УДК: 616.432+816432):612.015.31-02:616.831.34

Background. Traumatic brain injury (TBI) still remains the leading cause of death in people of working age. In Ukraine,
the frequency of TBI varies from 2.3 to 6 cases (average of 4–4.2) per 1,000 population annually depending on the regions. Patients with primary damage to the brain and hypothalamic-pituitary system are at risk of developing cerebral edema due to the water-electrolyte imbalance and, accordingly, osmolar imbalance between cellular and extracellular spaces. Water-electrolyte imbalance as a result of damage to the hypothalamic-pituitary system in traumatic brain injury is not described enough in the literature. The functioning of the central and peripheral links of the endocrine system depending on the location, nature and severity of injury is examined not enough. The question of diagnostic and prognostic values of various indicators of volume status in patients with trauma is also underinvestigated. The purpose of this study was to examine the types of disorders of sodium balance in patients with isolated TBI and hypothalamic-pituitary lesions; to clarify the influence of sodium imbalance type on mortality in patients with TBI and hypothalamic-pituitary lesions. Material and methods. We examined 74 patients (men/women = 60/14) with focal cerebral contusion and lesions of the hypothalamic region. Forty-seven of them were diagnosed with hypovolemia combined with hyponatremia. Hypernatremia with hypervolemia was found in 15 patients. Intracranial pressure monitoring was performed using a multifunction monitor (BSM-3562, Japan, 2018, Nihon Kohden Corporation) with a line for invasive pressure measurement. Continuous non-invasive measurement of organ tissue oxygenation (rSO2) was carried out using. Somanetics Invos Oximeter Cerebral/Somatic monitor (Covidien, Mansfield, MA, USA, 2020). Plasma electrolytes were evaluated inall patients. Conclusions. Patients with TBI and hypothalamic-pituitary lesion have different types of water-sodium imbalance, which demand the differentiated approach to their treatment. Given the small number of observations, we do not dare to link the type of sodium imbalance with lethality in patients with brain trauma and hypothalamic-pituitary lesions. We consider this requires further researches

Objective: The aim: To find out whether diaphragm dysfunction might lead to unsuccessful weaning from MV.

Patients and methods: Materials and methods: We provided prospective observational cohort study and included 105 patients and divided them in the study and the control groups. To consider diaphragm function, we check amplitude of its movement and diaphragm thickening fraction (Dtf). The primary outcome was the incidence of successful weaning from MV. The secondary outcomes were changes in diaphragm function parameters.

Results: Results: In the current study, there were found that the incidence of successful weaning from MV was 100% for the day 1 in the control group, while in study group the incidence was significantly lower. Successfully weaned from MV in the study group among children 1 month - 1 year old on day 14 were 20 out 28 patients (71%), in children 1 - 3 years old - 9 out 11 patients (82%), in children 3 - 5 years old - 15 out 15 (100%). However, on day 1 - no one from the study group was weaned (0%), on day 7 - 5 out 28 patients 1 month - 1 year old (18%), 6 out 11 patients (55%) 1 - 3 years old, and 8 out 15 patients (53%) 3 - 5 years old (p<0.05).

Conclusion: Conclusions: Diaphragm dysfunction might alter weaning from MV.

Acute respiratory failure due to pneumonia is a significant cause of death in children 6-18 years old.; Objective - to find out whether diaphragm dysfunction might lead to unsuccessful weaning from MV in children 6-18 years old.; We provided prospective observational cohort study and included 104 patients, who were splitting in the study and the control groups and 2 age subgroups. To consider diaphragm function, we check amplitude of its movement and diaphragm thickening fraction (Dtf).; The primary outcome was the incidence of successful weaning from MV. The secondary outcomes were changes in diaphragm function parameters.; Dtf for right hemidiaphragm was significantly lower in the study group 1st subgroup on day 1 and day 5, and significantly higher on day 14 (p<0.05), while for left hemidiaphragm it was significantly higher on day 1 and lower on day 5 compared with the control group (p<0.05). In 2nd subgroup Dtf was significantly higher for both sides in the study group on day 1 compared with the control group (p<0.05). ; Amplitude of diaphragm movement was significantly decreased in 1st subgroup of the study group on day 1 and day 5 and increased on day 14 compared with the control group (p<0.05).; The incidence of successful weaning from MV in the study group was significantly lower compared with the control group.; Diaphragm dysfunction might alter weaning from MV in children 6-18 years old.