Aim. To study the influence of the trained environment of geriatric onco-surgical patients on the quality of the interventions in the complex of early postoperative rehabilitation in the Intensive Care Unit (ICU). Methods. The 96 patients aged 73.37.1 years operated on in the emergency onco-surgery clinic of the Tatarstan Cancer Center of the Ministry of Health of the Republic of Tatarstan between 2016 and 2020. Patients, similar in age and condition (American Society of Anaesthesiologists Physical Status category IIIE) were divided into three equal groups: the first group generally accepted measures for early rehabilitation were carried out by medical staff; the second group the prepared relatives of the patient was additionally involved in rehabilitation; the control group early rehabilitation was not carried out. The quality of nutritional support and measures to prevent pressure ulcers, cognitive function were assessed. Statistical processing was performed by using Microsoft Excel 2007 and IBM SPSS Statistics version 20 software. The statistical significance of data was determined by using the chi-square test at p 0.05. Results. The involvement of previously trained relatives made it possible to reduce the incidence of pressure ulcers grade IV to 0%. There was a significant difference in the volume of assimilated enteral oral feeding (180.620.8; 240.620.8; 80.510.2; p 0.05) and the serum albumin level by 11 days after surgery (26.81.5; 28.91.2; 24.21.1 g/L, respectively; p 0.05). Assimilation of enteral oral feeding improved 3 times compared with the control group and 1.5 times compared with the first group (p 0.05). Indicators of cognitive status by the Mini Mental State Examination (MMSE) on the 6th day were 23.31.1; 25.31.1; 21.21.2 (p 0.05), respectively. Conclusion. A rationally organized preparation of the patient's environment for the implementation of care, participation in rehabilitation measures and the prevention of complications can improve outcomes of medical intervention and reduce the incidence of postoperative complications.

The development of hypoglycemic coma is a severe complication of insulin therapy for diabetes mellitus. According to the literature, being in a hypoglycemic coma for more than 12 hours is associated with a threat to life due to the development of decortication and leads to high mortality. Most often, hypoglycemic coma occurs as a result of the administration of insulin in combination with the intake of large amounts of alcohol against the background of insufficient food intake. The patient's condition in connection with the intake of alcohol is underestimated by others, which leads to late hospitalization and, accordingly, to severe outcomes.

Aim. To study the clinical and functional features of patients with colorectal cancer complicated by acute intestinal obstruction. Methods. A retrospective analysis of the data of 147 patients with colorectal cancer operated on from 2014 to 2016 for urgent indications for acute intestinal obstruction was performed. The study of lethality during the period from 1993 to 2016 was carried out separately. The study was performed in the clinic of urgent oncologic surgery of the State Autonomous Healthcare Institution “Republican Clinical Oncologic Dispensary” MH RT. Results. Among patients with acute intestinal obstruction in colorectal cancer, a constant increase of the ration of elderly and senile patients is observed, as well as high anesthesia risk. Statistically significant indices of decrease of nutritional status in the group of patients of elderly and senile age and subtle manifestations of hypovolemia were revealed. In the elderly and senile patient group, polypragmasia was registered in 50.5 %. Conclusion. Patients with colorectal cancer complicated by acute intestinal obstruction, have their own characteristics, different from patients operated on in clinics of urgent abdominal surgery with other diagnoses, the main ratio of which is made up of acute inflammatory diseases. This category of patients should be operated on in institutions where it is possible to provide specific highly skilled surgical and anesthesia-resuscitation care for malignant neoplasms.

The catheterization of subarachnoid space was used which made it possible to perform the adequate anesthesia in lower extremity amputation, adenomectomy and phlebectomy, and the prolonged anesthesia in the immediate postoperative period. The catheterization of subarachnoid space has the following advantages: anesthesia comes earlier, its level is higher, it is easily performed, dozes of drugs are less.

Актуальной и сложной проблемой реаниматологии является интенсивная терапия синдрома острой дыхательной недостаточности (ОДН) различного генеза. По данным литературы, в последние годы в связи с внедрением в практику новых методов диагностики и лечения в высокоспециализированных клинических лечебных учреждениях, имеющих возможность применения дорогостоящей аппаратуры, достигнуты определенные успехи в решении данной проблемы. Однако в рядовых больницах до полного решения проблемы интенсивной терапии синдрома ОДН еще далеко.