The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was February 01, 2021. To develop the recommendations for the Guidelines, were used documents directly describing the features of the management of patients with NCI COVID-19 (guidelines - 34; randomized clinical trials and Cochrane Reviews - 13; observational and comparative studies - 107; other documents, notes and comments - 64), and documents describing anesthesia and intensive care in the general population of patients. Compared to the previous 4th version of the guidelines, the recommendations in 8 sections have been corrected; new subsections “Chronic kidney disease”, “Rehabilitation treatment of patients with COVID-19 in the intensive care unit”, “Routing of patients with COVID-19 to the stages of rehabilitation” were created; revised 1 Appendix, additionally developed 7 Appendices; the section “Quality criteria” has been supplemented. The provisions of the current version of the guidelines highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of management of pregnant women, children of different age groups, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered.
The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was June 29, 2020. To develop the Guidelines for the recommendations, were used documents that directly describing the features of the management of patients with coronavirus disease COVID-19 (guidelines and guidelines - 16; randomized clinical trials and Cochrane Reviews - 8; observational and comparative studies - 77; other documents, notes and comments - 54) and describing anesthetic and resuscitation support in the general population of patients. The provisions of the recommendations highlight the specifics of anesthesia, intensive care, resuscitation, manipulation, and prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis are described. The features of the management of pregnant women, children of different age, patients with concomitant diseases, issues of transportation of patients are considered.
Aim of the study: to investigate chest compression parameters by city hospital staff under simulated conditions with and without the use of a sensor device for quality control of chest compressions.Materials and Methods. The study was conducted in Moscow's multidisciplinary hospitals. The study included 359 medical staff members. The participants were divided into 4 groups: physicians (n=97) and nurses (n=82) from intensive care units (ICU) and physicians (n=92) and nurses (n=88) from specialized departments. Participants performed 2 minutes of chest compressions without a chest compressions quality control (CCQC) sensor, followed by 2 minutes of chest compressions using a defibrillator sensor with audiovisual prompts from the device turned on. The percentage of target compressions, rate and depth of compressions were analyzed.Results. Compression parameters in the group of ICU doctors were outside the reference range (% target compression — 0.5 (0.0; 14.5)%, rate 124.1±17.8 per minute, depth 5.6±1.1 cm), in the group of ICU nurses, the percentage of target compressions was 0.0 (0.0; 3.5)%, rate — 123.6±23.7 per minute, depth — 5.3±1.2 cm, in the group of specialist doctors the percentage of target compressions was 0.0 (0.0; 1.2) %, rate — 123.8±23.2 per minute, depth — 5.8±1.2 cm, in specialized nurses group the percentage of target compressions was 0.0 (0.0; 6.1)%, rate — 119.7±29.5 per minute, depth — 5.6±1.2 cm. There was a significant improvement in compression performance in all groups when the sensor device was used: in ICU physicians the percentage of target compressions was 81.6 (64.80; 87.90)%, rate — 124.1±17.8 per minute, depth — 5.5±0.2 cm; in ICU nurses the percentage of target compressions was 69.1 (47.4; 80.6), rate — 123.6±23.7 per minute, depth — 5.3±0.3 cm, in specialist doctors the percentage of target compressions was 69.30 (50.50; 78.70), rate — 123.8±23.2 per minute, depth — 5.4±0.3 cm, in specialized nurses the percentage of target compressions reached 63.70 (42.90; 75.80), rate — 119.7±29.5 per minute, depth — 5.4±0.3 cm. There were no differences in analysed compression parameters between staff in different departments or positions.Conclusion. Compression parameters (percentage of target compressions, rate, depth) were not influenced by the department where the staff member worked and the position held (doctor or nurse). The use of a compression quality sensor device has improved compression parameters by reducing rate and normalizing depth. The use of the sensor does not increase the percentage of target compressions to the maximum values, indicating the need for training by an instructor.
In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was November 1, 2021. To develop the recommendations for the Guidelines, documents were used that directly describe the features of the management of patients with a new coronavirus infection COVID-19 (recommendations and guidelines - 35; randomized clinical trials and Cochrane Reviews - 23; observational and comparative studies - 134; other documents, notes and comments - 72). Compared to the previous, 5th, version of the recommendations, 35 provisions have been corrected in 10 sections. The provisions of the current version of the recommendations highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of the management of pregnant women, children, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered. For management of COVID-19 patients, the following were specified and supplemented: 1) indications and contraindications for the administration of drugs (acetaminophen, glucocorticosteroids, remdesevir, tocilizumab, baricitinab, statins, convalescent plasma), depending on the severity of the disease; 2) features of intensive care for concomitant diseases (cardiovascular system, inflammatory bowel disease, cancer, arrhythmia); 3) the timing of elective surgery in patients who survive COVID-19, and post vaccination; 4) thromboprophylaxis and management of coagulation disorders; 5) regulatory and legal documents concerning the activities of healthcare workers facing COVID-19.
The aim is to study the current aspects of resident training in anesthesiology and intensive care. The article focuses on the theoretical training of residents, the importance of a thorough knowledge of pathophysiology, and the formation of clinical thinking. Opportunities for the use of innovative educational computer technologies in residency training are shown. A consistent interdisciplinary pedagogical interaction makes it possible to improve the outcomes of residency training by achieving the main goal of developing a physician who has acquired universal, general and specific professional competences and is capable of providing high-quality medical care.
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