Perioperaciina Medicina en-US <p><a href="" rel="license"><img src="" alt="Creative Commons License"></a><br>This work is licensed under a <a href="" rel="license">Creative Commons Attribution 4.0 International License</a></p> (Oleksandr Marchuk) (Viktor Vitkovskyi) Thu, 10 Jan 2019 00:00:00 +0200 OJS 60 Perioperative infusion therapy in children <p>This article is devoted to the questions of infusion therapy – a method of treatment, which gives the possibility of parenteral administration of various substances and medicines into the body and directions for the promotion of basic functions and bio-chemical processes in the body. We considered the organization of conducting adequate infusion therapy in a particular patient, with a specific clinical situation, the questions of the purpose and tasks of infusion therapy now and in the future (tactics and strategy), the means that will be applied, their type, volume, quantitative and qualitative correlation, ways of introduction, speed and duration of the general and, if necessary, of the skin volumetric component, methods for controlling effectiveness and safety. In addition, the issues of physiological and pathological and physiological processes taking place in the child’s body and the justification of the use of different methods of infusion therapy for effective and safe infusion therapy in the child are considered.</p> D V Dmytrіiev, A I Starodub ##submission.copyrightStatement## Fri, 22 Feb 2019 00:00:00 +0200 Antibiotic resistance in Acinetobacter baumannii as agent of surgery infection and approaches to its overcoming by means of deca-methoxinum antiseptic <p><strong>Introduction.</strong> Non-fermenting Gram-negative bacilli are known as one of the most frequent causative agents of hospital-acquired infections. Acinetobacter baumannii, as causative agent of infection complications of different localization, has obtained recently high resistance to anti-biotics and has belonged to ESKAPE group of pathogens. Antimicrobials, recommended for the prophylaxis and therapy of hospital-acquired infections, have been failing in their effectiveness and lead to selection of antibiotic resistant strains of A. baumannii.</p> <p><strong>The aim</strong> of this research was to substantiate the way of overcoming of resistance in clinical strains of A. baumannii, by means of synergic antimicrobial activity of antibiotics and antiseptic decamethoxinum®.</p> <p><strong>Material and methods.</strong> The research was carried out on 190 clinical strains of A. baumannii, isolated from patients with burn disease during the period 2011–2015. The sensitivity of clinical strains of A. baumannii was determined to such antibiotics as ampicillin/sulbactam, cefoperazone, cefoperazone/sulbactam, meropenem, imipenem, amikacin, ciprofloxacin, gatifloxacin and antiseptic decamethoxinum® (DCM; Registration certificate No UA/14444/01/01 since 24.06.2015. Order of the Ministry of Health of Ukraine No 373). The sensitivity of A. baumannii to antibiotics and DCM was determined by means of disk diffusion test and serial dilution (Order of the Ministry of Health of Ukraine No167 since 05.04.2007; EUCAST expert rules).The study of the influence of antiseptic DCM on the sensitivity of acinetobacteria to antibiotics was studied on 35 clinical strains of A. baumannii, drafted from the general number of isolates enrolled in the research. For this, the sensitivity of A. baumannii to antibiotics in the presence of sub-minimal inhibitory concentrations (subMIC) of DCM was identified. The received experimental data were analyzed by “Statistica 6.0”.</p> <p><strong>Results and discussion.</strong> The changes of antibiotic sensitivity profile of A. baumannii for five years were shown. It was found that the sensitivity of A. baumannii to majority of antibiotics, selected for study, decreased significantly. But the only ampicillin/sulbactam was found to have vice versa tendency. We found the rising quantity of antibiotic resistant strains of A. baumannii. At the same time, high resistance of acinetobacteria to fluoroquinolones (ciprofloxacin– 96,1%; gatifloxacin– 95,8%) was found in 2015.</p> <p><strong>The in vitro</strong> research of combined activity of DCM antiseptic remedy and early mentioned antibiotics against clinical strains of A. baumannii demonstrated the reveal antibiotic effectiveness. As follows, minimal inhibitory concentrations of antibiotics decreased in 1.5–4 times in the mediums which contained subMIC of DCM. Especially this tendency was found in resistant clinical strains.</p> <p><strong>Conclusion.