Clinical physiology of general anesthesia. Zilber A

Place of work: Academic degree: Academic title: Alma mater: Awards and prizes:

Anatoly Petrovich Zilber(born in 1931) - organizer of the first intensive respiratory therapy department in Russia (1989), then a respiratory center (2001). Author of the concept of critical care medicine (MCM) (1989). Doctor of Medical Sciences (1969), professor (1973), academician of the Russian Medical-Technical Academy (1997) and the Academy of Security, Defense and Law Enforcement of the Russian Federation (2007).

Honorary and full member of the Board of the Federation of Anesthesiologists and Reanimatologists of the Russian Federation, Honored Scientist of the Russian Federation, Honorary Worker of Higher Professional Education of the Russian Federation, People's Doctor of the Republic of Karelia, Knight of the Orders of Friendship and Honor.

Biography

Bibliography

Author of more than 400 published works, including 34 monographs. Being one of the founders of domestic anesthesiology and resuscitation, A.P. Zilber pays great attention to the study of the respiratory system, and his first monograph “Operating position and anesthesia” has the subtitle “Postural reactions of blood circulation and breathing in anesthesiology.” The subject of his research is the reaction of the respiratory system in any critical condition. For A.P. Zilber, the respiratory system is not only a structure that provides the entire body with the necessary amount of oxygen and relieves it of excess carbon dioxide. This is the most important life support system of the body, protecting it from “external and internal enemies”, creating the conditions necessary for the normal functioning of other vital organs. It is difficult to say what is more surprising in his works - the non-standard approach to the problems being studied or the unexpectedness of the findings and identified patterns. A clear proof of this is the professor’s main works on this topic: “Regional functions of the lungs. Clinical physiology of uneven ventilation and blood flow”, “Respiratory therapy in everyday practice”, “Respiratory failure” and, finally, “Respiratory medicine”(!). The main feature of these (and other) books by A.P. Zilber, which makes them books “for all times,” is their clinical and physiological focus and validity. This is probably why none of the fundamental provisions derived by A.P. Zilber from his research was refuted or, at least, reasonably rejected. Zilber A.P. Blood loss and blood transfusion. Principles and methods of bloodless surgery. - Petrozavodsk: Petrozavodsk State University Publishing House, 1999. - 114 p. - 5000 copies. - ISBN 5-8021-0057-5.

Zilber A.P. Clinical physiology in anesthesiology and resuscitation. - 1984. - 486 p.

Zilber A.P. Sketches of critical medicine. - 2006.

Zilber A.P.. - Ministry of Health of the Russian Federation, 2001.

Zilber A.P. Treatise on euthanasia. - Petrozavodsk: Peter. State University, 1998. - 464 p.

Zilber A.P. Ethics and law in critical care medicine. - Petrozavodsk: Petrozavodsk University Publishing House, 1998. - 560 p.

Famous sayings

if the doctor is familiar with modern ideas about the clinical physiology of blood, blood loss and blood transfusion, he will find alternative methods suitable for a particular patient and will do without donor blood transfusion

Jehovah's Witnesses proved useful to medicine […] They... forced doctors to reconsider the effectiveness of blood transfusions, prompted the search for alternative methods, and, finally, increased attention to the rights of patients. Thus, paraphrasing Voltaire, who ... wrote - “If God did not exist, he would have to be invented,” I would say - “If Jehovah’s Witnesses did not exist, they would have to be invented,” so that we would quickly get a correct idea of ​​the acute blood loss and the role of blood transfusion

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Excerpt characterizing Zilber, Anatoly Petrovich

