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FOREWORD

This manual summarizes the experience of teaching anesthesiology and resuscitation and training of anesthetists and resuscitators in clinical residency and internship at the Russian State Medical University.

The manual is based on the program of university postgraduate education, which includes sections on intensive care, resuscitation and first aid for the most common diseases and critical conditions.

From a modern point of view, the etiology, clinical presentation and treatment of various pathological syndromes are considered: acute respiratory and heart failure, cardiogenic, hypovolemic, septic and anaphylactic shock, pain, water-electrolyte and acid-base disorders. The methods of respiratory and inotropic support, infusion therapy and parenteral nutrition are discussed in detail. Algorithms for the treatment of acute respiratory disorders, left ventricular and right ventricular failure, asthmatic status, acute airway obstruction, pulmonary edema, respiratory distress syndrome, and coma are presented. A detailed interpretation of such conditions as “sudden death”, “brain ischemia”, “brain death”, “shock”, “hypo- and hyperosmolar syndromes”, “disqualification syndrome” is given. A significant place is given to the description of pharmacological agents used in intensive care units: inotropic, vasoactive and analgesic drugs; crystalloid and colloidal infusion solutions, mixtures to ensure the energy needs of patients in critical condition. Possible approaches to the prevention and treatment of pain and depression in resuscitation patients are described.

Particular attention is paid to resuscitation methods. The causes of sudden cardiac arrest, the basic and specialized methods of resuscitation, traditional and new methods of cardiopulmonary resuscitation are considered.
Based on the latest recommendations of the Russian School of Resuscitation and the Committee on Emergency Medicine of the American Cardiology Association, algorithms for resuscitation measures for asystole, ventricular fibrillation, ventricular tachycardia and electromechanical dissociation are given. The methods of various manipulations are described in detail: tracheal intubation, conicotomy, vascular catheterization, etc. Extensive illustrative material is presented, anatomical guidelines are given, knowledge of which is necessary for an intensive care physician.

The manual contains general provisions that should be followed when providing first aid at the prehospital stage - in case of road accidents, electric shock, drowning, during terrorist acts, in case of poisoning, etc.

Considering the increasing requirements of the Higher School for teaching the subject to students, interns and residents, which is closely related to the supervision of seriously ill patients and participation in their treatment, we considered it possible to expand the clinical part of the manual, since from our point of view this section is covered in the scientific and educational literature not enough.

The authors of the book are employees of the Department of Anesthesiology and Intensive Care of the Russian State Medical University, with extensive experience in practical, scientific and pedagogical work. Illustrative material prepared by associate professor Kh.T. Omarov.

The authors hope that this manual will be useful not only to anesthesiologists and resuscitators, but also to other doctors who meet in their practice with a contingent of seriously ill patients when urgent decisions are required. We will be grateful to the readers for feedback and comments, and we will take them into account when preparing specialists.
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FOREWORD

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