The temperature of the brain can reflect the activity of its different regions, allowing us to evaluate the connections between them. A study involving 111 patients in a vegetative state or minimally conscious state used microwave radiometry to measure their cortical temperature. The patients were divided into a main group receiving a 10-day selective craniocerebral hypothermia (SCCH) procedure, and a control group receiving basic therapy and rehabilitation. The main group showed a significant improvement in consciousness level as measured by CRS-R assessment on day 14 compared to the control group. Temperature heterogeneity increased in patients who received SCCH, while remaining stable in the control group. The use of microwave radiometry to assess rehabilitation effectiveness and the inclusion of SCCH in rehabilitation programs appears to be a promising approach.

The study of circadian rhythms in the human body using temperature measurements is the most informative way to assess the viability of the body’s rhythm-organizing systems. Pathological processes can affect circadian rhythm dynamics in damaged organs. Severe brain damage that caused the development of disorders of consciousness (DOC) (strokes, traumatic brain injury) disrupts the activity of central oscillators, by directly damaging or destroying the periphery links, and the level of preservation of circadian rhythms and the dynamics of their recovery can be informative diagnostic criteria for patient’s condition assessment. This study examined 23 patients with DOC by using a non-invasive method for obtaining body and cerebral cortex temperature to compare with healthy controls. Measurements were made with a 4 h interval for 52 h beginning at 08:00 on day 1 and ending at 08:00 on day 3. The profile of patients with DOC showed complete disruption compared to healthy controls with rhythmic patterns. The results indicate that the mechanisms for maintaining brain circadian rhythms are different from general homeostasis regulation of the body. Use of microwave radio thermometry for the identification of rehabilitation potential in patients with DOC is a promising area of investigation.

According to various data, sports traumatic brain injury (TBI) accounts for up to 20% of all injuries in athletes, and the number of cases of traumatization is progressively increasing year by year due to an increase in the number of people involved in sports, the growing popularity of extreme and contact sports, as well as a high level of motivation to achieve record results. The structure of sports TBI is dominated by mild TBI, which can provoke the development of a very wide range of complications and negative consequences that affect not only the result, but, most importantly, the quality of life of athletes. The pathogenesis of mild TBI has been studied, therapy and rehabilitation programs have been developed. At the same time, the features of sports TBI that significantly distinguish it from domestic, road or criminal injuries are not sufficiently taken into account: repeated frequent TBI, increased body and brain temperature, peripheral redistribution of blood flow and hypocapnia associated with physical exertion and significantly affecting cerebral blood flow. An athlete receives a TBI during the most vulnerable period for the brain. To a large extent, these features are associated with the high incidence of various kinds of neurological complications of sports TBI (cognitive disorders, memory impairment, sleep disorders, migraines, etc.). Special techniques that can prevent complications of sports TBI have not been developed. Brain injury is an independent cause of the development of cerebral hyperthermia, which significantly worsens the course and consequences of TBI. The well-known technology of craniocerebral hypothermia (CCG) allows to reduce physical general and cerebral hyperthermia, to increase the resistance of neurons of the cerebral cortex to hypoxia and trauma. However, this technology is used sporadically, which, apparently, is due to the lack of awareness of coaches and doctors of sports teams specializing in sports medicine and rehabilitation. The purpose of the review is to analyze the features of the action of selective hypothermia of the cerebral cortex, used to prevent complications of mild sports TBI.

The literature review covers an analysis of the typical protective and adaptive reaction mechanisms that develop in small rodents that spontaneously hibernate under the cold snap, together with warm-blooded animals and humans during circadian fall of the body temperature at night time and in a course of a slow-wave sleep, along with induced artificial therapeutic hypothermia. The general features of neuroprotection states development in natural endogenous and induced hypothermia are highlighted, which include metabolic, epigenetic and biophysical reactions that ensure the formation of nonspecific tolerance of the brain to potentially damaging effects. Significant attention has been devoted to the participation of hibernation proteins, opioids and antioxidant systems in the processes of safe exit from state of torpor in animals and in implementation of sleep restoration functions. Taking into account the circadian nature formation of endogenous brains hypothermia at night and in the phases of slow sleep, it is suggested that periodic temperature exposure on the cerebral cortex can be applied in order to restore the disturbed circadian rhythms. From the standpoint of common mechanisms of endogenous and induced hypothermia, selective hypothermia of the cerebral cortex can be considered as a nature-like technology. Based on the extensive experimental material indicating a significant neuroprotective potentials of low temperatures during hibernation, diurnal hypothermia as well as artificially induced hypothermia, it was stated that implementation of the technology for selective hypothermia of the cerebral cortex in order to prevent the negative consequences of cerebral catastrophes are a perspective trend.

