From Big Medical Encyclopedia

INTENSIVE CARE UNIT (Latin re-the prefix meaning repetition, resuming, + animatio revival) — the functional and structural division of hospital intended for rendering the resuscitation help to seriously ill patients of various profile and carrying out an intensive care by it.

Rubles of the lake as a part of large hospitals were organized 50 at the end — the beginning of the 60th of 20 century as a result of development resuscitation (see). Lakes were R. first in our country the intensive care unit opened in 1959 in Moscow clinical the Orders of Lenin-tse of S. P. Botkin — clinical base of Research laboratory of the general resuscitation of the USSR Academy of Medical Sciences run by V. A. Negovsky, R. the lake at hospital surgical clinic of the 1st MMI and scientific research institute of clinical and experimental surgery the M3 of the USSR directed by B. V. Petrovsky.

Depending on problems of treatment in the USSR developed three ooze P. of the lake — all-profile, chambers of a postoperative intensive care and specialized R. of the lake.

All-profile intensive care units are intended for holding both the emergency, and long resuscitation actions at sharply arisen terminal states — traumatic shock, blood loss, acute respiratory and heart failure of various etiology, postoperative complications, in the postresuscitatic period after clinical death (see. Resuscitation ). They will be organized on the basis of the large multi-profile BCs having exit resuscitation service for assistance to patients in other hospitals of the city (area, the republic).

All-profile R. the lake shall have the spacious room (30 — 40 m 2 ) for primary inspection and rendering the emergency help to the arriving patients. Chambers for the subsequent treatment of patients also shall be rather spacious (13 — 15 m 2 on one bed) and to have a post of sisterly observation. All rooms are supplied with the centralized distributing of oxygen, compressed air and vacuum, have planimetric grounding, not less than 4 sockets of the power supply network on a bed, necessary diagnostic and to lay down. equipment, medicinal and infusional means for rendering the planned and emergency help to patients. For patients with it is purulent - allocate with septic complications the isolated room (20% of bed fund of department). Important division of R. of the lake is round the clock functioning express laboratory with the volume of researches corresponding to a profile of the main contingent of patients. Minimum volume of researches of laboratory following: gas composition and acid-base equilibrium of blood, electrolytic structure of a blood plasma and urine, indicators of anemia, crude protein, urea and creatinine of blood, indicators of coagulant system of blood.

Maintaining patients in all-profile R. of the lake is carried out by resuscitators with obligatory participation of the profile specialist and involvement as required of consultants.

The river of the lake has corresponding diagnostic and to lay down. equipment: system for monitor observation with bedside blocks and the central panel (see. Monitor observation ), devices for electrocardiography (see) and electroencephalography (see), ekhoentsefalografiya (see), spirocount, mobile X-ray apparatus (see), devices for studying of a hemodynamics, devices for artificial respiration (see) — manual and automatic (one respirator on 2 beds), the narcotic device (see. Anaesthesia ), defibrillators (see. Defibrillation ), supports or suspended devices for infusions (on 2 on each bed), surgical tools (see), dressing material (see), bronchoscopes (see. Bronkhoskopiya ), inhalers, etc. Also sets (not less than two) for an intubation tracheas, sterile sets are necessary for thoracotomies (see), tracheostomies (see), exposures of vessels (see. Venosektion ), a resuscitation set of devices and tools on the mobile cart for assistance to patients in other departments. It is desirable to have the equipment for hemodialysis (see), hemosorptions (see) and the camera for hyperbaric oxygenation (see).

Chambers of a postoperative intensive care will be organized as a part of departments of anesthesiology resuscitation and are intended for overseeing by the patients operated under anesthetic, prevention of complications of the postoperative period and carrying out intensive care (see). The number of beds in them would depend on the power of the surgical sector and 5% of number of beds in departments of the general surgery and traumatology shall be presented, to 1% — gynecology, 10% — thoracic surgery.

Specialized intensive care units are intended for treatment of seriously ill patients with certain types of pathology. Respiratory departments are created in large neurologic clinics for carrying out long artificial ventilation of the lungs at patients with the respiratory insufficiency caused by diseases of a nervous system (a polyradiculoneuritis, encephalitis, tetanus, etc.). Treatment of patients with poisonings with various poisons is carried out in toxicological departments or the centers. Cardiological R. of the lake where help is given generally sick with a myocardial infarction were widely adopted. The organization and specialized R.' equipment of the lake depends on their profile: in respiratory departments it is enough to have 2 respirators on each bed; the toxicological centers shall have toksikol. laboratories and the equipment for a hemodialysis and hemosorption. In cardiological departments much attention is paid to equipment for carrying out monitor observation, cardiostimulation and cardiac defibrillation.

See also Hospital .

Bibliography: Negovsky V. A., etc. The organization of work of intensive care unit of the general profile and mobile resuscitation teams, in book: Fundamentals of resuscitation, under the editorship of V. A. Negovsky, page 347, Tashkent, 1977; Petrovsky B. V. Organization of intensive care units, Surgery, No. 6, page 15, 1976; Chernyakhovsk F. R. Organization of department of anesthesiology resuscitation, M., 1979; Hunter A. R. Intensive care as ^а specialty, Lancet, v. 1, p. 1151, 1967; M a t h e P. Centre de reanimation polyva-lente, Ann. Anesth. frang., t. 6, p. 43, 1965.

B. L. Kassil.