Marina Petrova
Doctor of Medical Sciences
Professor, Head of the Department of Anesthesiology and Resuscitation with Medical Rehabilitation Course,
"In the 21century, patients should not die from iatrogenic complications."
1980
Graduated from the Medical Faculty of the 2nd Moscow Order of Lenin State Medical Institute named after N. I. Pirogov (now - Pirogov Russian National Research Medical University), in specialty ”General Medicine”.
1980
Junior researcher, then - senior researcher, and from 1998 - Head of the Laboratory of Anesthesiology and Resuscitation of the Surgical Department of the Research Institute of Roentgenology and Radiology of the Ministry of Health of the Russian Federation.
1991
Thesis on “Prevention of cicatricial stenosis of the trachea” for the degree of Candidate of Medical Sciences in the specialty “Anesthesiology and resuscitation” was defended.
1998
Honorary title “Honored Doctor of the Russian Federation” for services in the field of healthcare and many years of conscientious work.
2005
Thesis on “Respiratory monitoring in lung cancer surgery” for the degree of Doctor of Medical Sciences in the specialty “Anesthesiology and resuscitation” was defended.
2005 - present
Member of the European Society of Intensive Medicine, ESICM.
2012 - 2016
Professor of the Department of Anesthesiology and Resuscitation of the Institute of Medicine, RUDN University.
2017 - present
Head of the Department of Anesthesiology and Resuscitation (since 2018 - Department of Anesthesiology and Resuscitation with Medical Rehabilitation Course) of the Institute of Medicine, RUDN University.
2017 - present
Deputy Director for Scientific and Clinical Activities of the Federal Scientific and Clinical Center for Resuscitation and Rehabilitation.
Teaching
Gives lectures to RUDN students and residents of the Institute of Medicine on the following subjects:
- “Anesthesiology: types of anesthetics and analgesics”;
- “Anesthesiology: ensuring the perioperative period”;
- “Intensive care for sepsis”;
- “Differential diagnosis of comatose states”;
- “Rehabilitation of patients with a low level of consciousness at the resuscitation stage”;
- “Neuroprotection in intensive care”;
- “Nutritional support for patients in critical conditions”;
- “Respiratory support for patients with long-term impaired consciousness”.
Author of the manuals:
- Nutritional and metabolic therapy in patients in a chronic critical condition after a cerebral catastrophe. Manual for doctors. Moscow, “Green Print” Publishing House, 2018. 40 p. Krylov K. Yu., Grechko A.V., Petrova M. V., Shestopalov A. E., Yagubyan R. S.
Nutritional and metabolic therapy is the main method of recovery of patients after a cerebral catastrophe. The monograph outlines the basic principles of planning and implementing nutrition therapy in this category of patients.
https://www.elibrary.ru/item.asp?id=35206631 - Guide to medical and social expertise and rehabilitation in 3 vols. Vol. 2: Restrictions of life activity in children. Moscow, “Tonchu” Publishing House, 2018. Achkasov E. E., Volynets G. V., Gal I. G., Grechko A.V., Nikitin A. N., Petrova M. V., Pryanikov I. V., Puzin S. N., Skvortsova T. A.
The guide highlights the most important social problem - the possibilities and legal issues of medical and social expertise and rehabilitation, including patients with a low level of consciousness.
https://search.rsl.ru/ru/record/01009896322
https://www.elibrary.ru/item.asp?id=36624993 - Stationary automated system to maintain human life (ADLK-S). Methodological recommendations for use. Moscow, “Publishing Technologies”, 2017. Sadovnichy V. A., Makarovets N. A., Podolsky V. E., Sokolov M. E., Molchanov I. V., Petrova M. V., Baykova O. M., Baranov A. P., Belousov A. A., Budanov V. M., Galatenko V. V., Gridchik I. E., Gulai Yu. S., Kochergin V. G., Kuvshinova Ya. V., Kulabukhov V. V., Minchuk S. V., Oktyabrskaya L. V., Potievskaya V. P., Roginko O. A., et al.
A team of authors has created the system to maintain the vital activity of the human body. The manual presents a detailed algorithm for using this system for the diagnosis of urgent critical conditions in district hospitals.
www.semanticscholar.org
Science
- Developed and implemented an algorithm for perioperative (from the moment of diagnosis to the patient, the decision on surgical treatment until the patient's recovery) patient management, based both on the principles of evidence-based medicine and on a personalized approach to the problems into the practice of anesthesiology and resuscitation departments.
