Objective: to analyze our own experience of intensive care in a patient in the state of cardiogenic shock under the control of invasive hemodynamic monitoring. Material and methods. The article presents a clinical case of treatment of a 57-year old patient with acute myocardial infarction of the left ventricular posterior wall complicated by ventricular fibrillation, cardiogenic shock, and respiratory distress syndrome. During the monitor control of the patient`s state, invasive hemodynamic monitoring according to PiCCO technology was additionally used. The complex treatment of the patient involved the application of inotropic and vasopressor drugs, maintaining of fluid balance, artificial lung ventilation. Results. Daily repeated control over central hemodynamics parameters for five days made it possible to apply inotropic and vasopressor drugs differentially, which led to the stabilization of hemodynamics. When the patient was disconnected from the artificial lung ventilation, his venous and arterial blood were tested. To be completely disconnected the patient had to undergo respirator tracheostomy. The patient was discharged in a satisfactory condition on the thirty-second day. Two months later, the patient`s quality of life was assessed by the questionnaire EQ-5D as good. Conclusion. The application of invasive hemodynamic monitoring in myocardial infarction complicated by cardiogenic shock favors the choice of the optimal treatment tactics. Repeated control over central hemodynamic parameters makes it possible to predict the course of the illness.

Objective : to analyze our own experience and literature data on the use of targeted antibacterial therapy in a patient with severe pneumonia and multiple organ dysfunction syndrome (MODS). Materials. The work presents a clinical case of successful treatment of a patient with community-acquired pneumonia, sepsis, and MODS, caused by multidrug resistant pathogens. Targeted antibiotic therapy was used during the treatment of the patient. Discussion . We have done a review of the literature and our own data on the antibiotic therapy for community-acquired pneumonia. The targeted antibacterial therapy in severe patients having a multidrug-resistant flora and MODS has the following features: it includes several drugs, is administered by courses, is often combined with antimycotic drugs, antibacterial drugs can be used via inhalation. The evaluation of clinical data, blood counts, as well as indicators of procalcitonin, C-reactive protein, and cholesterol provide substantial assistance during the monitoring of the therapy effectiveness. Conclusion. Among all the components of intensive care in a patient with community-acquired pneumonia, sepsis, and MODS, etiotropic therapy plays a leading role.