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Relevance. The timely use of extracorporeal membrane oxygenation within resuscitation measures for patients with refractory circulatory arrest is becoming a routine rescue practice in the world, making it possible to increase the efficiency of resuscitation measures up to 30 %; however, this technology is not widespread in Russia, despite the fact that without extracorporeal mechanical support, the effectiveness of cardiopulmonary resuscitation is no more than 9 %.Objective. Analysis of the experience of using transport venoarterial extracorporeal membrane oxygenation (ECMO) within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Methods. Analysis of the experience of using transport ECMO within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Results and Discussion. Of the 16 cases of extracorporeal cardiopulmonary resuscitation, effective circulation was restored in 37.5 % (6 out of 16) of cases. In these cases, the duration of extended cardiopulmonary resuscitation outside the medical organization was significantly lower, (50.8 ± 4.2) minutes versus (65.6 ± 4.6) minutes. In the group of patients with ineffective extended cardiopulmonary resuscitation, there was a significant increase in troponin (1820 ± 164) versus (473 ± 180) ng/l and D-dimer (17 566 ± 429) versus (13 122 ± 628) µg/l (FEU).Conclusion. Transport ECMO technology, which is used for extracorporeal cardiopulmonary resuscitation in patients with out-of-hospital refractory circulatory arrest, allows the use of a wide range of diagnostic and therapeutic procedures, including percutaneous coronary interventions. The analysis revealed the need to reduce the duration of resuscitation by ambulance teams on the spot in favor of extended CPR in motion using an electromechanical device for chest compressions.
Relevance. The timely use of extracorporeal membrane oxygenation within resuscitation measures for patients with refractory circulatory arrest is becoming a routine rescue practice in the world, making it possible to increase the efficiency of resuscitation measures up to 30 %; however, this technology is not widespread in Russia, despite the fact that without extracorporeal mechanical support, the effectiveness of cardiopulmonary resuscitation is no more than 9 %.Objective. Analysis of the experience of using transport venoarterial extracorporeal membrane oxygenation (ECMO) within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Methods. Analysis of the experience of using transport ECMO within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Results and Discussion. Of the 16 cases of extracorporeal cardiopulmonary resuscitation, effective circulation was restored in 37.5 % (6 out of 16) of cases. In these cases, the duration of extended cardiopulmonary resuscitation outside the medical organization was significantly lower, (50.8 ± 4.2) minutes versus (65.6 ± 4.6) minutes. In the group of patients with ineffective extended cardiopulmonary resuscitation, there was a significant increase in troponin (1820 ± 164) versus (473 ± 180) ng/l and D-dimer (17 566 ± 429) versus (13 122 ± 628) µg/l (FEU).Conclusion. Transport ECMO technology, which is used for extracorporeal cardiopulmonary resuscitation in patients with out-of-hospital refractory circulatory arrest, allows the use of a wide range of diagnostic and therapeutic procedures, including percutaneous coronary interventions. The analysis revealed the need to reduce the duration of resuscitation by ambulance teams on the spot in favor of extended CPR in motion using an electromechanical device for chest compressions.
Cardiovascular diseases (CVD) are a leading cause of mortality in many countries worldwide. Genetic testing is an integral part of CVD prevention. The most common hereditary diseases in the practice of a cardiologist are cardiomyopathy and channelopathy (arrhythmogenic syndromes), as well as familial hypercholesterolemia, which causes a high risk of atherosclerosis and coronary heart disease (CHD). The total carrier frequency of pathogenic variants is 1:100. Timely genetic diagnosis is necessary for conditions that can lead to sudden cardiac death (for example, long QT syndrome, Brugada syndrome, arrhythmogenic cardiomyopathies). Pharmacogenetic testing is also important in cardiology, since it allows taking into account the role of genetic factors in the formation of a response to therapy. Incorporating individual patient characteristics can increase efficiency and minimize the likelihood of complications. The design of modern targeted cardiopanels must necessarily take into account monogenic and oligogenic forms of dyslipidemia and cardiovascular pathologies, polymorphic markers associated with a violation of the lipid spectrum of blood plasma and the early development of CVD in a particular population, as well as a minimum set of pharmacogenetic markers according to modern recommendations for clinical pharmacologists. In this review we provide a justification for the optimal design of such a panel for use in medical practice and scientific research.
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