Zgrzheblovska L. Adrenomymetic correction and volemic support in intensive care of multiply trauma.

The thesis devoted to elaboration of new methods of critical care in order to improve the outcome of multiply-injured patients with MOF development. The typical characteristics of MOF course during 12 days of postinjury period were described in clinical chapter, also the effectiveness of intensive care among 240 multiply injured patients with MOF development was investigated. The combined application of volemic support with balanced crystalloids and adrenergetic support with norepinephrine permited to correct the parameters of central and peripheral circulation, acid-base disorders, derangements of ventilation and gas exchange, improve function of kidneys and gut, normalize the immune response. The combined application of volemic support with balanced crystalloids and adrenergetic support with norepinephrine led to decrement of nosocomial infections development: nosocomial infection of urogenital tract, the wound infection, the catheter sepsis. The application of this method had decreased the period of mechanichal ventilation by 184.2 hours, adrenomymetic support by 91.2 hours, ICU-stay-by 7.56 days. The key marker of this method effectiveness - the 15-days mortality level had decreased by 34.4 %, the 90-days mortality - by 32.2 % in comparision with control group.