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.

Placenta accreta is one of the two leading causes of bleeding in childbirth and postpartum, and the most common indication for hysterectomy. The frequency of placental ingrowth increases in parallel with the increase in the frequency of caesarean section. The choice of caesarean section and planned hysterectomy is a traditional approach to the treatment of placental ingrowth. Treatment of ingrowth requires coordination between anesthesiologists, obstetricians, radiologists, blood Bank workers and specialized surgical teams. The article describes the experience of doctors of anesthesiology department of the Regional Perinatal Center of the Kemerovo Regional Clinical Hospital named after S.V. Belyaeva. The use of the proposed method of regional anesthesia in the delivery of women with placental rotation can help to avoid maternal complications that are possible with General anesthesia, such as complex and unsuccessful intubations, pulmonary aspiration, intraoperative awakening, the development of chronic pain and increased maternal morbidity. When comparing women with different types of anesthesia, there was a more rare use of blood transfusion, a decrease in blood loss against the background of regional anesthesia. In addition, the ability to maintain intraoperative blood pressure during regional anesthesia has been successful in most caesarean sections under presentation, even under bleeding conditions.

The article presents a clinical case of delivery of a patient with orphan disease - hereditary angioedema. The complexity of managing a patient with this pathology is demonstrated.