Leliuk D. Improving the algorithm of medical care for patients with hypertensive crisis in the prehospital stage.

Object of study: the thesis is devoted to solving an important scientific and practical problem of health care – improving the algorithm of medical care for patients with hypertensive crisis in the prehospital stage. The purpose of work: The objective was to improve the provision of medical care to patients with hypertensive crisis in the prehospital stage by developing an optimized algorithm for managing patients taking into account the balance of the autonomic nervous system, systemic and intracardiac hemodynamics, markers of systemic inflammatory response. Scientific novelty of the obtained results: Scientific novelty of the results obtained. It was first established that the development of uncomplicated hypertensive crisis in patients with hypertension is accompanied by activation of systemic inflammation with an increase in plasma markers of hs-CRP, tumor necrosis factor-α and IL-1β. The data on the increase in the severity of the inflammatory process in terms of hs-CRP, tumor necrosis factor-α and IL-1β with the degree of increase in blood pressure; - the scientific base on the pathogenetic role of disorders of autonomic balance among patients with hypertension in uncomplicated hypertensive crisis (in terms of heart rate variability) has been significantly expanded; - for the first time, the effectiveness of the introduction of the original differentiated scheme of emergency therapy of uncomplicated hypertensive crisis in patients with hypertension at the prehospital stage depending on the dominance of the autonomic nervous system was scientifically substantiated, developed and evaluated; - for the first time the optimized algorithm of management of patients with a hypertensive disease at development of uncomplicated hypertensive crisis at a prehospital stage in practice of the family doctor is developed. Further development was received: analysis of moribility, disability, complications of hypertensive crisis, correction of antihypertensive therapy and prevention.