[A single absolute critical threshold of oxygen transport and anemia in patients with isovolemic hypovolemia]. / Do pytannia pro iedynyi absoliutnyi krytychnyi porih transportu kysniu i anemiï u khvorykh na izovoliumichnu hipovolemiiu.

The oxygen parameters in patients in dynamics of early period after surgical stoppage of gastro-intestinal bleeding and urgent intravascular volume replacement have been investigated. The concentration of erythrocyte hemoglobin was the main reason of the change of oxygen transport (DO2) from the lung to exchange vessels. The fluctuations of DO2 was accompanied by unidirectional change of the integrated value of oxygen consumption (VO2), even in cases of normal level of the blood lactic acid. The lactate concentration changed independent of DO2. That is the reason why the absolute critical threshold of oxygen transport could not be revealed. In addition, we have considered the change of oxygen parameters depending on the concentration of hemoglobin. The decrease of hemoglobin concentration to 6 g/dl was accompanied by the stepped reduction of DO2, but under its decrease below 6 g/dl no further reduction of DO2 could happen because of hyperdynamic hemodynamic reaction. All this in combination with the possible intensification of anaerobic metabolism from the data of lactate level at the higher hemoglobin concentrations, allowed us to think, that the critical threshold of anemia of 6 g/dl is not absolute for all cases.

[The patterns of oxygen metabolism in the early posthemorrhagic period]. / Zakonomirnosti obminu kysniu v rann'omu pisliahemorahichnomu periodi.

Investigated all links of oxygen homeostasis of patients in early period afterwards surgical stoppage gastro-intestinal bleeding and urgent intravascular volume replacement. Macrodelivery of oxygen (DO2) was reduced in two and more time in comparison with norm predominant in connection with anemia. In spite of the infringement of transport of oxygen through alveolar-capillary membrane (especially in patients with complications and death in early postoperative period), little affected of degree of hemoglobin saturation by oxygen. Despite decrease of erythrocyte zeta-potential, largely expressed in cases of lethal outcome, considerable infringement of passage through microcirculation vessels is fixed was not. The increase of degree of morbidity and anaerobic metabolism in early postoperative period was accompanied of hyperdynamic hemodynamic reaction. The increase of degree of morbidity was accompanied of increase oxygen deficit owing to infringement of oxidoreduction in fabries also.

[The relative critical threshold of erythrocyte hemoglobin concentration in isovolemic hemodilution]. / Vidnosnyi krytychnyi porih kontsentratsiï hemohlobinu erytrotsytiv pry izovoliumichnii hemodyliutsiï.

The purpose of our research was register the relative critical threshold of erythrocyte hemoglobin concentration: that criteria, on basis of which was possible to be determined, whether the parameters of red blood for maintenance of oxygen delivery are sufficient in each particular case. Have compared two groups patients afterwards surgical stoppage gastro-intestinal bleeding and urgent intravascular volume replacement; 1) hemotransfusion was accompanied decrease of concentration patient's lactate level; 2) hemotransfusion was not accompanied decrease of concentration patient's lactate level. Have generated the algorithm of indications for transfusion of homologous blood in kind pyramid, in basis are incorporated sensitive, but underspecifically symptoms: the decrease of hemoglobin concentration, especially less 6 g/dl; the decrease of oxygen pressure, degree of hemoglobin saturation with oxygen in venous blood; the increase of blood lactate level; the relative increase cardiac output for account frequency of stroke volume and/or value of stroke volume; positive "oxygen cost" of hemotransfusion.