection of information performed through online forms.

[Russian national observational study of nutritional support in children in the ICU--"NutriPed.ru"].

The article deals with results of the first Russian national observational study of nutritional support in children in the ICU. We assessed a frequency of use of enteral and parenteral nutrition and analyzed preparations for enteral and parenteral nutrition. The article discusses methods of the calculation of malnutrition in children in critical states.

[Study of glutamine solution use efficiency in pediatric patients with heavy thermic burns and concomitant injuries in the intensive care unit].

Comparing analysis of randomized study was conducted. 40 Pediatric patients (2-15 years old) with heavy thermic burns and concomitant injuries were recruited into the study to assess the glutamine solution intravenous use efficiency. Parenteral feeding and feeding with glutamine solution intravenous use were clinicaly and laboratory compared Duration of mechanical ventilation decreased in group of feeding with glutamine solution intravenous use.

[Application of artificial lung respiration in intensive care units in Russia: national epidemiological research "RuVent"].

Unlabelled: The purpose of the research is to study the real use of the various modes and parameters of prolonged respiratory support in Russia.

Materials And Methods: The study included all patients from ICU with no limitation by sex and age with ALV duration more than 12 hours in the period from February 7 to 11. 2011.

[Application of bis monitoring in children during intensive therapy of severe traumatic brain injury].

The article presents the experience of the BIS monitoring in comparison with indicators of the pediatric Glasgow coma scale in 20 children with severe traumatic brain injury. Analyzed sample consists of 881 observations that contain two variables that contain high-quality sequence (a score on a scale of Glasgow in grades) and quantitative discrete values (the values of BIS). The Analysis is carried out by the nonparametric statistics with the definition of the relation between quality and quantity of ordinal traits by the rank correlation.

[Hemodynamic correction in children with severe traumatic injuries by the means of transpulmonary hemodilution].

The purpose of the research is t objectify the indications for use of catecholamines and/or change of the infusion therapy volume based on transpulmonary thermodilution in children with severe traumatic injuries. The examined group consisted of 22 children with thermal concomitant or isolated trauma and drowning. All the patents were transferred to the Intensive Care Unit from other hospitals.

[Hypernatremia as a predictor of poor outcomes in children with severe brain injury].

The aim of the study was to elucidate a relationship between the development of hypernatremia and the frequency of poor outcomes in children with severe brain injury (SBI). The retrospective study enrolled 77 children (54 boys and 23 girls) aged 1 month to 18 years, who had SBI in the period of January 2008 to September 2009, and were divided into 3 groups after treatment termination. The admission injury severity criterion was Glasgow coma scale (8 scores or less) rating.

[Efficiency of pre-emptive analgesia using ketoprofen in a program of combined regional anesthesia in pediatric orthopedics].

It is difficult to make an objective assessment of postoperative pain in children so anesthetic methods must ensure prolonged effective analgesia. The study was undertaken to determine the efficiency and duration of analgesia when using ketoprofen in a combined regional anesthesia (CRA) program in children aged 13 to 15 years who had correctable supracondylar osteotomy of the hip. Preference is given to preventive parenteral administration of ketoprofen.

[Organization of specialized health care of children who have suffered during traffic accidents in the Moscow Region].

The paper describes some experience in organizing and delivering specialized emergency health care to children who have suffered during traffic accidents in the Moscow Region, by attracting the forces and means of a disaster medicine service. In May 2004 to October 2008, examinations were made among 615 children, 552 of whom were evacuated to Moscow by intensive care cars (n = 469) and medical helicopters (n = 83). The paper shows that the two-stage medical victim medical evacuation provision system is effective and provides evidence for prospects for putting the developed model into practice of rendering a medical aid to traffic accident victims on out-of-town highways.

[Estimation of the validity of pediatric severity rating scales in multidisciplinary children's intensive care units].

The aim of this study was to estimate the validity of pediatric severity rating scales at general pediatric intensive care units. This was a prospective, observational multicenter study that was performed from November 1, 2007, to January 31, 2008. The end points were the estimation of the severity of disease, by using the PRISM, PIM II, RELOD scores, and 28-day survival.

[Prolonged venovenous hemofiltration in the complex therapy of children with severe thermal injury complicated by multiple organ failure].

