[Experience in the use of the new artificial lung ventilation apparatus "Avenir-221P" for treatment of children].

The positive features of the new ventilator Avenir-221 P, such as wide set of functional characteristics, built-in monitoring with indication of many digital and analog parameters on a screen, reliability and convenience of work are briefly described. The long experience of application of the device for intensive care of children in the age ranging from 7 days up to 14 years in Intensive care and resuscitation unit of the St. Vladimir children's municipal clinical hospital (Moscow) is discussed The conclusion is made that the MLV apparatus Avenir-221 P for treatment of children will be of considerable demand in urban and rural regional hospitals of the appropriate structure.

[Principles of intensive care during the acute period of severe craniocerebral trauma in children]. / Printsipy intensivnoi terapii v ostrom periode tiazheloi cherepno-mozgovoi travmy u detei.

Prospective analysis of the course of severe craniocerebral injury (CCI) in 37 children showed that the results of treatment depended on methods of intensive care. In children the outcome of CCI depends primarily on adequacy of maintaining effective cerebral bloodflow during the acute period of CCI irrespective of the terms and etiological factors of coma. Adequate cerebral perfusion pressure is attained with osmodiuretics, saluretics, and hemodynamic therapy. Hyperventilation is justified in cases with coma developing within 2 h after the injury; it should not lead to long (more than 1 h) decrease of PaCO2 below 28 mm Hg. The authors emphasize that every delayed decrease of consciousness after the injury should be thoroughly analyzed in order to rule out intracranial complications (epi/subdural and intracerebrai hematomas) in no more than 6 h, which is the maximal time allowed for decision making. Use of unapproved medical methods and drugs in children during acute period of severe CCI is ineffective and even hazardous, because it distracts the physician's attention to negligible details of treatment; in addition many of such drugs have side effects.

[Continuous intravenous administration of fentanyl during multicomponent anesthesia in children]. / Nepreryvnoe vnutrivennoe vvedenie fentanila pri mnogokomponentnoi anestezii u detei.

136 anesthetic procedures during planned and emergency surgery in children have been analysed. It has been demonstrated that non-stop intravenous fentanyl injection with an automated syringe of "Lineomat" type ensures an adequate analgesia over a 2-10 h period. The adequacy of anesthesia was confirmed by the data of central and peripheral hemodynamics monitoring, acid-base balance, temperature gradient and clinical course. Non-stop injection of the analgesic made it possible to reduce the drug expenditure by 30% on average as compared to the theoretically calculated dose, as well as to free paramedical personnel and decrease their exposure to blood.