We examined and conducted intensive therapy in 449 patients with polytrauma. A retrospective study of the survival and causes of death of 233 patients with extremely severe polytrauma (estimated severity of injury 51-75 points according to ISS) using two methods of fluid resuscitation together with a prospective study conducted in 216 patients with less severe polytrauma in patients aged 18 up to 72 years. Compared the effects of adding to the most common method of fluid resuscitation, added of 25% magnesium sulfate solution at a dose of (30.0 ± 5.0) ml in patients with hemorrhagic shock (n = 82) on the background of polytrauma had positive effect on the indicators of central and peripheral hemodynamics, content in blood of carboxylated hemoglobin (HbCO%), malonic dialdehyde, lactate, activity of α-amylase and aminotransferases in blood, quantity of complications, terms of stay in intensive care unit. In patients with myocardial contusion (n = 34) compared the effect of the same methods of infusion therapy on the state of hemodynamics, its stability, improved methods for diagnosing myocardial contusion by ECG monitoring, ultrasound, determination of markers of myocardial damage in the blood. Rheoencephalographic monitoring performed in patients with a predominance of clinical manifestations of cerebral insufficiency on the background of traumatic brain injury. We compared the rate of recovery of consciousness and normalization of cerebral circulation under the influence of intensive care measures recommended by the Brain Trauma Foundation and with the addition of a combined drug with antihypoxic action, including succinic acid, inosine, riboflavin and nicotinamide. Patients with a predominance of clinical manifestations of acute respiratory failure on the background of chest contusion and pulmonary contusion compared with the effects of measures recommended by the American Thoracic Society and the European Society of Intensive Care, and the addition of magnesium therapy and N-acetylcysteine (NAC). An increase in the formation of HbCO% in the body of patients with polytrauma due to the growth of endogenous production of carbon monoxide. Signs of significant acceleration of improvement of cardiac output, vascular tone, normalization of central venous pressure, decrease in blood content of HbCO%, lactate, malonic dialdehyde, severity of enzyme in patients with hemorrhagic shock under the influence of magnesium therapy. Signs of significant acceleration of improvement of cardiac output, normalization of central venous pressure, decrease of carboxylated hemoglobin content in patients with myocardial contusion under the influence of magnesium therapy has revealed. In patients with traumatic brain injury under the influence of antihypoxants significantly accelerated the normalization of cerebral circulation and recovery of consciousness. In patients with acute respiratory failure on the background of pulmonary contusion under the influence of magnesium therapy and NAC, significantly accelerated the restoration of normal blood gas tension, HbCO% blood content, recovery of pulmonary compliance, the amount of fluid in the chest. A new original method for determining the amount of thoracic fluid content, recommendations for improving intensive care in patients with polytrauma have been developed and applied. In extremely severe patients who died, within 3 years, significantly longer survival with magnesium therapy. It has found that the main causes of early mortality from polytrauma are decompensated hemorrhagic shock, severe traumatic brain injury, chest damage
