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Внутрибрюшная гипертензия и абдоминальный компартмент-синдром тесно связаны с заболеваемостью и смертностью среди критически больных. Несмотря на достаточно большое количество специальных публикаций, посвященных данной проблеме, очень мало внимания уделяется абдоминальному компартмент-синдрому у больных с тяжелой термической травмой. В ряде исследований показано, что тяжелые ожоги являются фактором риска развития внутрибрюшной гипертензии. Большие объемы инфузионной терапии, используемые при лечении тяжелой ожоговой травмы, дополнительно предрасполагают пациентов к увеличению внутрибрюшного давления. Частота развития внутрибрюшной гипертензии у больных с тяжелой термической травмой составляет, по данным разных авторов, 57,8–82,6 %. После возникновения абдоминального компартмент-синдрома и связанной с ним полиорганной дисфункции летальность при обширных ожогах очень высока. Цель данной работы — проанализировать проблему развития абдоминальной гипертензии и абдоминального компартмент-синдрома у ожоговых больных, а также сделать выводы о профилактике данного состояния и улучшении результатов лечения пострадавших с тяжелой термической травмой.

The Deficiency of vitamin D is common in the gene­ral population. It is also noted in 40–70 % of critical patients in the intensive care units. Vitamin D has a wide range of pleiotropic effects on various processes and systems, including the immune-inflammatory response. Low level of vitamin D in critical patients is associated with more frequent Development of sepsis, respiratory Distress syndrome, multiple organ failure, and increased mortality. The clinical understanding of hypovitaminosis D remains underestimated and therefore is often ignored in acute clinical situations, including burn injury, in which several factors contribute to the Development and long-term maintenance of vitamin D Deficiency. Although studies on the level of vitamin D in burn patients are limited, vitamin D levels have been shown to Decline after thermal injury. Clarification of the current understanding of the role of vitamin D in patients with thermal injury, the effect of vitamin D level on treatment outcomes at Different periods of burn Disease, and the possibility and necessity of correcting of hypovitaminosis D in this category of patients is the goal of this review. The article analyzes the possibility of improving the results of the treatment of burn injury, preventing several complications of burn Disease by correcting the level of vitamin D.

Modern treatment of burns has led to a significant reduction in mortality in patients with burns whose injuries were fatal several years ago. However, along with improved survival, new problems arose in the treatment of burn patients. Systemic inflammatory response, capillary leak, sepsis top the list of the most common problems in both adults and children with severe thermal injury. Currently, new strategies are being developed and studied in the treatment of this category of patients. One of the ways to improve the results of treatment of patients with severe burn injury is to prescribe corticosteroids, both in the stage of burn shock and in the development of septic complications. Do corticosteroids reduce mortality and improve recovery in burn patients? The discussion about this has been going on for many years, but the opinion about their effectiveness remains controversial. An analysis of the literature shows that corticosteroids can play a significant role in the treatment of patients with severe burn injury and can be successfully used at any stage of a burn disease. The effect of reducing capillary leakage, increasing myocardial contractility, antiemetic, membrane-stabilizing effect of corticosteroids will be useful in the stage of burn shock. The anti-inflammatory, immunomodulatory effect of corticosteroids will play a role in any stage of a burn disease. With the aim of preventing and treating sepsis, corticosteroids may be useful in the stage of toxemia, septicotoxemia. It is also necessary to remember about adrenal insufficiency, which develops in burn patients. The article analyzes the literature, substantiates the use of corticosteroids in patients with severe burn injury in different periods of a burn disease.