- Well, what, my Cossack? (Marya Dmitrievna called Natasha a Cossack) - she said, caressing Natasha with her hand, who approached her hand without fear and cheerfully. – I know that the potion is a girl, but I love her.
She took out pear-shaped yakhon earrings from her huge reticule and, giving them to a beaming and blushing Natasha, immediately turned away from her and turned to Pierre.
- Eh, eh! kind! “Come here,” she said in a feignedly quiet and thin voice. - Come on, my dear...
And she menacingly rolled up her sleeves even higher.
Pierre approached, naively looking at her through his glasses.
- Come, come, my dear! I was the only one who told your father the truth when he had a chance, but God commands it to you.
She paused. Everyone was silent, waiting for what would happen, and feeling that there was only a preface.
- Good, nothing to say! good boy!... The father is lying on his bed, and he is amusing himself, putting the policeman on a bear. It's a shame, father, it's a shame! It would be better to go to war.
She turned away and offered her hand to the count, who could hardly restrain himself from laughing.
- Well, come to the table, I have tea, is it time? - said Marya Dmitrievna.
The count walked ahead with Marya Dmitrievna; then the countess, who was led by a hussar colonel, the right person with whom Nikolai was supposed to catch up with the regiment. Anna Mikhailovna - with Shinshin. Berg shook hands with Vera. A smiling Julie Karagina went with Nikolai to the table. Behind them came other couples, stretching across the entire hall, and behind them, one by one, were children, tutors and governesses. The waiters began to stir, the chairs rattled, music began to play in the choir, and the guests took their seats. The sounds of the count's home music were replaced by the sounds of knives and forks, the chatter of guests, and the quiet steps of waiters.
At one end of the table the countess sat at the head. On the right is Marya Dmitrievna, on the left is Anna Mikhailovna and other guests. At the other end sat the count, on the left the hussar colonel, on the right Shinshin and other male guests. On one side of the long table are older young people: Vera next to Berg, Pierre next to Boris; on the other hand - children, tutors and governesses. From behind the crystal, bottles and vases of fruit, the Count looked at his wife and her tall cap with blue ribbons and diligently poured wine for his neighbors, not forgetting himself. The countess also, from behind the pineapples, not forgetting her duties as a housewife, cast significant glances at her husband, whose bald head and face, it seemed to her, were more sharply different from his gray hair in their redness. There was a steady babble on the ladies' end; in the men's room, voices were heard louder and louder, especially the hussar colonel, who ate and drank so much, blushing more and more, that the count was already setting him up as an example to the other guests. Berg, with a gentle smile, spoke to Vera that love is not an earthly, but a heavenly feeling. Boris named his new friend Pierre the guests at the table and exchanged glances with Natasha, who was sitting opposite him. Pierre spoke little, looked at new faces and ate a lot. Starting from two soups, from which he chose a la tortue, [turtle,] and kulebyaki and to hazel grouse, he did not miss a single dish and not a single wine, which the butler mysteriously stuck out in a bottle wrapped in a napkin from behind his neighbor’s shoulder, saying or “drey Madeira", or "Hungarian", or "Rhine wine". He placed the first of the four crystal glasses with the count's monogram that stood in front of each device, and drank with pleasure, looking at the guests with an increasingly pleasant expression. Natasha, sitting opposite him, looked at Boris the way thirteen-year-old girls look at a boy with whom they had just kissed for the first time and with whom they are in love. This same look of hers sometimes turned to Pierre, and under the gaze of this funny, lively girl he wanted to laugh himself, not knowing why.
Nikolai sat far from Sonya, next to Julie Karagina, and again with the same involuntary smile he spoke to her. Sonya smiled grandly, but apparently was tormented by jealousy: she turned pale, then blushed and listened with all her might to what Nikolai and Julie were saying to each other. The governess looked around restlessly, as if preparing to fight back if anyone decided to offend the children. The German tutor tried to memorize all kinds of dishes, desserts and wines in order to describe everything in detail in a letter to his family in Germany, and was very offended by the fact that the butler, with a bottle wrapped in a napkin, carried him around. The German frowned, tried to show that he did not want to receive this wine, but was offended because no one wanted to understand that he needed the wine not to quench his thirst, not out of greed, but out of conscientious curiosity.

At the male end of the table the conversation became more and more animated. The colonel said that the manifesto declaring war had already been published in St. Petersburg and that the copy that he himself had seen had now been delivered by courier to the commander-in-chief.
- And why is it difficult for us to fight Bonaparte? - said Shinshin. – II a deja rabattu le caquet a l "Autriche. Je crins, que cette fois ce ne soit notre tour. [He has already knocked down the arrogance of Austria. I am afraid that our turn would not come now.]
The colonel was a stocky, tall and sanguine German, obviously a servant and a patriot. He was offended by Shinshin's words.
“And then, we are a good sovereign,” he said, pronouncing e instead of e and ъ instead of ь. “Then that the emperor knows this. He said in his manifesto that he can look indifferently at the dangers threatening Russia, and that the safety of the empire, its dignity and the sanctity of alliances,” he said, for some reason especially emphasizing the word “unions”, as if this was the whole essence of the matter.
And with his characteristic infallible, official memory, he repeated the opening words of the manifesto... “and the desire, the sole and indispensable goal of the sovereign: to establish peace in Europe on solid foundations - they decided to send part of the army abroad and make new efforts to achieve this intention “.
“That’s why, we are a good sovereign,” he concluded, edifyingly drinking a glass of wine and looking back at the count for encouragement.
– Connaissez vous le proverbe: [You know the proverb:] “Erema, Erema, you should sit at home, sharpen your spindles,” said Shinshin, wincing and smiling. – Cela nous convient a merveille. [This comes in handy for us.] Why Suvorov - they chopped him up, a plate couture, [on his head,] and where are our Suvorovs now? Je vous demande un peu, [I ask you,] - he said, constantly jumping from Russian to French.

Reviewers: Head of the Department of Anesthesiology, Resuscitation and Intensive Care, State Educational Institution of Higher Professional Education

"St. Petersburg State Medical University named after Academician I. P. Pavlov" Ministry of Health and Social Development, Doctor of Medical Sciences, Professor V. A. Koryachkin (city. Saint Petersburg);

Head of the Department of Anesthesiology and Reanimatology, State Educational Institution of Higher Professional Education "Altai State Medical University" Ministry of Health and Social Development, Doctor of Medical Sciences, Professor M. I. Neimark (Barnaul).

