A new methodology for systemic audit of ischemic stroke in the most acute and acute periods of the disease

  • L. M. Smyrnova State Institute «Shalimov’s National Institute of Surgery and Transplantation” to National Academy of Medical Sciences of Ukraine»
  • G. A. Shifrin Zaporizhzhia State Medical University
  • K. V. Serikov State institution "Zaporizhia Medical Academy of Post-Graduate Education Ministry of Health of Ukraine"
Keywords: Ischemic stroke, energy-structural status, eubiotic state, hypoergic dysfunction, hypoergic damage, hypoergic insufficiency, hyperergic dysfunction, hyperergic damage, hyperergic insufficiency


Purpose of the study. Create a methodology for systemic audit of ischemic stroke (IS) in the most acute and acute periods of the disease.

Materials and methods. The clinical study included 328 patients with IS (mean age 71,26 ± 0,44 years), who were in the intensive care unit of the neurology department in the most acute and acute periods of the disease. There were 147 men (mean age 69,80 ± 0,66 years), women 181 (mean age 72,45 ± 0,58 years).

According to the intensity of ESST disorders, assistive technologies of personalized intensive therapy (IT) were developed, such as homeostasisprovision for eubiotic state, energy-protection for hypoergic dysfunction, energy-resuscitation for hypoergic damage, energy-correction for hypoergic insufficiency, status-protection for hyperergic dysfunction, status-resuscitation for hyperergic damage, status-correction for hyperergic insufficiency.

Results. The main parameters of energystructural status (ESST), which characterize the stabilization of the general condition of patients in the most acute and acute periods of IMI, such as cardiac index (CI) in the range of 2,99–3,79 L×min-1 × m-2, oxygen delivery (DO ) at the level of 415–514 ml × min-1 × m-2; oxygen consumption (VO2) in the range of 130–160 ml × min-1 × m-2; basal metabolism (BM) in the range of 916–1134 kcal × day-1 × m-2 and specific peripheral vascular resistance (SPVR) in the range of 29–36 conditional unit.

Conclusion. The conducted clinical research allowed to develop assistive technologies of personalized IT, which were used depending on the severity of energy-structural disorders in patients with IS. The use of personalized IT technologies, in accordance with the intensity of ESST recovery, has reduced mortality, the number of complications and the length of stay of patients with IS in the intensive care units of the neurology department.


United Nations, Department of Economic and Social Affairs, Population Division (2017). World Population Ageing 2017 – Highlights (ST/ESA/ SER.A/397).

Botev VS, Gryb VA. Cell therapy for ischemic stroke. Ukrainian Neurosurgical Journal. 2020; 26: 5–19.

Nakaz MOZ Ukrayiny vid 03.08.2012 № 602 “Unifikovanyy klinichnyy protokol medychnoyi dopomogy ishemichnyy insult (ekstrena, pervynna, vtorynna medychna dopomoga, medychna reabilitatsiya)”. Praktychna angiologiya. 2013; 1: 23–53.

Powers WJ, Rabinstein AA, Ackerson T et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2018; 49: 46–110.

Norrving B, Barrick J, Davalos A et al. Action Plan for Stroke in Europe 2018–2030. European stroke journal. 2018; 3: 309–336.

Blanco M, Castellanos M, Rodrіguez-Yanez M et al. High blood pressure and inflammation are associated with poor prognosis in lacunar infarctions. Cerebrovasc Dis. 2006; 22: 123–129.

Weiss A, Beloosesky Y, Kenett RS et al. Systolic blood pressure during acute stroke is associated with functional status and long-term mortality in the elderly. Stroke. 2013; 44: 2434–2440.

Sokhor NR. Clinical-hemodynamical features of different subtypes of ischemic stroke in acute period. Ukrains’kyi visnyk psykhonevrolohii. 2015; 2: 26–31.

Mikadze YuV, Bogdanova MD, Lysenko ES et al. Transcranial doppler ultrasound study of brain hemispheric functional specialization: a review of foreign literature. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics. 2016; 8: 51–56. doi: http:// dx.doi.org/10.14412/2074-2711-2016-4-51-56.

Cheng B, Forkert ND, Zavaglia M et al. Influence of stroke infarct location on functional outcome measured by the modified rankin scale. Stroke. 2014; 45: 1695–1702.

Dariy VI. Computed tomographic and postmortem ratios of hemispheric ischemic strokes with the breakthrough of necrotic masses into the ventricles of the brain. Journal of Neurology im. B.M. Mankovsky. 2017; 5: 10–11.

Keller K, Geyer M, Munzel T. Impact of atrial fibrillation on in-hospital mortality of ischemic stroke patients and identification of promoting factors of atrial thrombi – Results from the German nationwide inpatient sample and a single-center retrospective cohort. Medicine (Baltimore). 2019; 98: 14086.

Hsieh YC, Seshadri S, Chung WT et al. Associationbetweengeneticvariantonchromosome 12p13 and stroke survival and recurrence: a one year prospective study in Taiwan. J Biomed Sci. 2012; 19: 1.

Korchagin VI, Mironov KO, Dribnokhodova OP et al. A role of genetic factors in the development of individual predisposition to ischemic stroke. Annals of Clinical and Experimental Neurology. 2016; 10: 65–75.

Glushakova OY, Glushakov AV, Miller ER et al. Biomarkers for acute diagnosis and management of stroke in neurointensive care units. Brain Circulation. 2016; 2: 28–47.

Zadorozhna BV, Saiko OV. The role of biochemical markers in the pathogenesis, diagnosis and prediction of acute cerebral ischemia. Emergency Medicine. 2018; 4: 86–93.

Kandyba DV. Stroke. Russian Family Doctor. 2016; 20: 5–15.

Milyukov VE, Zharikova TS. Criteria for the formation of patients’ age groups for medical research. Clinical medicine. 2015; 93: 5–11.

Shyfryn GA, Tumanskyy VA, Kolesnyk YuM. Vitalologiia. Zaporozhe. Dykoe Pole. 2018: 288.

SmirnovaLMTheconceptoforganoprotective anesthesia. Kyiv: Liga-Inform. 2009: 137.

Zinchuk VV, Balbatun OA, Emelianchik YuM. Praktikum po normalnoi fiziologii: uchebnoe posobie. CHast II. Grodno: GrGMU. 2013: 259.

How to Cite
Smyrnova, L. M., Shifrin, G. A., & Serikov, K. V. (2021). A new methodology for systemic audit of ischemic stroke in the most acute and acute periods of the disease. Modern Medical Technology, (4(51), 47-53. https://doi.org/10.34287/MMT.4(51).2021.9
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