Department of Intensive Care
General characteristics
Department of Intensive Care of Medical Center Erebouni is a leader in Armenia providing expanded scope of highly qualified intensive therapy. This is the department of general profile resuscitation, where patients in critical condition regardless of their diagnosis can receive appropriate treatment. Annually more than 3000 patients enter in to the Deaprtment, from which around 25% are the patients that transffered from other hospitals. We have also the the bigest amount of high qualified and specialized employee more than 90 high qualified specialists, including 14 doctors and 54 nurses.
The department had been equipped with high-tech medical equipment to monitor and maintain the vital functions of patients in severe critical condition ventilators; heart monitors multipurpose, modern devices for monitoring intracranial pressure, cerebral circulation, ultrasound machines and X-ray diagnostics, dialysis machine, etc. It has also own express laboratory that performs all tests required for rapid adoption of effective clinical decisions to save the patient's life.
The Department is the pioneer in implementing of the multiple clinical and organizational protocols of diagnostics and therapy for the doctors and for nurses as well. The examples of this sort of extremely important approaches, determining final results of the treatment are the followings:
Examples of such extremely important approach, that determine the final results of the treatment are:
- Protocol of the disconnection of the patients from the artificial ventilation and transfer for independent breathing;
- Assessment of the severity of the patient's condition and degree of consciousness,
- Evaluation of sedation degree and sensation of pain,
- Instructions for early enteral nutrition and inotropic support,
- Protocol of prevention of nosocomial pneumonia,
- Empiric antibacterial therapy of out-hospital pneumonia;
- Protocol for the information transfer for the paramedic personnel
В отделении имеются:
- 8 аппаратов ИВЛ “Draeger Savina”
- 26 многофункциональных кардиомониторов
- 14 перфузоматов
- Многофункционалньый монитор “Massimo Radical 7”
- Аппарат сонографии
- Аппарат транскраниальной доплерографии
- Аппарат для инвазивного кнотроля внутричерепного давления “Codman”
- Мобильная рентген установка
- Диализный аппарат
- Централизованная подача медицинских газов
- Централизованная вакуумная система
The department provides the treatment of patients in critical states regardless etiology. The priority activity of the clinic are:
- Obstetric sepsis, obstetric and gynecological bleeding complications;
- Neurotrauma,
- Acute cerebrovascular accident,
- Post-hypoxemic brain damage,
- Sepsis and poly-organ failure,
- Nosocomial or severe out – hospital pneumonia;
- Central nervous system infections,
- Severe peritonitis and condition after relaparotomies.
Moreover, at the period of respiratory infection epidemics or in occurrence of new infections threats precisely here hospitalized the overwhelming majority of serious cases that need the polyvalent intensive therapy.
Innovative techniques implemented on the basis of the intensive care unit
Percutaneous dilatation tracheostomy
It was on the basis of our department that for the first time in the country the routine percutaneous tracheostomy was performed by a specialist in resuscitation and did not required the transfer of the patient to the operating room. About 4-5 of such intervention per month are performed at the department. This significantly reduces the duration of respiratory support, incidence and severity of nosocomial infection.
Transcranial Doppler (TCD)
Despite to the long history of the method of Transcranial Doppler, just the ICU of Erebouni Medical Center has become a pioneer for routine monitoring transcranial hemodynamics. In order to correct the treatment of the patients with stroke or head injury the measurement and analyzes of TCD data are performed at the department by Dr. Mangoyan.
The protocol of antibiotic therapy
The ICU Department of MC Erebouni is the expert in the field of antibiotic therapy and provides training and consultation of specialists not only from various departments of EMC but from other hospitals either. The widespread theoretical and practical knowledge is the hallmark of ICU department. These traditions had been established by its founder honored doctor of the Republic of Armenia, Professor GG Mkhoyan
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The Department is the basis for the chair of postgraduate and continuous medical education in specialty of anesthesiology and resuscitation science of Yerevan State Medical University after M.Heratsi, where pass their training most of clinical residents in anesthesiology and resuscitation science specialty, and also the doctors from various clinics of regions of Armenia.