Published by decision of the editorial and publishing council of the Northern State Medical University

B17 Basic anesthesiologist course: textbook, electronic version / ed. E. V. Nedashkovsky, V. V. Kuzkov. - Arkhangelsk: Northern State Medical University, 2010. - 238 p.

ISBN 978-5-91702-041-9

In a training manual prepared under the auspices of the World Federation of Societies of Anesthesiology (World Federation of Societies of Anaesthesiologists, WFSA), issues of applied physiology, clinical pharmacology and technical support of modern anesthesiology are comprehensively considered. Along with detailed theoretical information, a large number of clinical examples and illustrations are presented. There is a list of questions to assess the knowledge gained.

The manual is intended for clinical interns and residents, as well as cadets of the faculty of advanced training, studying in the specialty of anesthesiology and resuscitation.

UDC 616-089.5(075) BBK 54.5ya73

© World Federation of Societies of Anaesthesia

	Physiology
	Myocardial physiology
	Physiology of breathing
	Carbon dioxide transport
	Kidney physiology
	Physiology of the liver
	Physiology of pain
	Pharmacology
	Introduction to pharmacology and drug dosing
	Pharmacokinetics and anesthesia
	Pharmacodynamics and physiology of receptors
	Pharmacology of the autonomic nervous system
	Pharmacology of intravenous anesthetics
	Pharmacology of inhalational anesthetics
	Pharmacology of muscle relaxants and cholinesterase inhibitors
	Paracetamol: three methods of administration
	Pharmacology of non-steroidal anti-inflammatory drugs
	Pharmacology of opioids
	Pharmacology of local anesthetics
	Physics and equipment
	Gases and vapors
	Evaporators
	Physics of Flow
	Breathing circuits in anesthesiology
	SI System Units
	Humidification of the breathing mixture
	Capturing and removing gaseous and volatile anesthetics
	Practical application of pulse oximetry
	Blood pressure measurement
	Biological signals and their measurement
	Respiratory gas analysis
	Electricity and magnetism
	Heat balance
	Decontamination of medical equipment
	Fires and explosions in the operating room
	Self-tests
	Assignments for independent work
	Guide to Contributors: Update in Anaesthesia

From the editor

From the editors of the Russian edition

E. V. Nedashkovsky,

Doctor of Medicine, Professor, Head of the Department of Anesthesiology and Reanimatology, Northern State Medical University, Troitsky Prospekt, 51, 163000, Arkhangelsk, E-mail: [email protected]

V. V. Kuzkov,

candidate of medical sciences, associate professor of the department of anesthesiology and resuscitation of SSMU,

Email: [email protected]

	Dear colleagues!
	This textbook was published under
	under the auspices of the World Publishing Committee	feasible even under limited conditions
	Federation of Societies of Anaesthetists (WFSA) and	material and technical equipment, that's all
	intended for the initial stage of subsequent	not uncommon in various areas of our
	full training in the specialty of anesthesia
	stesiology and resuscitation. "Basic course	Comprehensive manual editing and
	anesthesiologist" corresponds to current requirements	adaptation for publication in Russia, including sub-
	requirements for teaching aids and was conceived	cooking a large number of illustrations and ta-
	as a special supplement to the educational journal	blitz required a lot of work and time.
	nal Update in Anaesthesia. The manual is recommended	The translation of the “Basic Course” was carried out by a team of
	provided by WFSA for all member countries of this association	team of translators who simultaneously
	associations, which include the Russian	are highly qualified doctors
	Federation.	several anesthesiologists and resuscitators. This
	The edition you are holding in your hands or	Candidates of Medical Sciences D. B. Borisov,
	reading from your computer monitor, it was	E. L. Neporada, D. N. Uvarov, E. V. Suborov,
	prepared with sponsorship from	A. I. Lenkin, A. A. Smetkin and V. V. Kuzkov.
	form of educational collection for anesthesiologists.	We especially thank A. A. Smetkin for his
	In our opinion, "Basic course of anesthesia"	power in preparing illustrations and K. M. Guy
	ziologist" must fill a certain	Dukov for his participation in compiling the list of issues
	gap in initial training of specialists	owls and tasks for self-test.
	this profile, which arose due to the lack of	Besides three	submitted
	I eat short, but at the same time comprehensive	sections in the manual should also include
	manual aimed at basic training	study issues of clinical anatomy, biochemical
	anesthesiologists. The publication may represent	mia and other related areas of medicine.
	interest for both senior students and	We believe that this gap can be filled
	and young doctors undergoing internship,	thread, preparing a second special issue
	residency or primary specialization.
	This guide will undoubtedly be useful	Together with our English colleagues
	and for an experienced anesthesiologist-resuscitator,
		we strive to improve the quality of magazines
	which in the process of continuous medical
		fishing and benefits. Please note that
	education would like to refresh their
		English and Russian versions of the magazine are available
	knowledge. The need for such a publication
		download freely available on the Internet. If
	dictated by the anesthesia training program
		it so happened that you got your hands on it for the first time
	ziologists around the world, and we are grateful to the WFSA
		printed version of the manual, you can download
	and personally to the editor-in-chief of the English-
		him, as well as a number of issues of Update magazine
	th edition to Bruce McCormick for support
		in Anaesthesia on	Russian in
	publications in Russian.
	This publication may be considered
		faculty/department/anesthesiology/journal/index.
	as a complete textbook for elementary
	level. It includes 40 articles, presented	If you have any questions,
	within three basic sections: clinical
		comments or suggestions regarding co-
	skoy physiology, clinical pharmacology
		holding future benefits and regular payments
	and physical and technical fundamentals of anesthesiology and
		measures of the journal, please write to the E-mail address
	resuscitation. It is extremely important that
		technical editor: [email protected].
	each of the presented topics is considered
	from the standpoint of its significance in practical,		Prof. E. V. Nedashkovsky,
	everyday work. At the same time, illuminated		Associate Professor V.V. Kuzkov

