In 44,6% of cases, the reason for transferring patients to mechanical ventilation was a worsening of neurological status; 69,1% of patients underwent prolonged respiratory support for a period of 3 days to 2 weeks. 54.2% of patients died. Half of the surviving patients had a severe disability. In patients of the older age group, the risk of an unfavorable outcome increased. Mortality increased and the rehabilitation potential decreased with the increase of age and duration of respiratory care. The results point to the need to create a unified concept for carrying out artificial ventilation of the lungs in patients of older age groups taking into account clinical and economic feasibility.

The article presents an analysis of different methods of positioning patients with acute cerebral pathology. Changing of 'head-of-the bed' position is a routine and simple method of correction of intracranial hypertension. For the majority of patients with cerebral damage, regardless of the etiological factor, 15-30° 'head - of - the bed' position is preferable. However, in some cases head-of-bed manipulation can lead to the irreversible ischemic damage due to the reduction in systemic and perfusion pressure and cerebral blood flow. Thus, the selection of the optimal body position in different types of acute cerebral pathology remains a debated issue.

У статті звернено увагу на можливість за даними анкетування викладачів виявляти проблеми викладачів і формувати позитивні зміни в поліпшенні їх роботи.

The central nervous system injuries are a common neonatal pathology, hypoxia being one of the main causes of cerebral dysfunction. The purpose of this study was studying the incidence of hypoxic cerebral disorders in premature infants with an extremely low body weight and a very low birth weight and revealing the risk factors that adversely affected the disease outcome. The subject of the study was preterm infants whose gestational age did not exceed 31 weeks. The main criterion for inclusion into the study was the presence of hypoxic-ischemic and hypoxic-hemorrhagic brain damage. To reveal the perinatal risk factors, the somatic health of mothers, and pregnancy and childbirth peculiarities were studied. The structure of children’s pathology and intensive care techniques were analyzed. Cerebral disorders were verified in 42 out of 176 patients (23.5 %). 2–3rd-degree intraventricular hemorrhage was diagnosed in 34 newborns (80.9 %), severe ischemia in 8 children (19.1 %). To determine the structure of the disease outcome, all children were divided into deceased and survivors. A fatal outcome was observed in 14 cases (33.3 %). The mothers of deceased children were more likely to have obstetric and concomitant extragenital pathologies. Analysis of pediatric pathology showed that the hemodynamically significant functioning arterial duct and severe asphyxia in childbirth were much more frequent in deceased children. Intensive therapy of deceased children included «hard» parameters of artificial ventilation and high doses of cardiotonic drugs. Thus the presented risk factors can be considered as predictors of an unfavorable outcome in children with this pathology.

Introduction and purpose. Change of the «head-of-bed» position is a routine and simple method of correction of intracranial hypertension. There is still no consensus what exactly situation most effectively reduces intracranial pressure and doesn't compromise a cerebral blood flow. The purpose of the conducted research was the assessment influence of positioning on intracranial pressure and system hemodynamic at patients with a hemorrhagic stroke. Methods. 80 patients with a hemorrhagic stroke entered research. All of the patient carried out continuous monitoring of intracranial and system arterial pressure, transcranial doppler was daily carried out. To each patient was carried out «head-of-bed position» test (30°-0°-60°). Results. Despite various mechanism of hemorrhage in two studied groups in the first three days from the beginning of a disease similar tendencies to the progressing increase of intracranial pressure and decrease in mean arterial and cerebral perfusion pressure were observed. Only for the fifth days there were essential distinctions of the studied indicators. At consecutive «head-of-bed» changes are received the essential distinctions in the studied groups which aren't allowing to apply to them uniform algorithm of positioning. Conclusions. Positioning of patients with subarachnoid hemorrhages has no essential impact on the studied parameters. For patients with parenchymatous hemorrhages is preferable «head-of-bed» situation 30° and 60° the first and third day and 30° for the second and fifth day. Thus even short stay in horizontal position (0°) leads to the expressed growth of intracranial pressure and critical decrease in cerebral perfusion.