[Correction of intracranial hypertension syndrome using hyperosmolar solutions in patients with severe brain damage (multicenter randomized clinical study)].

The paper presents the results of a muticenter study of the effect of 3 hyperosmolar solutions (15% mannitol solution, 10% sodium chloride solution, and the combined solution HyperHAES containing 7.2% sodium chloride and hydroxyethyl starch 200/0.5) on the value of intracranial pressure (ICP) (invasive ICP monitoring) and systemic hemodynamic parameters (PiCCOplus) in 94 clinical cases of intracranial hypertension (ICP more than 20 mm Hg) in 25 patients with acute cerebral pathology (severe brain injury, aneurysmatic subarachnoid hemorrhage). Intravenous infusion of the solutions was found to induce a reduction in ICP; however, this was most pronounced (by 30-40%) and longer (up to 4 hours) when HyperHAES solution was used. This solution produced not only an osmotic, but also hemodynamic effect.

[Acute cerebral insufficiency syndrome as a concept of neuroreanimatology].

The introduction of concepts of acute cerebral insufficiency syndrome into the clinical practice of a number of therapeutic-and-prophylactic institutions raises a lot of questions as to its clinical interpretation and approaches to diagnosing, monitoring, and treating patients who meet its criteria. By attempting to have methodologically adequate solutions of this problem, neuroresuscitators are making a complex scientific developments of reproducible modes of neuromonitoring and cerebrotropic intensive therapy. The theory of acute cerebral insufficiency and a cerebral protection complex becomes an area that determines researches in the development of new methods of intensive cerebrotropic therapy, as well as the ways of neuroreparation and neuroprotection as components of complex pathogenetic therapy for neuropathological syndromes resulting from the formation of pathological systems in response to abnormal determinants.