From the editor of the English edition

From the editor

		Special edition Update in Anaesthesia,	developing countries, Committee on International
		brought to your attention, focused	People's Relations and the Association of Anesthesia
	focuses exclusively on basic		logs of Great Britain and Ireland (AAGBI)
	scientific knowledge necessary for an anesthesiologist.		found that in these countries there is no
	Some of the topics presented have already been considered		leadership consciously dedicated to the basic
	was published earlier, in previous issues of the magazine.		relevant issues, taking into account the characteristics of work
	nala. Collecting them together in the pages of this		these specialists. The following proposal
		benefits, we emphasize the fact that	The Committee's deliberations led to the development of the concept
	some understanding of scientific principles is		special edition sponsored by
	cornerstone of safe and adequate		made by WFSA and the foundation established by AAGBI
	anesthesiological activities. For example,		"Anesthesia abroad" (Overseas Anaesthesia).
	we must be able to identify dangers		Given our modest capabilities,
	risk of electrical injury or explosion in operational		this publication still cannot claim to be
	no, avoid unintentionally superficial		the role of full-fledged leadership, containing
	anesthesia or dangerous overdose when		go the whole range of basic knowledge required
	use of inhalational anesthetics.		anesthesiologist. Where possible, we use
	At the same time, the anesthesiologist must understand
		in normal physiology, in order to dis-	Anaesthesia, as well as reviews provided by
		recognize and eliminate physiological disturbances	in the series “Weekly Anesthesiology
	tions in patients in critical		workshop" WFSA (Anaesthesia Tutorial of the
	condition or having severe damage		Week). Each of these articles became the subject
	nia. When logistical conditions		volume of careful editing, updating
	extremely scarce, there is an obvious need		and adaptations that were necessary in order to
	The key is that the anesthesiologist understands and		to ensure that the data is up to date and
		if necessary, could carry out at least	their compliance with the working conditions of an anesthesiologist
		surface maintenance of its	in various parts of the planet. In addition, we
		th equipment. This is of particular importance	tried to emphasize practical aspects
	when the conditions for formal engineering		basic knowledge in everyday activities
	there are no services or service		sti. More than a quarter of the forty presented
	organizations are located far away.		on the pages of this edition of articles it was necessary
		The importance of basic knowledge in our profession	compose again. The established priorities
		tionality is once again emphasized by the fact	thetas - cover as many topics as possible in
		inclusion of this section in the preparation schedules	within the framework of physiology, pharmacology and physical
	training of anesthesiologists around the world. Every		ki - inevitably led to the exclusion of pro-
	academic year one or two cycles of electronic education		many disciplines, including, for example, anatomy
	teachings of the Royal College of Anesthesiology		and questions of biochemistry, which are presented
		gov are devoted to these issues. Total topic	extremely superficial. I will be very happy to receive
	basic disciplines are devoted to more than one		to receive letters from you with a request to sort it out in
	a third of 900 training sessions. This is reflected in		subsequent editions of topics that were not
	the organization of college exams itself - in		are sufficiently covered in the current edition. We
	UK two primary oral exams		We will make every effort to prepare	Dr. Bruce McCormick
	applications for the FRCA title aim to evaluate
	ku basic anesthesiological training		him in one of the subsequent issues of the magazine
				Update in Anaesthesia,
	specialists and include up to 50% of questions from		nala. If such questions arise
	areas of general scientific knowledge.		you can contact me by E-mail: Bruce.
			[email protected].	Royal Devon and Exeter
	ska basic teaching aids, suitable		I am deeply indebted to the editorial board
				Barrack Road, Exeter EX2
		suitable for use by anesthesiologists in	Update in Anaesthesia for the work done, and	5DW, United Kingdom
	Basic course anesthesiologist |   Basic Sciences

also to the editors of the Weekly Anesthesiology Workshop, in particular Carl Gwinnutt, who acted as co-editor of the basic knowledge section and made the maximum personal contribution to the appearance of this publication. I am also grateful to the large team of local colleagues who assisted us as much as possible in preparing this project, and to Dave Wilkinson for his tireless efforts in preparing the figures for many of the included articles.

