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LIST OF REFERENCES. Acute cardiovascular failure // Manevich A.Z., Plokhoy A.D.Intensive care, reanimatology, anesthesiology

Acute cardiovascular failure // Manevich A.Z., Plokhoy A.D. Intensive care, reanimatology, anesthesiology. - M.: Triad-X, 2002. - P. 168-190.

Amosova E.N. Myocardial infarction without Q wave: contemporary notions of pathogenesis, criteria of diagnosis and methods of antithrombotic therapy // Ukrainian cardiologic journal, No.3, 2001. - P. 113-119.

Comparative analysis of pharmacokinetic characteristics of three heparins of low molecular mass - dalteparinum, enoxaparinum, nadroparinum - in the use to prevent thromboembolic complications. / F. Kollinyon, H. Kaplen, M.L. Ozu, I. le Ru, G.G. Tebon / Ukrainian medical chasopys. - No.2, 1998.-P. 97-99.

Cranio-cerebral injury: Methodical instructions for practical classes for students, subordinators, surgeons-interns, doctors of the faculty for advanced doctors' training / Crimean Medical Institute; Molchanov V.I., Kondratenko V.I., Taleysnik S.L. - Simferopol, 1991.-44 pp.

Current problems of diagnosis and treatment of acute myocardial infarction // Clinical pharmacology, physiology, biochemistry. - 1997, -No.l. -7-60 pp.

Doshchitsyn V.L. Clinical analysis of cardiogram. M.: Medicine, 1982. -208 pp.

Gobzhelyanov A.N., Goloborod'ko B.I., Prokopova T.N. European standards of treatment: development aimed at treatment of acute myocardial infarction. Odessa, 1999. - 30 pp.

Lebedinsky K.M. Anesthesia and systemic hemodynamics: Assessment and systemic hemodynamics during operation and anesthesia. S.Petersburg: Man, 2000. - 200 pp.

Low molecular heparins in anesthesiology and intensive care (Methodical recommendations) // Edited by Prof. L.V. Usenko. Dnepropetrovsk, 2000. - 41pp.

Lutay M.I., Parkhomenko O.M., Shumanov V.O. Ischemic heart disease, classification, principles of prevention and treatment. K.: MORION, 2002. -48 pp.

Marino R.L. Intensive care: transl. from English. -M.: GEOTAR Medicine, 1998.-639 pp.

Methodical recommendations. Organization of neurosurgical aid for patients with craniocerebral injury in the system of Medical Service of Civil Defense / Ministry of Health Protection of Ukr.SSR; Kondratenko V.L, Taleysnik S.L., Shparkovsky A.A., Krutitsky A.G., Molchanov V.L -Kiev, 1998.-21 pp.

Methodical instructions for practical classes on nervous diseases for students of the IV course of stomatological faculty / Republican Methodical Cabinet of Ministry of Health Protection of Ukr.SSR; Compiled by Kondratenko V.L, Taleysnik S.L., Molchanov V.L, Baranenko A.B., Krutitsky A.G. - Kiev,

1987.-113 pp.

Morgan D.E., Michail M.S. Clinical anesthesiology: vol. 2. Transl. from English. - M.-S.Petersburg: BINOM - Nevsky dialect, 2000. - P. 7-76.

Neurosurgery: Methodical instructions for practical classes with test control to master the materials intended for students, trainee physicians, interns, doctors of the faculty for advanced doctors' training/ MHP of Ukraine, Crimean State Medical Institute, Donetsk Medical Institute named after M. Gorky, V.L Molchanov, C.L. Taleysnik, V.L Kondratenko. - Simferopol, 1992. - 25 pp.

Perftoran in intensive care of blood loss: Methodical recommendations / MHP of Ukraine, Ukrainian Center of scientific and medical information and patent and license work, Dnepropetrovsk Medical Academy; E.N. Kligunenko, O.V. Kravets, A.I. Novikov. - Dnepropetrovsk, 2004. - 27 pp.

Prevention of postoperative venous thromboembolic complications: Russian consensus (Association of phlebologists of Russia). M.: 2000. - 20 pp.

Protocols of delivering emergency medical aid in case of urgent states. / MHP of Ukraine, Ukr. Scientific-and-Practical Center for emergency medical care and medicine of catastrophes. Kiev Medical Academy of postdiploma education named after PL. Shupik. Edited by V.F. Moskalenko and G.G. Roshchin. -Kiev: Pharm Art, 2002. - 110 pp.

Treatment of acute coronary syndrome without persistent ST-segment elevation on the ECG: Russian recommendations (All-Russian scientific society of cardiologists). Moscow, 2001. - 23 pp.

Usenko L.V., Maltseva L.A., Tsarev A.V., Chernenko V.G. Contemporary view on the intensive care of ischemic insult: a place of Lacardium in complex therapy // Dnepropetrovsk, 2004. - 45 pp.

3.3. SHOCK

Shock, in medicine, is a long-standing problem, but most of all is done to solve it for the past two decades. It is associated with development and improvement of techniques on the study of shock at the cellular and subcellular level not only in the experiment, but in clinic as well.

The term "shock", per se, is too abstract to undertake concrete measures on its treatment. Not being made specific, it designates a distress signal and a need in immediate intensive care. This is the information of patient's condition at the present moment, and in this sense the term is valuable and significant. So that this term should become a clinical diagnosis, it is required to specify anatomical lesions and distinct definition of the causes of catastrophe, before all, in the sphere of gas exchange and blood circulation.

The notion "shock" is being changed along with the idea of processes of the organism's vital activity. In the recent past they were satisfied with the definition of shock as a peculiar response to the extreme stimuli accompanied by arterial hypotension. The most prevalent is the notion of shock as a symptom-complex of disorders of vitally important functions of the organism arising as a result of discrepancy between tissue blood flow and metabolic demand of tissues:

Emphesizing this characteristic feature of blood circulation disorders a shock is called as a "crisis of microcirculation". But even this definition is not final. Taking into consideration that hypoperfusion leads to hypoxia of tissues, it is just inadequate tissue oxygenation that is considered as the central problem of shock. If to unwind further these judgements, it will be legitimate to consider the disorder of tissue metabolism as the final point in definition of shock right after a disorder of central hemodynamics and tissue hypoperfusion.

General rules of the organism's response to trauma: a trauma causes a reaction of the organism that is genetically defensive, but in case of strong stimulus this reaction becomes a source of pathological changes (Fig. 43).

1. Normal blood 2. Early shock 3. Late shock 4. Irreversible

circulation (1 phase) (2 phase) shock (3 phase)

1. Arteriole; 2. Capillaries; 3. Sphincters of arterioles; 4. A-V shunt; 5. Capillary sphincter; 6. Intravascular thrombi; 7. Necrosis of cells.

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