Aim – to assess the effectiveness of the «open reanimation» project in a redesigned infectious diseases hospital during a pandemic of a new coronavirus infection (NKI). Materials and methods. The study was carried out in two stages. The first stage was carried out at the time of the opening of the re-profiled hospital and included an assessment of the psychoemotional state of patients with NKI (n = 50, group A) before the implementation of the «open resuscitation» project in the RO, the second stage was carried out after the implementation of the «open resuscitation» project in the RO (n = 50, group B). An objective assessment of the psychoemotional state in all groups was carried out using the Hospital Anxiety and Depression Scale (HADS) questionnaire by summing two indicators of anxiety and depression and was assessed for 1-6 days of stay in the RC. The results obtained. 84 % of patients in group A and 90 % in group B had comorbid and polymorbid pathologies, p = 0.372. Upon admission to the RO, humidified oxygen received 30 % and 36 %, respectively, NIVL received 76 % and 64 % respectively, p = 0.532. The frequency of delirium was 26 % and 6 % respectively, p = 0.006. Insomnia was noted in 34 % and 18 % of patients, respectively p = 0.068. Light sedative therapy with desmedetomidine was performed in 28 % and 12 % respectively, p = 0.045. When comparing, HADS indices in patients of both groups were 36 (29; 39) points in group A and 34 (29; 38) points in group B on the 1st day of stay in RO, U [50; 50] = 1081, p = 0.246; on the 6th day of stay 32 (27; 33) and 26 (22; 30) respectively, U [50; 50] = 572, p = 0.001. Conclusions . The assessment of HADS indicators clearly demonstrates that all patients experienced severe stress during admission to the RC, however, adherence to the principles of open reanimation was accompanied by a significant decrease in the level of anxiety and depression in patients who are conscious

Aim – to assess the effectiveness of the «open reanimation» project in a redesigned infectious diseases hospital during a pandemic of a new coronavirus infection (NKI). Materials and methods. The study was carried out in two stages. The first stage was carried out at the time of the opening of the re-profiled hospital and included an assessment of the psychoemotional state of patients with NKI (n = 50, group A) before the implementation of the «open resuscitation» project in the RO, the second stage was carried out after the implementation of the «open resuscitation» project in the RO (n = 50, group B). An objective assessment of the psychoemotional state in all groups was carried out using the Hospital Anxiety and Depression Scale (HADS) questionnaire by summing two indicators of anxiety and depression and was assessed for 1-6 days of stay in the RC. The results obtained. 84 % of patients in group A and 90 % in group B had comorbid and polymorbid pathologies, p = 0.372. Upon admission to the RO, humidified oxygen received 30 % and 36 %, respectively, NIVL received 76 % and 64 % respectively, p = 0.532. The frequency of delirium was 26 % and 6 % respectively, p = 0.006. Insomnia was noted in 34 % and 18 % of patients, respectively p = 0.068. Light sedative therapy with desmedetomidine was performed in 28 % and 12 % respectively, p = 0.045. When comparing, HADS indices in patients of both groups were 36 (29; 39) points in group A and 34 (29; 38) points in group B on the 1st day of stay in RO, U[50; 50] = 1081, p = 0.246; on the 6th day of stay 32 (27; 33) and 26 (22; 30) respectively, U[50; 50] = 572, p = 0.001. Conclusions. The assessment of HADS indicators clearly demonstrates that all patients experienced severe stress during admission to the RC, however, adherence to the principles of "open reanimation" was accompanied by a significant decrease in the level of anxiety and depression in patients who are conscious

Aim of the present study was to optimize the anesthesia aid for endoscopic manipulations based on the determination of the patient's functional change index (IFI). Materials and methods. We examined 34 patients who underwent colonoscopy with polypectomy or biopsy, the average age was 45.7 ± 5.9 years, the degree of anesthetic risk was consistent with ASA I-II, the duration of the procedure was 20.3 ± 7.1 minutes. IFI (in conventional units-points) was calculated immediately before endoscopic manipulation. To calculate it, we determined the pulse rate( PE), blood pressure (ADp-systolic, ADp-diastolic), height (P), body weight (MT) and age (B): IFI = 0.011PE + 0.014ADp + 0.008ADp + 0.014B + 0.009MT – 0.009P – 0.27. During the anesthesia support, the opinion of not only the doctor who conducted the study, but also the patients about the comfort during the EVPV was taken into account. Results. Based on the obtained index value, each subject was assigned to one of four groups according to the degree of adaptation: satisfactory adaptation (IFI less than 2.59), stress of adaptation mechanisms (IFI from 2.6 to 3.09), unsatisfactory adaptation (IFI from 3.1 to 3.49), failure of adaptation (IFI more than 3.5). In the first group of patients, dexmedetomidine sedation was sufficient to achieve comfortable conditions for both the patient and the endoscopist. In the second group, the recommended dosages of dexmedetomidine were insufficient, which required additional administration of propofol. At the same time, there was a decrease in the average blood pressure below 70 mm hg. In this regard, the second group was divided into two subgroups: patients who were sedated with dexmedetomidine in combination with propofol (n = 10) and patients (n = 10) who were sedated only with propofol, which allowed them to achieve the necessary level of sedation for high-quality manipulation without significant arterial hypotension. Conclusion. The calculation of the IFI and the determination of the patient's adaptive potential before endoscopic intervention allows us to optimize the anesthetic manual and make a rational choice of the drug for sedation. Thus, when the adaptation mechanisms are stressed, it is sufficient to achieve the required level of dexmedetomidine sedation in the recommended dosages. When identifying a state of unsatisfactory adaptation, the drug of choice is propofol.

Amyotrophic lateral sclerosis (ALS) is rare neurodegenerative disease that needs prolonged respiratory therapy. Ventilator respiratory support is strongly requested for intensive care in different critical illnesses, but it is associated with high risk of specific complications. Latter could rarely be avoided especially in cases of prolong mechanically ventilation that provided in cases of central nervous system injury, major trauma, persisting organ dysfunction etc. Despite the fact of incurable loss of spontaneous breathing in patients with ALS, logistic path of outpatient palliative care provision is absent. Nonetheless outpatient individual intensive care, for respiratory tract particularly, makes possible to avoid serious ventilator-associated adverse events for a long period.

Amyotrophic lateral sclerosis (ALS) is rare neurodegenerative disease that needs prolonged respiratory therapy. Ventilator respiratory support is strongly requested for intensive care in different critical illnesses, but it is associated with high risk of specific complications. Latter could rarely be avoided especially in cases of prolong mechanically ventilation that provided in cases of central nervous system injury, major trauma, persisting organ dysfunction etc. Despite the fact of incurable loss of spontaneous breathing in patients with ALS, logistic path of outpatient palliative care provision is absent. Nonetheless outpatient individual intensive care, for respiratory tract particularly, makes possible to avoid serious ventilator-associated adverse events for a long period.