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Objective. This article describes the first experience of using an oxygenated salt intestinal solution (SIS) in the complex intensive care of functional intestinal failure (FIF) developed due to pancreonecrosis in a child aged 10 years 11 months after a blunt abdominal injury and burdened with concomitant alimentary factor. Complex treatment was aimed to eliminate increasing endotoxicosis, pain syndrome, suspected secondary ischemia of the affected organs of the pancreaticoduodenal zone, restoration of motor and barrier functions of the intestine. In this connection, adjustments were made to the early enteral nutrition and enteral correction method using an oxygenated salt enteral solution (with a description of the oxygenation method), which allowed for 12 h to eliminate intestinal paresis, with the production of stool. According to the intestinal lavage method, repeated use of SIR-RA led to the significant persistent improvement in the patients condition and a decrease in inflammatory markers, which subsequently allowed the transition to adequate enteral nutrition. The patient was subsequently transferred to a specialized surgical Department and discharged from the hospital, and recovered with no signs of endocrine pancreatic insufficiency. Positive treatment results of a patient with pancreonecrosis complicated by FIF were made possible by improving intensive therapy tactics using an oxygenated salt enteral solution. The scheme of gradual enteral correction developed and used by us is an essential component of complex therapy of pancreonecrosis and functional intestinal insufficiency. The use of an oxygenated salt enteral solution helps to restore the main functions of the gastrointestinal tract.

The article discusses current approaches to anesthesia in providing vascular access in children in Russia and the framework of the existing problem and global practice. Several features of the child's body, such as small size, increased flexibility of the punctured vessel, expressed psycho-emotional and the childs motor reaction to a potentially painful invasive procedure create significant additional difficulties in peripheral vein catheterization in children, especially at an early age, compared with adults. This fact until recently caused a high frequency of unsuccessful peripheral vein catheterizations in children and, as a result, a high percentage of punctures and central vein catheterizations, which in turn is associated with the risk of serious potentially life-threatening complications accompanying the puncture and catheterization of the latter. The article describes various, including non-pharmacological methods for inducing adequate sedation and analgesia during vein catheterization. The parents presence in the intensive care unit plays an essential role in non-pharmacological methods of child protection. It is a factor that reduces stress and psycho-emotional stress, both for the child and indirectly for the medical staff. Information from domestic and foreign sources on the use of various administration methods and various pharmacological drugs demonstrate the variety of approaches to solving this urgent problem. This article presents our research results showing the advantages of using a combination of methods and drugs that provide adequate anesthesia, expressed as an increase in successful peripheral vein catheterizations, the corresponding reduction in the unjustified number of central vein catheterizations, and the positive economic effect accompanying this dynamic.

Introduction. Catatrauma is one of the main causes of childhood injuries and deaths in Russia. The severity of the condition of catatrauma is caused by combined injuries, high disability and lethality depend on them. Most often, children fall from the balconies of houses, windows, trees, and playgrounds. The purpose of the study was to show, on a clinical example, the case of a fall of a child from the height of the 16th storey of a dwelling house and the survival with a favorable outcome. Material and methods. The clinical example demonstrates the provision of medical care to a 5 years old child with catatrauma in a metropolis. After falling from a critical height (48 m) at the prehospital stage, he was assisted by ambulance brigades, and transportation was carried out by a helicopter. At the hospital stage, the victim was treated at the Research Institute of Emergency Surgery and Traumatology, where all departments of the clinic were involved. Results. This clinical case is unique in that the child, having fallen from the 16th sorey, from a height of more than 48 m, having received multiple combined injuries with an ISS score of 34 points, survived. An outcome was favorable due to the fact that the child was dressed in winter clothes with a jacket hooded over his head and fell into the snow, as well as coordinated actions of the services and units providing medical care at the prehospital and hospital stages in the metropolis. Conclusion. A favorable outcome after the child had fallen from a critical height, was affected by facts that both the child was dressed in winter clothes with a hood and a hat, put on the head, falling into the snow, and the coordinated activity of the structures and units participating in the prehospital and hospital stages of medical care.