[Characteristics of hemostatic disorders in septic shock in children]. / Osobennosti narushenii gemostaza pri septicheskom shoke u detei.

Changes at different stages of coagulation cascade have been assessed during intensive therapy of septic shock in 40 children aged 1 to 14 years. Progressing septic shock is accompanied by chronometric and structural hypocoagulation with potential hypercoagulation in transfer samples, thrombocytopenia and thrombocytopathy. Terminal stages of septic shock are characterized by profound hypocoagulation without potential hypercoagulation, predominance of antithrombin and antiaggregant blood activity with persistent depletion of antithrombin III and plasminogen. The decrement of arterio-venous difference in hemostasis parameters is typical of marked stages of the shock lung. Dynamic control over hemostasis shifts makes it possible to predict the outcome of septic shock.

[Diagnostics and correction of thrombohemorrhagic impairments in patients with purulent-septic complications in obstetrics and gynecology]. / Diagnostika i korrektsiia trombogemorragicheskikh narushenii u bol'nykh s gnoino-septicheskimi oslozhneniiami v akushersko-ginekologicheskoi praktike.

The clinical course of thrombohemorrhagic complications was studied in 56 patients, aged 18 to 38, with sepsis, which developed due to obstetric and gynecologic processes on days 1, 3, 5, 7 and 10 after surgery. The patients were treated, 1999-2003, at the obstetric intensive-care and consultation center, MUZA Maternity Hospital No. 1, Krasnoyarsk. The coagulation, anti-coagulation and fibrinolytic chains of the coagulation cascade and vascular-thrombotic hemostasis were dynamically evaluated. Thrombohemorrhagic complications in severe sepsis and septic shock manifested themselves as hypercoagulation stage in 52% of observations. The hemostasis correction does not only require the elimination of changes in the hemocoagulation system but also the intensive care of the present systemic dysfunctions.

[An analysis of using the graphic monitoring of ventilation for an optimal choice of respiratory management parameters in patients with acute respiratory distress syndrome]. / Graficheskii monitoring ventiliatsii pri vybore optimal'nykh parametrov respiratornoi podderzhki u patsientov s ostrym respiratornym distress-sindromom.

The potentialities of graphic ventilation monitoring (graphic monitor "Servo Screen 390", Siemens Elema, Sweden) were analyzed for optimizing the respiratory management parameters in 48 obstetric and gynecology patients with acute respiratory distress syndrome (ARDS). The ventilation loops and curves, ALV parameters, mechanical lung properties, gas blood composition and gas indices were dynamically evaluated during examination stages. The graphic ventilation monitoring, when used for respiratory management in patients with ARDS, provides for optimizing, in the real time mode, the PEEP and Vt levels, which is in line with the AVL "safety" concept.