Diagnostics and treatment algorythms of acute brain injury period

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On the basis experience in 137 patients treatment we elaborated working classification of acute brain injury period which made it possible to compose diagnostic and intensive care algorithms. The classification is based upon the determination of main pathophysiological processes characterizing the duration of the acute injury period and takes into account stress reaction, primary reperfusion, cerebral edema, recurring reperfusion, adaptation as well as the display of the processes upon the evaluation of patient state severity (compensated, subcompensated, decompensated, terminal).

Patient state of severity was evaluated on the basis of remaining capacities of the vitally important patient organs and systems (central nervous system according to Glasgo coma scale, vegetative nervous system state — cardiointervalography, cardiovascular system, respiratory system, homeostasis systems — by Appache II scale). The classifications we present takes into account the dynamic complex pathophysiological processes taking place in patient organism, and gives an opportunity of fast change in main accents of intensive care. Diagnostics and treatment algorithms on the basis of the present classification with the other modern methods of surgical treatment allowed to improve the posttreatment outcomes, to reduce early (till 10 days) lethality in the acute brain injury period by 8%.