Our magazine is available for free download both as a complete publication and as individual articles from the WFSA website: www. anesthesiologists.org. Issues of the “Weekly Anesthesiology Workshop” series are also presented there, which continues

expand the freely accessible scientific library for anesthesiologists from all over the world.

I hope that this publication will be a useful and reliable reference for both trainees and qualified anesthesiologists. If you would like to receive a printed version of future editions of the journal in English, please contact Carol Wilson (E-mail: [email protected]). If you need large numbers of copies, they can be ordered through TALK (Teaching Aids at Low Prices, website: www.talcuk.org).

Bruce McCormick

editor-in-chief of Update in Anaesthesia

From the WFSA representative in Russia

M. Yu. Kirov,

Doctor of Medicine, Professor, Department of Anesthesiology and Reanimatology, Northern State Medical University, Troitsky Avenue, 51, 163000, Arkhangelsk, E-mail:

[email protected]

The appearance of a new supplement to the journal of the World Federation of Societies of Anesthesiology

"Update in Anaesthesia" , published in the form of a textbook on physiology, pharmacology and physical processes, is very relevant from the point of view of continuous postgraduate education of Russian anesthesiologists and resuscitators. It should be noted that this issue may be useful not only for young anesthesiologists - interns and clinical residents, but also for doctors who have been working in our specialty for quite a long time in order to refresh their knowledge on basic issues. In addition, a number of sections of the journal can be used in the training program for anesthesiology and resuscitation for senior students at medical universities.

It is noteworthy that this issue of the journal in Russian is published in the year of the 70th anniversary of the permanent editor of the Russian publication “Update in Anaesthesia”, prof. Eduard Vladimirovich Nedashkovsky, who did a lot for the development of anesthesiology education in Russia and its international integration. From the WFSA Education Committee I would like to once again congratulate Eduard Vladimirovich on his anniversary, thank him for his contribution to the educational process in our specialty and wish him further creative success, health and good luck in everything.

Prof. M. Yu. Kirov,

Member of the Education Committee of the World Federation of Societies of Anesthesiology (WFSA)

World Federation of Societies of Anaesthesiologists |  WFSA

News from the World Federation of Societies of Anesthesiology (WFSA)

Committee on Safety and Quality in Anesthesia Practice

The goal of the WFSA is to improve the standards of anesthesia throughout the world. Safety and Quality Committee makes its contribution to this process through the implementation of a number of projects.

Website development is an extremely important condition for communication with members WFSA . For regular and continuous updatesInternet resources webmaster answers Nain Chih Wang Committee(Nian Chih Hwang) . In particular, he developed an emergency information section.

Standards. International standards for safe anesthesia, developed by an independent problem committee and approved at the WFSA meeting in The Hague, have been revised as part of the WHO global project “Safe Surgery Saves Lives”. In solving this problem I relied on the help of a large number of colleagues, including Iain Wilson, Meena Cherian, Olaitain Sanyanwo

Olaitain Sanyanwo, Jeff Cooper

and John Eichhorn, a member of the initial problem committee group. The revision of the standards was approved at the WFSA General Assembly meeting in Cape Town and can be viewed on our website: www. anesthesiologists.org. Executive Council

WFSA also supported the standard regulating the mutual compatibility of anesthesia equipment, which is also reflected on the pages of the Internet site.

Global Pulse Oximetry Project (GO) is the result of cooperation between WFSA, AAGBI (Association of Anaesthetists of Great Britain and Ireland) and companies GE Healthcare . The goal of the project is to provide affordable pulse oximeters complete with necessary educational materials. The project involves collecting statistical data and signing an agreement with local specialists and health care administrators. Ultimately, the implementation of this project should allow for a long-term and sustainable change in the quality of anesthesiology practice. Group

The GO project was established by the Anesthesia Safety and Quality Committee, with Gavin Thoms as the overall leader and representative of the WFSA on this issue. Subsidiary projects are underway in Uganda, the Philippines, Vietnam and India. The goal of each of them is to raise their own funds for financing. For its part, GE Healthcare donated 58 oximeters, 125 sensors for them and training materials, and also provided significant organizational support (providing teleconferencing, delivering oximeters, providing after-sales service, etc.). Once again, in the implementation of the presented projects, this company has proven itself to be an excellent partner, and we are grateful to it for its continuous support of our projects. I would like to say special words of gratitude to Mark Philips and Colin Hughes.

Participating health professionals completed reports and presented the results at the World Congress in Cape Town. The final report is in preparation and will be presented in one of the peer-reviewed journals in our specialty.

For a number of reasons, a tripartite Committee was established in Cape Town, which resulted in the GO project returning to the WFSA Safety and Quality Committee. The Global Pulse Oximetry Project remains the single most important aspect of this Committee's work, with site visits and audits in Uganda and Vietnam aimed at educating and further pushing the project towards its goal of making a meaningful difference in anesthesia practice in those countries.

