[The system of hemostasis in experimental liver transplantation]. / Sistema gemostaza transplantatsii pecheni v eksperimente.

The status of haemostatic factors in 28 pigs after orthotopic liver transplantation was evaluated. The major changes took place in fibrinolytic system during the "non-liver" stage: rapid increase of fibrinolytic activity, plasmin activity, plasmin activator activity. From the moment of blood supply restoration to a transplanted liver the tendency to normalisation of fibrinolysis was detected. The deficiency of plasma haemostatic factors and platelets has increased during all the follow-up period and should be corrected in time. The following principles of corrective therapy are formulated: inhibition of fibrinolysis, correction of antithrombin-3 and blood clotting factors. Correction of haemostasis should be done in "pre-non-liver" period and later in "non-liver" reperfusion periods.

[Methods of the use of ketorolac tromethamine in patients during the early postoperative period]. / Metody primeneniia ketorolaka trometamina u bol'nykh v rannem posleoperatsionnom periode.

Analgesia with nonsteroid antiinflammatory drugs (NSAID) becomes a pressing problem today. One such drug is ketorolak tromethamine (KT), characterized by expressed analgesic activity comparable with that of opioid analgesics morphine or promedol. Our purpose was to assess KT efficacy in analgesia performed by different methods, including analgesia controlled by the patient (ACP) after surgery. In medium severe and strong pain KT was used in group I (n = 60) "as needed" in a dose of 30 mg up to 3-4 times a day, in group 2 (n = 12) by the ACP method, in group 3 (n = 16) KT was incessantly infused in a daily dose of up to 120 mg, and in group 4 (n = 11) KT was injected 3-4 times a day in a dose of 30 mg in combination with morphine ACP. The results indicate a high efficacy of KT: 83% after a single injection. Combined use of KT and promedol decreased the dose by 40-50%. Side effects were observed in 15% of patients: most often it was a sense of fever and sweating (in 4% of patients), nausea and vomiting (in 2%), insomnia (in 2%). ACP and planned injections in a daily dose of 90-120 mg is the optimal method of analgesia in patients after extensive surgical interventions.

[Disorders of hemostasis in orthotopic liver transplantation in an experiment]. / Narusheniia gemostaza pri ortotopicheskoi transplantatsii pecheni v éksperimente.

The study was undertaken to examine blood coagulative parameters in experimental orthotopic liver grafting. Plasma hemostatic parameters were studied in animals undergone successful and unsuccessful surgery. The preservation of a graft, anesthetization, and blood-substitute therapy were found to substantially affect the severity of hemostatic disorders. The liver-free period was characterized by changes in the fibrinolytic system and the activity of a plasma coagulation, by enhanced hypocoagulation, and thrombocytopenia. The findings suggest that timely correction of blood coagulative disorders is highly essential in orthotopic liver grafting. Prevention and prompt correction of hypocoagulation and thrombocytopenia are the most urgent.

[Changes in the hemostasis system during long-term intravenous administration of nitroglycerin in the acute period of myocardial infarct]. / Izmeneniia sistemy gemostaza pri dlitel'nom vnutrivennom vvedenii nitroglitserina v ostrom periode infarkta miokarda.

Twenty seven patients were examined in the first hours of the onset of myocardial infarction for the hemostatic systems during a long-term intravenous administration of nitroglycerin (N). They were compared with 24 patients from a control group. N was found to reduce the signs of blood hypercoagulation, decrease platelet aggregation, increase fibrinolytic activity, and elevate antithrombin III levels. Hemostatic alterations were related to a hemodynamic response to nitroglycerin. Positive shifts in the hemostatic system were the most evident in the patients who exhibited higher cardiac output and lower signs of heart failure. In the patients without signs of heart failure, N deteriorated hemodynamic parameters, aggravated hypercoagulation and inhibited blood fibrinolytic activity.