[Anesthesiological management in transplantation of the heart after temporary mechanical substitution of its function]. / Anesteziologicheskoe obespechenie transplantatsii serdtsa posle vremennogo mekhanicheskogo zameshcheniia ego funktsii.

The first experience of anesthesiological management of three two-step orthotopic heart transplantations is reviewed. As the first step of surgical treatment one recipient was implanted an artificial heart "POISK-IOM" (Russia), in 2 other patients left ventricular bypass was achieved using a "Biopump" ("Biomedics", USA). Anesthesia techniques, methods of infusion-transfusion therapy, and other components of intraoperative management are described. Hemodynamics, donor heart function recovery, and other homeostasis parameters have been analysed. It has been noted that high doses of fentanyl in combination with ketamine and diazepam ensured satisfactory course of general anesthesia. There were no cases of intraoperative lethality. A more complex aspect of anesthesiological management was correction of various homeostasis disturbances which progressed during surgery in patients with left ventricular bypass. In two cases the intraoperative period was characterized by the onset of multiorgan failure (heart, respiratory, renal failure, metabolic disorders, coagulopathy), which played a negative part for the postoperative period of heart transplantations. It is concluded that prediction of possible complications during temporary mechanical replacement of the cardiac function and timely determination of contraindications for the second step of two-step heart transplantations are the most important trends of investigations for anesthesiologists, intensive care specialists, and transplantologists.

[Characteristics of air retention by different extracorporeal filters during artificial circulation]. / Kharakteristiki uderzhivaniia vozdukha razlichnymi ékstrakorporal'nymi fil'trami pri iskusstvennom krovoobrashchenii.

The paper concerns the present-day problem of estimating the efficiency of the functioning of extracorporeal filters in artificial circulation. A method for laboratory studies of extracorporeal filters is offered. The results obtained with the use of the method are provided in order to compare air retention by modern filters. The interference-killing feature and practical feasibility with the use of the popular standard equipment should be attributed to undoubtful advantages of the method suggested. The data obtained are of interest both for users of extracorporeal filters and those who are engaged in the development of the equipment for artificial circulation.

[Anesthesiologic management of clinical orthotopic liver transplantation]. / Anesteziologicheskoe obespechenie ortotopicheskoi transplantatsii pecheni v klinike.

The first clinical experience of anesthesiological management during 6 orthotopic liver transplantations (5 primary operations and 1 retransplantation) in 2 males and 3 females, aged 20 to 52 years, is presented. The method of general anesthesia is described--the use of veno-venous bypass without systemic heparinization and rapid infusion system. Hemodynamic, temperature, metabolic and coagulologic homeostasis disturbances are analysed at different stages of orthotopic liver transplantation, especially upon reperfusion of the donor organ. The tactics of infusion-transfusion therapy, as well as correction of electrolyte disturbances and blood coagulation disorders are being discussed. Different intraoperative complications are characterized. It is concluded that anesthesiological management of liver transplantations is one of the most complex problems of modern anesthesiology which takes joint effort of a large team of specialists: surgeons, anesthesiologists, perfusiologists, transfusiologists, and laboratory assistants specializing in different areas.

[The first clinical experience with orthotopic transplantation of the liver]. / Pervyi opyt ortotopicheskoi transplantatsii pecheni v klinike.

The article deals with material concerning the performance of 4 operations for orthotopic liver transplantation (OLT). The operations were carried out on 2 males and 2 females whose ages ranged from 20 to 52 years. The indications for OLT were as follows: ++hemangioendothelioma of the liver, hepatocellular carcinoma, cirrhosis-carcinoma of the liver, and metastatic affection of the liver. One male patient died immediately after the end of the operation, another patient died 3 days after the operation due to nonfunctioning of the transplant. In 2 female patients the operations were carried out successfully. One of them was discharged from the clinic in 62 days in a satisfactory conditions and a well functioning transplant. The other patient died from a complication which was not connected with the operation--perforation of the small intestine 69 days after OLT. The technical aspects of and the provision for the operation and the postoperative management of patients are discussed. The encountered complications are analysed.

[Physiological and hygienic evaluation of the vibrations in a transport helicopter cockpit]. / Fiziologo-gigienicheskaia otsenka vibratsii v kabine transportnogo vertoleta.

In the cockpit of five helicopters the floor and the chair vibrated in a band of 8 Hz at a frequency of 112.5 and 114.0 dB, respectively. Before and after the flying shift 66 crewmembers were interviewed and examined. Vibration was referred to as the most unpleasant factor by 30.4% of them, noise was defined as the most unpleasant factor by 6.5% of them; 63.1% described both factors as similarly adverse. The level of psychophysiological changes was proportional to the flight time. The first signs of fatigue were seen after flights of up to 5 hours in duration to increase drastically after flights of 6 and 7 hours.

[Reverse valves in the drive line of occlusion pumps in "heart-lung" machines]. / Obratnye klapany v nagnetaiushchei magistrali okkliuzionnoykh nasosov v apparatakh "serdtse-legkie" apparatakh.

An analysis of hydraulic cyclograms of perfusion blood-pumps (A. A. Pisarevski et al., 1970) and characteristics of polymeric main lines in artificial blood-circulation units (A. A. Pisarevski et al., 1971) suggested that a reverse-acting valve placed at the outlet of the pressure pump will decrease regurgitation into its elastic chamber at the moment when the cycle is completed: it will increase the occlusion pump discharge during contraction, or even more, will lessen the variable pressure component behind the pump. This was confirmed by the roller-pump test with or without a valve at the pump outlet. The article presents the test method, types and functional assessment of the valves tested and the design of a newly developed petal-slotted V-shaped valve. Its comparison with other valve designs showed the best hydraulic features.

[Perfusion system for assisted blood oxygenation during treatment of children with acute respiratory insufficiency]. / Perfuzionnaia sistema dlia vspomogatel'noi oksigenatsii krovi pri lechenii ostroi dykhatel'noi nedostatochnosti u detei.

To conduct an auxiliary extracorporeal oxygenation in acute respiratory incompetence in young children a perfusion system with a small primary charging volume is proposed. The system was tested in an experiment and clinically in an infant with mass of 4.5 kg. The auxiliary oxygenation lasted for 73 1/2 hours. The operating characteristics of the perfusion system with a "Lande-Edwards" diaphragmatic oxygenator and its schematic diagram are described.