WHO, Safe Surgery and Pulse Oximetry Project. Together with Ian Wilson, the author of these lines was involved in the work of the organization Safe Surgery Saves Lives.(Safe Surgery Saves Lives) . We did not participate in this activity as representatives

Safety and Quality of

Practice Committee

WFSA were very pleased to see the development of a universal checklist, which is essential in promoting a team-based operating room style and highlights the important role of anesthesia in surgical safety. WHO is currently developing an initiative proposal to promote the Global Pulse Oximetry project, and the next phase of the project will be launched with the full participation of this organization.

Incident reports. Professor Quirino Piazevoli(Quirino Piacevoli) is responsible for a new project to make incident reports available to experts in countries that currently do not have access to these documents.

Drug safety. Over the next four years SQPD will increase the activity of a set of measures aimed at a clearer and standardized presentation of information on the labels of ampoule preparations.

	The virtual anesthesiological apparatus is	Connections with other organizations. List of recent
	is an independent educational project, carried out	includes ANZCA, RCoA, Operation Smile. Especially strong
	under the leadership of Dr. Sema Lampotang	ki our relationships with individual societies -
	(Sem Lampotang), and is supported by SQPC. Link to	members of the WFSA, in particular the AAGBI and NZSA.
	this project is posted on our website.	Please contact me with any comments.
	Guide to Crisis Management
		tariffs or offers, and also if you can
	tions (Crisis Management Manual). The website has-	make your contribution to the activities of one of the
		represented committees.
	on Crisis Management of the Australian	Alan Merry
	patient safety fund. We are grateful to APSF for
	this valuable contribution.	Head of the WFSA Safety and Quality Committee

Nedashkovsky Eduard Vladimirovich Kuzkov Vsevolod Vladimirovich

Basic anesthesiologist course

Electronic version

Proofreaders:

A. S. Deryabina, S. V. Kalinina, Yu. S. Kuznetsova, N. A. Nizovtseva

World Federation of Societies of Anaesthesiologists, 21 Portland Place, London, W1B 1PY, United Kingdom. Tel: (+44) 20 7631 8880. Fax: (+44) 20 7631 8882. E-mail: [email protected]

Correspondence to editor:

Dr. B. McCormick, Anesthetics Department, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.

Email: [email protected]

World Anaesthesia takes all reasonable care to ensure that the information contained in Update is accurate. We cannot be held responsible for any errors or omissions and take no responsibility for the consequences of error or for any loss or damage which may arise from reliance on information contained.

WARNING

The World Organization of Societies of Anesthesiology (WFSA) and the local editors have taken every possible precaution to ensure the accuracy of the information presented in this publication. They are not responsible for errors, inaccuracies or omissions that may appear in the texts, or for property damage or personal injury that may result from reliance on the information provided.

THIS PUBLICATION WAS PREPARED IN PART WITH THE SUPPORT OF THE WORLD FEDERATION OF SOCIETIES OF ANESTHESIOLOGY

World Federation of Societies of Anaesthesiologists |  WFSA

PHYSIOLOGY

Introduction to Cardiovascular Physiology
Myocardial physiology
Physiology of breathing
Physiology of oxygen transport
Carbon dioxide transport
Cerebral blood flow and intracranial pressure
Autonomic nervous system: basic anatomy and physiology
Physiology of the neuromuscular junction
Water sectors of the body, sodium and potassium
Physiology of the endocrine system
Kidney physiology
Physiology of the liver
Physiology of pain
Physiological changes associated with pregnancy

Anatoly Petrovich Zilber(born in 1931) - Soviet and Russian doctor, organizer of the first intensive respiratory therapy department in Russia (1989), then a respiratory center (2001). Author of the concept of critical care medicine (MCM) (1989). Doctor of Medical Sciences (1969), professor (1973), full member of the public academies of the Russian Medical-Technical Academy (1997) and the Academy of Security, Defense and Law Enforcement of the Russian Federation (2007).

Anatoly Petrovich Zilber
Date of birth	February 13(1931-02-13 ) (88 years old)
Place of birth	Zaporozhye, Ukrainian SSR, USSR
Country	USSR→Russia
Scientific field	Anesthesiology, pathological physiology
Place of work	Petrozavodsk State University
Alma mater	(1954)
Academic degree	Doctor of Medical Sciences
Academic title	professor
Awards and prizes

Honorary and full member of the Board of the Federation of Anesthesiologists and Reanimatologists of the Russian Federation, Honored Scientist of the RSFSR (1989), Honorary Worker of Higher Professional Education of the Russian Federation, People's Doctor of the Republic of Karelia, Knight of the Orders of Friendship and Honor.