- Developed criteria to predict the possibility of the patient’s recovery from prolonged unconsciousness.
- The initiator of a new direction in practical medicine - the rehabilitation of patients at the stage of resuscitation, when the patient needs to maintain vital functions.
- Developed unique rehabilitation techniques that are used in patients in a chronic critical condition to allow the patient to be weaned from the respirator after prolonged artificial ventilation, while maintaining or restoring motor activity and increasing the level of consciousness.
- Developed a method of craniocerebral hypothermia in patients with prolonged impaired consciousness. The method is based on the principles of hypothermic preconditioning. It allows to significantly reduce the mortality rate and increase the level of consciousness in this category of patients.
- Developed in co-authorship “Method for drug correction of central hemodynamic disorders in cancer patients in the early postoperative period”. The invention relates to medicine, namely to anesthesiology and resuscitation, and can be used to correct hemodynamic disorders in patients in the departments of anesthesiology, resuscitation and intensive care in the early postoperative period.
https://yandex.ru/patents/doc/RU2477128C2_20130310 - Developed in co-authorship “Device for continuous monitoring of the functional state of the patient”. The invention relates to medical technology, namely to devices for remote monitoring of patients for diagnosis by several physiological parameters, and can be used in practical health care institutions, including in the ambulance system, remote consultation centers with the use of telemetric communication channels to maintain human life.
https://yandex.ru/patents/doc/RU2568762C1_20151120
Scientific interests
- Respiratory therapy in patients with chronic impairment of consciousness and the search for objective criteria of readiness for weaning from prolonged artificial lung ventilation.
- Respiratory biomechanics in single-lung and traditional lung ventilation during thoracic surgery.
- Nutritional and metabolic therapy in patients in critical condition and the study of the problem of restoring the nutritional status in this category of patients.
- Study of the temperature balance of the brain and methods for restoring moderate heterogeneity in patients after cerebral catastrophes.
- Prevention of venous thrombosis in the postoperative period, in cancer patients and in chronic critical condition.
- Quality management of medical care in intensive care units.
In acute period of different cerebral events, often, there is fever & focal cerebral hyperthermia which can worsen the condition. Supposedly, the change in brain thermal balance (TB) can also develop in critical conditions (coma, vegetative & minimally conscious state) but there is inadequate information about variations in cerebral temperature (t°) thus, research was done to study the cerebral TB in the chronically critically ill (CCI) in comparison with healthy people (HP) & patients in acute period of ischemic stroke (IS).
Purpose: evaluation of the clinical significance of parametric monitoring of the effectiveness of intensive care and rehabilitation based on the analysis of the functional state of the autonomous nervous system in patients with brain damage of different genesis. Materials and methods. The study included 66 patients on day 20—50 after the traumatic brain injury; anoxic damage; and stroke consequences. The isolation of clinical groups and subsequent analysis of clinical status is based on the analysis of the functional state of the autonomic nervous system based on the dynamics of the heart rate variability (HRV) parameters. Findings obtained in studies of 500 patients in the postoperative period with a 5-minute HRV were tested as normal and abnormal ANS parameters [1]. Parasympathetic hyperactivity was measured within the limits for SDNN (standard deviation of all normal-to-normal R-R intervals) > 41.5 ms; for rMSSD (root-meansquare of the successive normal sinus R-R interval difference) > 42.4 ms; for pNN50% (the percentage of interval differences in successive NN intervals greater than 50 ms (NN50) / total number of NN intervals) > 8.1%; for SI (Baevsky stress index, in normalized units) < 80 n. u.; for TP (total power of variance of all NN intervals) > 2000 ms2. Sympathetic hyperactivity was determined within the limits for following parameters: SDNN, < 4.54 ms; rMSSD, < 2.25 ms; pNN50%, < 0.109%; SI, > 900 n. u.; TP < 200 ms2. Normal HRV parameters were selected within the limits of the values for: SDNN [13.31-41.4ms]; rMSSD [5.78—42.3 ms]; pNN50% [0.110—8.1%]; SI [80—900 nu]; for TP [200—2000 ms2]. To verify the parasympathetic or sympathetic hyperactivity within these limits, 3 of 5 parameters were chosen [1].