BACKGROUND: Chronic critical illness is characterized by ventilator dependence, systemic inflammatory response, multiorgan failure, secondary sarcopenia, hypermetabolism and hypercatabolism, and protein–energy malnutrition. In this category of intensive care unit patients, lower respiratory tract infections remain a significant cause of adverse outcomes, prolonged hospital stays, and increased treatment costs. It is impossible to provide adequate empirical treatment of lower respiratory tract infections without knowing the etiology and resistance of the leading pathogens of this nosocomial infection in a specific department of a healthcare organization. AIM: The study aimed to characterize the etiology of lower respiratory tract infections in intensive care unit patients from 2020 to 2023, determine their antibiotic susceptibility, identify the most common resistance mechanisms of leading pathogens, and provide recommendations for optimizing antimicrobial therapy. METHODS: The study included patients with confirmed lower respiratory tract infections, primarily those with prolonged or chronic critical illnesses, from 2020 to 2023. The BD Phoenix 100 automated analyzer was used to identify the pathogens. Susceptibility was interpreted using EUCAST criteria. RESULTS: From 2020 to 2023, the top 10 pathogens responsible for lower respiratory tract infections in 1,007 patients were predominantly gram-negative microorganisms. For this period, the following trends were noted: an increase in Acinetobacter baumannii from 13.22% to 21.40% (p 0.001), and a decrease in Escherichia coli from 7.90% to 2.98% (p 0.001). From 2020 to 2023, the resistance of Klebsiella pneumoniae and Acinetobacter baumannii to carbapenems increased significantly, from 80.50% to 91.64% (p 0.001) and from 89.89% to 98.14% (p 0.001), respectively. Among carbapenemase-producing Klebsiella pneumoniae, resistance to colistin, tigecycline, and ceftazidime + avibactam increased from 4.95% to 9.00% (p 0.001), from 48.76% to 71.28% (p 0.001), and from 33.06% to 47.73% (p = 0.041), respectively. CONCLUSION: The predominant pathogens causing lower respiratory tract infections in intensive care unit patients included Gram-negative bacteria with a high level of antibiotic resistance. These bacteria included carbapenem-resistant Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii. The etiological structure of lower respiratory tract infections and their antibiotic susceptibility in these patients should be evaluated to create local protocols for effective empirical antimicrobial therapy in each specific intensive care unit of a healthcare organization.

BACKGROUND: Bacteremia is a serious clinical condition that often precedes or accompanies sepsis and septic shock, which remain leading causes of hospital mortality worldwide. Understanding the epidemiology of bacteremia—including antimicrobial resistance patterns—and treatment principles is critical for improving outcomes in patients with chronic critical illness and severe brain injury. AIM: This study aimed to determine the profile of bacteremia in patients with severe brain injury in predominantly chronic critical illness admitted to intensive care units from 2018 to 2024 and their antibiotic susceptibility; to identify common resistance mechanisms of leading pathogens; and to formulate recommendations for optimizing antimicrobial therapy in this population. METHODS: The study included patients with severe brain injury in predominantly chronic critical illness who developed clinically significant bacteremia. Microorganisms were identified, and antibiotic susceptibility was determined using the BD Phoenix 100 automated analyzer. Susceptibility interpretation followed EUCAST criteria. RESULTS: Among 292 patients in predominantly chronic critical illness, the top ten bacteremia pathogens were primarily Gram-negative organisms, including Klebsiella pneumoniae (40.11%), Pseudomonas aeruginosa (6.22%), Proteus/ Providencia spp. (5.94%), Acinetobacter baumannii (5.37%), Serratia marcescens (4.24%), Escherichia coli (3.10%), and Enterobacter cloacae (1.69%). During this period, high carbapenem resistance was observed in Klebsiella pneumoniae (84.29%) and Pseudomonas aeruginosa (61.90%). Among Gram-positive organisms, coagulase-negative staphylococci predominated (21.47%). CONCLUSION: Gram-negative bacteria with high levels of antibiotic resistance, including carbapenem-resistant Klebsiella pneumoniae and Pseudomonas aeruginosa, were the predominant pathogens in bacteremia among patients with chronic critical illness in intensive care units. Establishing effective empirical antimicrobial therapy protocols requires analysis of local antibiotic susceptibility data.