Biography

In 1948 he graduated from school in Tashkent. Graduated in 1954. Since then - surgeon, and then () anesthesiologist of the Republican Hospital of Karelia. In 1959 he created one of the first ITAR branches in the country. Since this year, he has been the chief anesthesiologist of the Ministry of Health of the KASSR. In the city he organized the first independent course in anesthesiology and resuscitation in the USSR (from the city - department) at the Petrozavodsk State University. university, became its head.

Organizer of the Petrozavodsk annual educational and methodological Seminars of the ISS (since 1964). The main directions of scientific work: clinical physiology and intensive care of critical conditions, clinical physiology of breathing, promotion of the humanitarian foundations of training and practice of doctors, studying the activities of doctors who became famous outside of medicine (so-called medical truthism).

Scientific activities

Author of more than 400 published works, including 34 monographs. Being one of the founders of domestic anesthesiology and resuscitation, A.P. Zilber pays great attention to the study of the respiratory system, and his first monograph “Operating position and anesthesia” has the subtitle “Postural reactions of blood circulation and breathing in anesthesiology.” The subject of his research is the reaction of the respiratory system in any critical condition. For A.P. Zilber, the respiratory system is not only a structure that provides the entire body with the necessary amount of oxygen and relieves it of excess carbon dioxide. This is the most important life support system of the body, protecting it from “external and internal enemies”, creating the conditions necessary for the normal functioning of other vital organs. It is difficult to say what is more surprising in his works - the non-standard approach to the problems being studied or the unexpectedness of the findings and identified patterns. A clear proof of this is the professor’s main works on this topic: “Regional functions of the lungs. Clinical physiology of uneven ventilation and blood flow”, “Respiratory therapy in everyday practice”, “Respiratory failure” and, finally, “Respiratory medicine”(!). The main feature of these (and other) books by A.P. Zilber, which makes them books “for all times,” is their clinical and physiological focus and validity. This is probably why none of the fundamental provisions derived by A.P. Zilber from his research was refuted or, at least, reasonably rejected.

Anatoly Petrovich Zilber- graduate of the First Leningrad Medical Institute in 1954. The first official anesthesiologist of the Republican Hospital of Karelia (1957). In 1959 he created one of the first ITAR branches in the country. From this year until 2009 - chief anesthesiologist of the Ministry of Health of the KASSR. In 1966, he organized the first independent course in anesthesiology and resuscitation in the USSR (since 1989 - department) at Petrozavodsk State University, and became its head. The course worked according to the original program developed by A.P. Zilber.

Organizer of the first intensive respiratory therapy department in Russia (1989), then a respiratory center (2001). Author of the concept of critical care medicine (MCM) (1989). Currently, Anatoly Petrovich is the head of the Department of Critical and Respiratory Medicine, Doctor of Medical Sciences (1971), Professor (1973), Honored Scientist of the Russian Federation (1989), Academician of the Russian Academy of Medical and Technical Sciences (1997) and the Academy of Security, Defense and Law and Order of the Russian Federation (2007), Honorary Worker of Higher Professional Education of the Russian Federation (2000), Honored Doctor of the Russian Federation, People's Doctor of the Republic of Karelia (2001), Visiting Professor at Harvard and Southern California Universities (USA), Honorary Professor at Khorezm University (Uzbekistan, 2004), Honorary and full member of the Board of the Federation of Anesthesiologists and Reanimatologists of the Russian Federation (2000), Honorary Citizen of Petrozavodsk (2003), Chairman of the Ethics Committee under the Ministry of Health and Social Development of the Republic of Kazakhstan and Petrozavodsk State University.

Author of more than 450 published works, incl. 42 monographs, editor of translations of four manuals on the specialty: J. Duke “Secrets of Anesthesia.” M.: Medpress-inform, 2005. 552 pp.; "Guide to Clinical Anesthesiology", ed. B.J. Pollard. M.: Medpress-inform, 2006. 912 pp.; J.P. Rafmell, D.M. Neal, Cr.M. Viscomi "Regional anesthesia." M.: Medpress-inform, 2007. 272 ​​pp.; P. Marino “Intensive care”. M.: GEOTAR-media, 2010. 900 p. Co-author of the first textbook for medical universities on resuscitation, “Resuscitation and Intensive Care.” M.: Publishing center "Academy", 2007. 400 p. Co-author (with V.I. Bragina) of the monograph “Humanitarian Culture of Medical Education” - the first book on this most important topic of modern education.

Organizer of Petrozavodsk annual educational and methodological seminars of critical care medicine (since 1964). Currently these are international seminars “Silber School. Open Forum”, held under the auspices of the Committee on European Education in Anesthesiology (CEEA) of the European Association of Anesthesiologists (ESA). A total of 50 (!) seminars were held on current issues in critical care medicine. Physicians who have participated in six SEEA seminars are entitled to take the European Diploma in Anesthesiology exam.

A.P. Zilber has repeatedly given lectures in different cities of Russia, as well as in Austria, Sweden, Finland, Israel, Hungary, the USA, Canada and other countries near and far abroad. Currently, using the capabilities of telecommunications, Anatoly Petrovich gives lectures for doctors not only in Russia, but also in other CIS cities. In 2013 alone, the professor gave more than 30 video lectures. A record was given to giving a lecture on problems of medical ethics and law in critical care medicine to 8 different audiences at once - from Moscow to Yerevan and Krasnoyarsk.