The purpose of the study — assessment of the level of consciousness in patients with a brain damage on the basis of electrophysiological examination of the functional state of the autonomous nervous system by recording parameters of the heart rate variability (HRV). Materials and Methods. The study included 77 patients on Day 20—50 after a traumatic brain injury, anoxic injury, consequences of acute cerebral circulation disorders. The following parameters of the HRV for a 5-minute recording were accepted as criteria of norm and pathology of the autonomous nervous system (ANS) activity: (1) parasympathetic hyperactivity (hypervagal state) values with 95% confidence intervals were recorded within the accepted values for (a) SDNN (standard deviation of normal to normal R-R intervals), [41.5 —149.3 ms]; (b) rMSSD (root-mean-square of the successive normal sinus R—R interval difference in ms), [42.4—175.0 ms];(c) pNN50% (percentage of successive normal sinus RR intervals >50 ms), [8.14—54.66%]; (d) SI (Baevsky stress index), [0—80 normalized units, n. u.]; (2) the sympathetic hyperactivity recordered within the range of values for (a) SDNN [4.54—13.30 ms]; (b) rMSSD [2.25— 5.77 ms]; (c) pNN50% [0—0.109%]; (d) SI >900 n. u.; (3) the normal value of ANS parameters were recordered within the range of values for (a) SDNN [13.31—41.4 ms]; (b) rMSSD [5.78—42.3 ms]; (c) pNN50% [0.110—8.1%]; (d) SI [80—900 n. u.]. For verification of the hypervagal state, sympathetic hyperactivity or normal state, at least 3 of 4 parameters should be within the specified limits.
Purpose: improvement of the results of operative treatment in patients with emergency abdominal pathology by selecting the tactics of perioperative infusion therapy that would be optimum for postoperative bowel function recovery. Materials and methods. 52 surgical patients (28 men, 24 women, mean age 57.5±14 years) subjected to various emergency abdominal surgeries were studied. The patients were split into 2 groups. It was a prospective study; group affiliation was determined by randomization. In group 1 (n=29), balanced ionic solutions were used for perioperative infusion therapy. In group 2 (n=23), balanced ionic solutions were combined with synthetic colloids. The infusion therapy volume during operation was 2359 ml on average. To determine the bowel function during the postoperative period, comprehensive dynamic assessment of the gastrointestinal tract (GIT) status was undertaken, which included physical examination, intra-abdominal pressure (IAP) measurement, and ultrasound visualization of the intestinal wall condition; the dynamics of intestinal absorptive function and common laboratory tests were monitored. The level of intestinal failure during the postoperative period was determined based on assessment of the GIT condition and recommendations of the National Guidelines for Parenteral and Enteral Nutrition. Results. A strong significant correlation (r=1.000, P=0.01) between the volume of perioperative infusion therapy and the stage of postoperative intestinal failure was established. Conclusion. During performance of emergency surgeries, the volume of intra-operative infusion therapy rendered a direct influence on the postoperative bowel function. Optimization and application of a targeted corrective infusion therapy during the perioperative period promote earlier resolution of postoperative intestinal failure.
Article consists of literature review, authors experience of the application of neurovisualization and neurophysiological research methods to predict the recovery of consciousness in patients in vegetative state (VS). According to the literature data PET with FDG has higher sensitivity in the detection of signs of consciousness, then functional MRI (fMRI). The method fMRI allows assessing the functional activity of the brain in a state of rest and in response to stimulation with different modalities ― visual, auditory, etc (with the application of active and passive paradigm). A higher specificity in the detection of signs of consciousness have the methodology of fMRI with the active paradigm, at the same time, the absence of signs of consciousness according to the fMRI can not be charged as a basis for the conclusion of a poor prognosis in a particular patient. Neurophysiological tests (EEG, TMS, EP, etc) are more readily available and quite effective. Based on the literature analysis, the authors comes to the conclusion that neurovisualization and neurophysiological tests used in the prediction of the outcome of VS reflects the residual functional activity of different brain areas, in a context of diffuse brain damage, and the recovery of consciousness is usually combined with the restoring of the functional activity off the thalamocortical tracts, which activity, indirectly, is evaluated using these methods. In the authors' opinions, the main disadvantage in the interpretation of the is the lack of a common pathophysiological concept of the organization of brain functions in VS patients. The authors offer for the discussion their concept of stable pathological states of the brain, which is based on the works of Russian pathophysiologists.
One of the main problems in chronically critically ill patients is development of protein-energy deficiency in the acute phase, which persists in the chronic phase. We did not find any unified recommendations on energy needs in this patients' population. Usage of indirect calorimetry to determine energy needs of patients in chronic critical illness remains controversial. The aim of the study was to compare the energy needs of patients in chronic critical illness defined by indirect calorimetry according to international recommendations and by Harris-Benedict equation.