Chair of Postgraduate and continuous medical education in anestheology and resuscitation science of Yerevan State Medical University
Assistent Professor - Mangoyan Harutyun
- - Modern methods of intensive therapy of subarachnoid hemorrhage , Methodological guidance. UDK618.831-005 (072) BBK 56.1 M230, Yerevan, 2012
- - Principles neyrointensivnoy therapy , Methodological guidance. UDC 616.8-56.1-249, Yerevan, 2013
- , Mkhoyan GG - Actual problems of standardization in anesthesiology and intensive care , Armenian abstracts journal, pp. 130-134
- , - Analysis of the effectiveness of atorvastatin in the treatment of secondary brain complications in elderly patients with spontaneous subarachnoid hemorrhage , Abstract book of the International Congress of geronto-surgery, Yerevan, p. 149
- , R.V. Akopyan, Hakobyan G.R. - Analysis of the effectiveness of two schemes of antibiotic therapy in ICU patients with abdominal sepsis , Abstract book of Sepsis Congress - 2009, S32, # P69 in Amsterdam, Netherlands
- , R.V. Akopyan, D.L. Melkonyan - Cumulative fluid balance as a predictor of survival in the ICU , Journal of Intensive Care Medicine, vyp.36, Annex 2. Abstract book Congress ESICM-2010, S376, Barcelona Ispaniya
- , - Discussion of the concept of risk in anesthesiology , Erebouni Medical Bulletin, pp. 109-114
- , - Effect of atorvastatin on cerebral vasospasm, and the early results of treatment for subarachnoid hemorrhage of spontaneous and posttraumatic etiology , Journal of Intensive Care Medicine, vyp. 36, Annex 2. Abstract book Congress ESICM-2010, S182, Barcelona, Spain
- , - Effect of statin therapy on delayed neurological deficit and the level of early functional recovery after aneurysmal subarachnoid hemorrhage , Abstract book Evroanesthesia Congress - 2012, 7AR2-2, Paris, France
- , - Experience in the prevention of postoperative nausea and vomiting during reconstructive surgery on the anterior abdominal wall , Erebouni Medical Bulletin, Proceedings of the International Congress of Plastic Reconstructive and Aesthetic Surgery, pp. 45
- , Akopyan R.V. - Influence of nimodipine and atorvastatin on autoregulation and cerebral vasospasm after traumatic subarachnoid hemorrhage , Abstract book of the World Congress of anesthetic, poster; Rome, Italy
- , - Modern methods of intensive therapy of subarachnoid hemorrhage , Toolkit. UDK618.831-005 (072) BBK 56.1 M230, Yerevan
- , - Modern methods of laboratory and instrumental neuromonitoring in subarachnoid hemorrhage and traumatic brain injury , Erebouni Medical Bulletin, pp. 64-71
- , - Peculiarities of anesthesia during major reconstructive microsurgical interventions on limbs , Erebouni Medical Bulletin, Abstract-book of the 1st congress of plastic surgeons of Armenia, pp. 27
- , Varosyan A.F., Gnuni A. - Pharmacological neuroprotection citicoline in acute ischemic stroke , Abstract book of the World Congress of anesthetic, poster; Rome, Italy
- , - Preliminary experience in the assessment of factors influencing the burnout among staff of ICU at multidisciplinary clinic , Abstract book Evroanesthesia Congress - 2013, 1AR4-4, Barcelona, Spain
- , R.V. Akopyan, Harutyunyan G.G. - Preliminary experience with a use of statin in the treatment of cerebral vasospasm in spontaneous subarachnoid hemorrhage , Abstract book of Congress Evroanesthesia 2009, 7AR5-4 104. Milan, Italy
- , - Principles of neuro-intensive therapy , Toolkit. UDC 616.8-56.1-249, Yerevan
- , - Protecting the brain- Myth or Reality? , Erebouni Medical Bulletin, pp. 50-54
- , G.G. Harutyunyan, Mkhoyan G.G. - The cerebral tissue oxygen reactivity: pathophysiology and clinical significance , Frontiers in Pharmacology. 5: 100. doi: 10.3389 / fphar, 00100
- , R.V. Akopyan, D.L. Melkonyan, Mangoyan A.N., A. Petrosyan, Mr. Manucharyan - The prognostic value of intra-abdominal pressure in intensive care , Abstract book. Congress Evroanesthesia 2010, BAPCAP2-1 Helsinki, Finland
- , Melkonyan D.L. - The review of forecasting systems and scales of severity assessment in subarachnoid hemorrhage , Journal of Medical Research and the NIH MH RA, pp. 52-62
- , - The review patterns of intensive therapy of subarachnoid hemorrhage on a global scale , Erebouni Medical Bulletin, pp. 41-44
- , - The use of atorvastatin in the treatment of vasospasm in the subarachnoid hemorrhage spontaneous and traumatic etiology , Erebouni Medical Bulletin, pp. 46-49