In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was November 1, 2021. To develop the recommendations for the Guidelines, documents were used that directly describe the features of the management of patients with a new coronavirus infection COVID-19 (recommendations and guidelines — 35; randomized clinical trials and Cochrane Reviews — 23; observational and comparative studies — 134; other documents, notes and comments — 72). Compared to the previous, 5th, version of the recommendations, 35 provisions have been corrected in 10 sections. The provisions of the current version of the recommendations highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of the management of pregnant women, children, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered. For management of COVID-19 patients, the following were specified and supplemented: 1) indications and contraindications for the administration of drugs (acetaminophen, glucocorticosteroids, remdesevir, tocilizumab, baricitinab, statins, convalescent plasma), depending on the severity of the disease; 2) features of intensive care for concomitant diseases (cardiovascular system, inflammatory bowel disease, cancer, arrhythmia); 3) the timing of elective surgery in patients who survive COVID-19, and post vaccination; 4) thromboprophylaxis and management of coagulation disorders; 5) regulatory and legal documents concerning the activities of healthcare workers facing COVID-19.

The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was June 29, 2020. To develop the Guidelines for the recommendations, were used documents that directly describing the features of the management of patients with coronavirus disease COVID-19 (guidelines and guidelines — 16; randomized clinical trials and Cochrane Reviews — 8; observational and comparative studies — 77; other documents, notes and comments — 54) and describing anesthetic and resuscitation support in the general population of patients. The provisions of the recommendations highlight the specifics of anesthesia, intensive care, resuscitation, manipulation, and prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis are described. The features of the management of pregnant women, children of different age, patients with concomitant diseases, issues of transportation of patients are considered.

The article provides the main statements of the guidelines for the anesthesia and intensive care of patients with the coronavirus disease (COVID-19), developed by the Federation of Anesthesiologists and Reanimatologists of Russia. In the process of developing the recommendations, the publications of the official websites of the Russian Federation, the electronic databases of the RSCI, PubMed, MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) were analyzed by the developers independently of each other. The date of the last search query was February 01, 2021. To develop the recommendations for the Guidelines, were used documents directly describing the features of the management of patients with NCI COVID-19 (guidelines — 34; randomized clinical trials and Cochrane Reviews — 13; observational and comparative studies — 107; other documents, notes and comments — 64), and documents describing anesthesia and intensive care in the general population of patients. Compared to the previous 4th version of the guidelines, the recommendations in 8 sections have been corrected; new subsections “Chronic kidney disease”, “Rehabilitation treatment of patients with COVID-19 in the intensive care unit”, “Routing of patients with COVID-19 to the stages of rehabilitation” were created; revised 1 Appendix, additionally developed 7 Appendices; the section “Quality criteria” has been supplemented. The provisions of the current version of the guidelines highlight the specifics of anesthesia, intensive care, rehabilitation, resuscitation measures, manipulation, transportation, prevention of the spread of COVID-19 in the implementation of these activities. Methods of protecting personnel from infection with COVID-19 during manipulations, anesthesia and intensive care are considered. The features of respiratory support, extracorporeal detoxification, extracorporeal membrane oxygenation, thromboprophylaxis, drug interactions are described. The features of management of pregnant women, children of different age groups, patients with concomitant diseases, the principles of the formation of stocks of drugs and consumables are considered.

Acute ischemic stroke is a serious problem for healthcare systems worldwide. Searching for the optimal neuroprotector is a contemporary challenge. Various studies have demonstrated neuroprotective properties of argon in ischemic brain damage models. However, the published data are inconsistent.The aim of the study was to evaluate the effect of 24-hour argon-oxygen mixture (Ar 70%/O_₂ 30%) inhalation on the severity of neurological deficit and the extent of brain damage in rats after a photoinduced ischemic stroke. Material and methods. The experiments were carried out on male Wistar rats weighing 430–530 g (N=26). Focal ischemic stroke was modeled in the sensorimotor cortex of the rat brain using photochemically induced vascular thrombosis. The animals were randomly divided into 3 groups: sham procedure + N_₂ 70%/O_₂ 30% inhalation (SP, N=6); stroke + N_₂ 70%/O_₂ 30% inhalation (Stroke, N=10); Stroke + Ar 70%/O_₂ 30% inhalation (Stroke+iAr, N=10). The limb placement test (LPT) was used for neurological assessment during 14 days. Additionally, on day 14 after the stroke, brain MRI with lesion size morphometry was performed. Summarized for days 3,7 and 14 LPT scores were lower in the Stroke and Stroke + iAr groups as compared to the SP group.Results. Statistically significant differences in LPT scores between SP, Stroke, and Stroke+iAr groups were revealed on day 3 post-stroke: (scores: 14 (13; 14), 6.5 (4; 8), and 5 (3; 8), respectively, P=0.027). However, there was no statistical difference between the Stroke and Stroke+iAr groups.Conclusion. 24-hour inhalation of argon-oxygen mixture (Ar 70%/O₂ 30%) after stroke does not reduce the extent of brain damage or the severity of neurological deficit.

These guidelines were developed by a team of leading experts and representatives of the Federation of Anesthesiologists and Reanimatologists, the Russian Society of Emergency Medicine, the National Resuscitation Council and the Russian Society of First Aid.The guidelines provide a comprehensive framework for resuscitating adult patients with circulatory arrest. They cover: standardized terminology related to cardiac arrest; etiology and pathogenesis of cardiac arrest; epidemiology of both out-of-hospital and in-hospital cardiac arrest; diagnostic principles; algorithms for basic life support, including the use of automated external defibrillators; advanced cardiac life support protocols; special considerations for extracorporeal life support (ECLS); resuscitation procedures in catheterization laboratories, for cardiac surgery patients, and during labor; legal aspects of justified withdrawal (termination) from resuscitation efforts; quality indicators in emergency care.The guidelines also feature illustrated step-by-step algorithms for resuscitation procedures. The document includes 14 appendices and 232 references.

The noble gas argon is one of the most promising neuroprotective agents for hypoxic-reperfusion injuries of the brain. However, its effect on traumatic injuries has been insufficiently studied. The aim of this study was to analyze the effect of the triple inhalation of the argon-oxygen mixture Ar 70%/O₂ 30% on physical and neurological recovery and the degree of brain damage after traumatic brain injury and to investigate the possible molecular mechanisms of the neuroprotective effect. The experiments were performed in male Wistar rats. A controlled brain injury model was used to investigate the effects of argon treatment and the underlying molecular mechanisms. The results of the study showed that animals with craniocerebral injuries that were treated with argon inhalation exhibited better physical recovery rates, better neurological status, and less brain damage. Argon treatment significantly reduced the expression of the proinflammatory markers TNFα and CD68 caused by TBI, increased the expression of phosphorylated protein kinase B (pAKT), and promoted the expression of the transcription factor Nrf2 in intact animals. Treatment with an argon-oxygen breathing mixture after traumatic brain injury has a neuroprotective effect by suppressing the inflammatory response and activating the antioxidant and anti-ischemic system.