</strong> Under selective influence of antibiotics protected by β-lactamase inhibitors, carbapenems, fluoroquinolones aminoglycosides increase the antibiotic resistance in A. baumannii, causative agents of infectious complications in patients with burn disease. The antiseptic remedy decamethoxinum® helps to improve antibiotic sensitivity in resistant A. baumannii.</p> O A Nazarchuk, V I Nahaichuk ##submission.copyrightStatement## Thu, 10 Jan 2019 00:00:00 +0200 Influence of low molecular weight heparins on immune system of surgical patients <p>Venous thromboembolic complications are potentially dangerous complications to life in patients undergoing surgical intervention.</p> <p><strong>The aim</strong> of the work is to study the safety of enoxaparin thromboprophylaxis by eliciting the effect of sodium enoxaparin (Flenox) on the immune system of patients undergoing laparoscopic cholecystectomy.</p> <p><strong>Materials and methods.</strong> Study group: (n = 15)– patients who were treated with enoxaparin sodium (Flenox) for venous thromboembolic complications. Study of immunograms in patients with calculous cholecystitis was performed before surgery and after two days in post-operative period after appointment of enoxaparin.</p> <p><strong>Results and discussion.</strong> In the study group (Flenox), the values of the studied rates did not go beyond the norm.</p> <p><strong>Conclusions.</strong> It was established that sodium enoxaparin (Flenox) does not affect the immune system’s rates. In connection with the above mentioned, this medicine can be considered safe and effective for thromboprophylaxis in patients at risk of venous thromboembolism.</p> O O Budnyuk, I V Miastkivska, R Y Vododyuk, P I Pustovoyt, V O Nikolaev ##submission.copyrightStatement## Fri, 22 Feb 2019 00:00:00 +0200 Necessity of early correction of anal-coccygeal ligaments in traumatic damage to a coccyx <p>In order to prevent and correct the defecation disorders after destruction of the anococcygeal ligament, the meth-od of restoring its functional capacity was proposed (Patent of Ukraine for Invention No. 115280 “Method for Coccyx Re-moving”).</p> <p>It is proved that the damaging effect in the area of the traction and contraction mechanism of action on the rectum in 90.0% leads to continence disorders due to changes in the size of the anorectal angle due to the persistent disorders of the anococcygeal ligament function. The developed special mathematical model of the anococcygeal ligament function testifies that, when it is destroyed, the change in the anorectal angle value may reach changes in its value up to ≈63°, which distorts the direction of the anal canal and the distal rectum. Restoration by simulating of the anatomical fixation of anococcygeal ligament connection after its damage creates conditions for resto-ration of its physiological functioning.</p> V S Konoplytsky, V V Pogorelyi, A A Lukianets, D V Dmytriiev, R V Shavlyuk ##submission.copyrightStatement## Fri, 22 Feb 2019 00:00:00 +0200 Difficult airway. Clinical case: Lymphangioma of the neck in a child under one year old <p>The article describes an interesting clinical case of neck lymphangioma in a child under one year, as the cause of difficult airway during surgery. This case deserves the attention of anesthesiologists, surgeons, interns, considering the clinical features, these additional examination methods and features of anesthesia patients. There was emphasized the importance of pre-operative examination of patients, the use of additional tests and examination methods to determine further tactics. Based on this case, it was concluded that each anesthesiologist must have the skills and clearly know the clinical protocols for managing “difficult airway” and predict severe tracheal intubation.</p> Y M Babina, D V Dmytriiev ##submission.copyrightStatement## Fri, 22 Feb 2019 00:00:00 +0200 Abdominal tumor syndrome in children <p>This article deals with the actual problem of the syndrome of abdominal tumor in children. A complex of clinical symptoms and signs is described that characterize the presence of a tumor-like formation in the abdominal cavity of various origins. The various causes of the occurrence of volumetric processes in the abdominal cavity are examined. Considering that the volumetric process in the abdominal cavity in children is a common situation, and it occurs not only with true tumors, the article describes various clinical situations that lead to the syndrome of abdominal tumor in children.</p> O O Kalinchuk, K Yu Dmytriieva, O V Katilov ##submission.copyrightStatement## Fri, 22 Feb 2019 00:00:00 +0200