Area of ​​scientific interests

• Clinical Physiology and Critical Care Intensive Care;
• clinical physiology of breathing;
• promotion of the humanitarian foundations of training and practice of doctors;
• study of the activities of doctors who became famous outside of medicine (so-called medical truthism).

No one in Russia, and perhaps in the world, knows as much about the non-medical activities of doctors as Anatoly Petrovich Zilber knows. He talks about them with pleasure and writes books called "Truent Doctors."

Awards

For his contribution to the development of medical science and practice in Russia, increasing the authority of Russian medicine in the world, A.P. Zilber was awarded the Order of Friendship (1998), Honor (2006), the Order of Hippocrates, medals “For outstanding achievements in resuscitation” (2004), “For strengthening the authority of Russian science" (2007), "A.L. Chizhevsky Gold Medal for professionalism and business reputation" (2008), Lomonosov Medal (2012), gold badge "Ibi Victoria ubi Concordia" ("Where there is agreement, there is victory") (2012), Memorial Medal named after Academician of the Russian Academy of Medical Sciences V.A. Negovsky - “For significant contribution to the development of anesthesiology and resuscitation, aimed at preserving and strengthening human health, and training highly qualified scientific personnel” (2013).

• Order "Sampo" (2019)
• Certificate of Honor from PetrSU (2016)
• Certificate of honor from Petrozavodsk (2015)
• Order of Honor (2006)
• Honorary title Honorary Citizen of Petrozavodsk (2003)
• Honorary title Laureate of the Republic (2001)
• Honorary title People's Doctor of the Republic of Kazakhstan (2001)
• Honorary title "Honorary Worker of Higher Professional Education of the Russian Federation" (2000)
• Honorary title of 100 laureates of the year in Petrozavodsk (1999)
• Order of Friendship (1998)
• Honorary title Honored Scientist of the Russian Federation (1989)
• Honorary title Honored Doctor of the Republic of Kazakhstan (1968)

Publications

Articles (16)

• Zilber, A.P. Medical education: creativity or standard? (Etymological excursion [Text] / A.P. Zilber // History of the Medical Institute of PetrSU 2015-2019. - Petrozavodsk, 2019. - P.115-122.
• Zilber, A.P. COMMENTARY ON THE ARTICLE by K.A. TOKMAKOVA ET AL. "ENGLISH FOR ANESTHESIOLOGIST AND RESUSCITATOLOGIST: A TRIBUTE TO FASHION OR NECESSITY?" [Text] / A.P. Zilber // Bulletin of Intensive Therapy named after. A.I. Saltanova. - Moscow, 2018. - No. 4. - P.88. (RSCI)
• Zilber, A.P. Critical and respiratory medicine needs a humanitarian culture. [Text] / A.P. Zilber // Bulletin of intensive care. - Moscow, 2017. - No. 2. - P.8-11. - ISSN 1726-9806. (RSCI)
• Zilber, A.P. How to develop the Federation of Anesthesiologists and Resuscitators of Russia? [Text] / A.P. Zilber // Bulletin of intensive care. - Moscow, 2016. - No. 1. - P.61-67. (RSCI)
• Zilber A.P. History of the critical care medicine service (MCS) in Karelia. [Text] / A.P. Zilber, A.P. Spasova, V.V. Maltsev // Current problems of anesthesiology and resuscitation: collection of articles and abstracts. - Svetlogorsk, 2016. - P. 17 - 24. (RSCI)
• Zilber, A.P. Iridium from the Greek “Iris” – rainbow [Text] / A.P. Zilber // History of the Medical Institute of PetrSU. - Petrozavodsk, 2015. - P.162-170.
• Zilber, A.P. Rationalism in the management of patients with respiratory failure [Text] / A.P. Zilber // Ukrainian Pulmonological Journal. - Kyiv, 2013. - No. 2 (80). - P.20–25. - ISSN 2306-4927. (VAK)
• Zilber, A.P. Do we need to find new anesthesia techniques? [Text] / A.P. Zilber // Bulletin of anesthesiology and resuscitation. - 2013. - No. 1. - P.70-71. (VAK, RSCI)
• Zilber, A.P. Critical medicine as a modern but unnatural section of healthcare [Text] / A.P. Zilber // Bulletin of intensive care. - Moscow, 2012. - No. 1. - P.4-7.
• Zilber, A.P. Correction of metabolism - p. 54-58, Artificial ventilation - p. 58-62, Shock lung syndrome - p. 266-269, Aspiration syndrome - p. 268-269, Hyperthermia and hyperthermic syndromes - p. 302-304, Amniotic embolism - p. 308-310. [Text] / A.P. Zilber // Handbook of anesthesiology and resuscitation. - Moscow: Medicine, 1982.