The paper describes the authors' experience in using prolonged venovenous hemofiltration in the complex treatment of children with severe thermal injury complicated with multiple organ dysfunction, showing the higher efficiency of treatment in patients with the above condition and the reduction in the number of complications and mortality. This technique is not limited by renal function replacement.

[Efficiency of using ondansetron in the surgical treatment of post-burn cicatricial deformity in children with a history of postoperative nausea and vomiting].

The efficiency of using various formulations of the antiemetic ondansetron to prevent postoperative nausea and vomiting (PONV) in the surgical treatment of postburn scars and deformities in children with a family history of PONV was compared. The patients were randomized into 4 representative groups. Preoperative administration of ondansetron (zofran) as lingual tablets was shown to be most effective.

[Prolonged venovenous hemofiltration in intensive care of children with severe thermal injury].

The efficiency of using prolonged venovenous hemofiltration (PVVH) was studied in 12 children with severe thermal injury in the presence of multiple organ dysfunctions. All the children were critically ill (having artificial ventilation, inotropic support, states of coma, renal dysfunction) and received the whole package of intensive care measures. Five of the 12 children were diagnosed as having sepsis, as verified by the procalcitonin ( >10 ng/ml) test.

[Balanced spinal-epidural anesthesia in pediatric orthopedics].

The problem of spinal epidural anesthesia used in pediatric surgery has been inadequately studied. This investigation was undertaken to develop a balanced spinal epidural anesthesia schedule and to analyze its efficiency during orthopedic operations on the lower extremities in 119 children aged 2 to 16 years. Preference is given to sequential subarachnoidal and epidural space punctures via the same access.

[Assessment of a hypnotic component on the basis of BIS monitoring during balanced anesthesia in children].

The hypnotic components of balanced anesthesia under regional anesthesia were estimated in 60 children during operations on the limbs and urogenital area. BIS monitoring was to assess the grade of sedation. Analysis of the findings showed that balanced anesthesia could ensure an adequate and stable anesthesia throughout the surgical intervention.

[Hypermetabolism syndrome in critically ill children].

The paper focuses on the developmental mechanisms and triggers of hypermetabolism, by describing the specific features of pathophysiological reactions occurring in the child's body. It also shows the leading role of artificial therapeutic feeding included into the multimodality therapy of children under stresses in restoring plastic and energy demands and in preventing the development of multiple organ dysfunction.

[Short bowel syndrome in children: etiology and basic approaches to treatment].

The paper considers the main causes and clinical manifestations of the short bowel syndrome in children, defines the clinical and physiological features of the disease in children. The world experience in managing patients with short bowel syndrome is summed up. Indications for total parenteral or parenteral-and-enteral feeding in relation to the site of intestinal resection are analyzed.

[Experience of using nutrition therapy in children with multiple and combined trauma in intensive care units].

Caloric and nutrient requirements significantly increase in a pediatric patient with severe injury. This is attributable to catabolism and metabolic features in children cause postoperative complications, increases mortality rates in pediatric surgical patients. This generates the need for early administration of diet therapy using specialized formulas that correct nutrient deficiency.

[The diagnosis and correction of impairments of microcirculation, central hemodynamics, and oxygen status in children with traumatic shock].

The paper presents the results of studies of microcirculation, central hemodynamics, and oxygen status in 120 children aged 2-14 years who had traumatic shock of various etiology (40 with burn injury, 50 with mixed injury, and 30 with brain injury). The following studies were used: biomicroscopy of conjunctival microvessels with photo recording and processing on a computer; central hemodynamic monitoring; studies of a thromboelastogram, acid-alkali balance, and blood gases. The authors found the previously unknown parallels of the impairments of microcirculation, the severity of traumatic injury, and the parameters of central hemodynamics, and oxygen status in the patient.

[Infusion-transfusion therapy of acute blood loss during early surgeries in children with severe thermal trauma].

Research results of the central hemodynamics, microcirculation and of oxygen status are described for 48 children (aged 8 months to 14 years) as observed during surgeries aggravated by massive hemorrhage in the routine infusion-transfusion therapy plus a 6% solution of INFUKOL GEK. Solution dosages of 6% were approved; the drug's positive effect on the central-hemodynamics condition, microcirculation and on the oxygen regime, as observed in the process of the infusion therapy made to compensate for a massive blood loss, was demonstrated; besides, the related shrinking of the infusion therapy total volume and the possibility to give up totally or to significantly reduce the blood-drug preparations, administered intraoperatively, were shown.