Chernenko V. Optimization and differentiation strategy of intensive therapy of secondary purulent meningoencephalitis

The dissertation is dedicated to improving the diagnosis; methodology for assessing the severity at admission and in the dynamics of surveillance and optimization of IT SPME. A retrospective analysis of 873 case histories of patients with SPME includes the study of the dynamics of the level and structure of hospital admissions and deaths, according to the localization of the primary tumor and algorithms IT revealed modifiable, modifiable and nonmodifiable part of mortality. Modifiable and modifiable factors in part, together constituting 50% are reserve VGME treatment optimization. Infectious complications in patients with medical emergencies of the CNS, and absolute contraindications to the use of invasive methods of measuring intracranial pressure in patients with SPME prompted us to justify, develop and implement a non-invasive method of assessing cerebral oximetry in the assessment of cerebral perfusion and metabolism. Positive gradient plCO2 – paCO2 and cerebrospinal acidosis always occurs at lower CPP, there is an objective clinical signs of cerebral edema. Reduced gradient pl CO2 – paCO2 and increase pHl > 7,32 are positive predictors of prognosis in patients with acute cerebral pathology. Despite initially more severe condition of patients with SPME in group II, the addition to basic therapy solution reamberine helped accelerate recovery.