European Journal of Medicine

37-43

Authors: Igor R. Trutyak, Oleg V. Obaranets

Transcondylar and supracondylar fractures of the humerus in children are one of the most pressing and still not completely solved problems of modern pediatric traumatology. In the problem of condylar and supraorbital fractures of the humerus, the issues of diagnosis, choice of indications for surgical revision of the vascular-nervous bundle of the elbow area in this pathology are insufficiently covered. To solve the problems of the study, we analyzed the treatment of 313 victims with transcondylar and supracondylar fractures of the humerus, which were treated at the City Children's Clinical Hospital in Lviv in the period from 2013 to 2018. The structure of the distribution of arrays on the basis of rotational displacement in condylar fractures of the humerus is dominated by displacement up to 30 °, which in the first group was found in 61.8 % of cases, and in the second group – 69.2 % of cases. The share of severe rotational displacements in the structure of group arrays is almost the same in both observation groups: 29.1 % in the first group and 29.5 % in the second group. Analysis of the proportion of extremely severe rotational displacements up to 90 ° in the structure of group arrays revealed that such victims were 7 times more among the victims of the first group than among the victims of the second group, due to the use of the proposed unified protocol scheme for diagnosis and treatment humeral fractures in pediatric patients, which avoids or reduces the difference in the occurrence of secondary displacements.

20-25

Authors: Оleg V. Voennov, Кonstantin V. Моkrov, Valery I. Zаgrekоv, Sergey А. Аbramov, Danyil S. Chumanov, Olesya N. Gunderchuk

An observational prospective study was conducted, during which 50 patients of both sexes with severe COVID-19 and moderate manifestations of acute respiratory failure were examined. The study included patients who showed a decrease in transcutaneous saturation of less than 93 %, with a respiratory rate of no more than 25 per minute, who did not have complaints of dyspnea and impaired consciousness, but required, according to temporary clinical recommendations for the treatment of patients with COVID-19, correction of respiratory disorders. We determined the values of transcutaneous saturation using pulse oximetry, studied the acid-base state and gas composition of arterial and venous blood, and also took into account complaints of respiratory disorders, respiratory rate, the presence of forced breathing, heart rate, the "white spot" symptom and blood lactate level. The selected methods of treatment of respiratory disorders, necessary for the correction of acute respiratory failure, and the results of hospitalization were also taken into account. Based on the data obtained, it was concluded that in patients with COVID-19 "silent hypoxia" is associated with the development of moderate compensated arterial hypoxemia without the development of hypercapnia, tissue hypoxia and acidosis. Arterial hypoxemia in patients with "silent hypoxia" is compensated by known compensatory mechanisms – an increase in the delivery and utilization of oxygen to the tissues and an increase in the alkaline reserve. Moderate arterial hypoxemia without tissue hypoxia is corrected by pron-position and oxygen therapy, and does not require conversion to artificial ventilation.