Kuchyns'ka I. The protective tactics of mechanical ventilation in patients with severe multiple injuries complicated by multiple organ failure.

The thesis are devoted to improved health outcomes affected by the severe polytrauma who required prolonged ventilatory support, by selecting protective ventilation modes, taking into account their effects on the central hemodynamics, ventilation, gas exchange and expression of multiple organ failure. The results of examination and treatment of 107 patients with severe multitrauma who received long-term ( > 72 h ) respiratory support . The systematization and introduced into clinical practice of the two-phase modes of mechanical ventilation, and performed the comparative assessment of systemic effects of traditional and alternative modes of ventilation on the performance of transport and oxygen consumption, gas exchange parameters, indicators of ventilation, hemodynamic parameters. A scheme change modes with a two-level mechanical ventilation for more rapid transfer of patients with concomitant injury to spontaneous respiration, as well as the possibility of recruitment using inverted phase modes. The proposed scheme allows for respiratory support with a "soft ventilation parameters" without the use of a long analgosedation, to reduce the risk of complications and duration of respiratory support, to reduce the period of stay of patients in the intensive care unit .