[The use of modified ultrafiltration in correcting complex congenital heart defects in newborn and nursing infants]. / Primenenie modifitsirovannoi ul'trafil'tratsii pri korrektsii slozhnykh vrozhdennykh porokov serdtsa u novorozhdennykh i grudnykh detei.

Modified ultrafiltration (MUF) was used in radical correction of complex congenital heart disease in 61 newborns and infants. The children were divided into 2 groups: group 1, 46 patients subjected to MUF, and group 2, 15 children operated on without MUF. Hemodynamic, hematological, biochemical, and immunological parameters were monitored. MUF in the newborns and infants helped adequately correct the hemohydrobalance due to ultrafiltration in the patient and hemoconcentration of the remaining volume in artificial ventilation device; it normalized the hematocrit values without additional infusion of donor blood. Elimination of inflammation mediators and cytokines recommends MUF for the treatment of newborns and infants.

[Evaluation of the effectiveness of continuous renal replacement therapy in critical patients after cardiovascular surgery]. / Otsenka éffektivnosti postoiannoi pochechnoi zamestitel'noi terapii u bol'nykh v kriticheskom sostoianii posle operatsii na serdtse i sosudakh.

The efficacy of continuous methods of renal substitute therapy (RST) in patients with multiple organ failure is assessed. The patients were divided in 2 groups administered different types of PST. Group 1 were 16 patients subjected to RST by peritoneal dialysis, in group 2 (n = 16) GP and/or GDP were used. Hemodynamics, hematological and biochemical values, and clearance of inflammation mediators were monitored and hemohydrobalance and complications of therapy assessed in the course of RST. Both RST methods proved to be highly effective. The possibility of differentiated use of peritoneal dialysis and GP/GDP permits an individual approach to treatment, and equally high efficacy of both methods solves the problem of treating total renal insufficiency in the majority of patients with multiple organ failure following cardiovascular surgery.

[Cellular mechanisms of calcium regulation of cardiac rhythm in children with ectopic arrhythmias]. / Kletochnye mekhanizmy kal'tsievoi reguliatsii serdechnogo ritma u detei s éktopicheskimi aritmiiami.

Regulation of intracellular calcium homeostasis by means of secondary mediators calmodulin and 4,5-inositol phosphates (products of phosphatidyl inositol hydrolysis) was studied in children with ectopic forms of arrhythmias. Alterations in the system calmodulin-Ca2+ and the activity of phosphoinosite metabolism correlated highly with clinical manifestations of the arrhythmias. The data obtained suggest that a number of molecular mechanisms and responsible for arrhythmias were realized in cell membranes and depended on a complex of intracellular messengers affected within various steps of the hormonal signal transmission.

[The intracellular second messenger system and its regulatory effects in children with a bronchial asthma attack complicated by heart failure]. / Sistema vtorichnykh vnutrikletochnykh posrednikov i ee reguliarognye éffekty u detei v pristupnom periode bronkhial'noi astmy, oslozhnennoi serdechnoi nedostatochnost'iu.

Components of the intracellular mediators system: calmodulin in leukocytes, Ca2+ and cyclic nucleotides in leukocytes and blood plasma were studied in children with attack of bronchial asthma and heart failure. Alterations in content of these biologically active substances correlated with clinical manifestations of bronchial asthma: severity of the disease, duration of the attack, contractile activity of myocardium. Calmodulin, Ca2+ and cyclic nucleotides were demonstrated to be involved in development of the asthmatic attack. Alterations in the system calmodulin-Ca2+ were related to adaptation and contributed to realization of regulating effects responsible for a decrease of impairments in tissues.

[The concentrations of somatotropic hormone and insulin in the blood of heart surgery patients with a complicated course of the postoperative period]. / Kontsentratsii somatotropnogo gormona i insulina v krovi kardiokhirurgicheskikh bol'nykh pri oslozhnennom techenii posleoperatsionnogo perioda.

It has been shown that the course of the early postoperative period in cardiosurgical patients and its outcome is to a great extent related to adequate balance of adaptation hormones, whose levels and changes are determined by the functional state of compensatory-adaptive systems. Patients with favourable outcome of the complicated postoperative period along with synchronous activation of sympathoadrenal system (SAS), hypophyseoadrenal system (HAS) and an elevated somatotropic hormone (STH) level demonstrated adequately high blood insulin content, with the equilibrium in adrenalin/insulin and cortisol/insulin ratios retained, and moderate STH predominance over insulin. In 1/4 of patients with complicated postoperative period and unfavourable outcome an attenuated SAS response was accompanied by excessively high STH, ACTH, cortisol blood content and a lower insulin level, which determined relative insulin insufficiency.

[The use of artificial feeding during the resuscitation of heart surgery patients]. / Ispol'zovanie iskusstvennogo lechebnogo pitaniia v reanimatsionnom periode u kardiokhirurgicheskikh bol'nykh.

The data on the use of various schemes of artificial nutrition (AN) are reviewed in 137 patients with postoperative complications after cardiopulmonary bypass surgery. It has been established that AN as part of a complex therapy of patients in the early postoperative period has a correcting effect on metabolism and promotes the improvement of the patients' clinical condition. Rational combination of parenteral and enteral tube nutrition ensures adequate AN of cardiosurgical patients in the early postoperative period.

[The course of the early postoperative period in heart surgery patients in relation to the state of humoral regulatory mechanisms]. / Techenie rannego posleoperatsionnogo perioda u kardiokhirurgicheskikh bol'nykh v zavisimosti ot sostoianiia gumoral'nykh mekhanizmov reguliatsii.

It has been shown that the course and outcome of the early postoperative period in cardiosurgical patients are to a great extent related to the functioning of the adaptation systems under study and their interrelations. An essential role of sympathoadrenal system (SAS) in the control over hormonal body status has been established. It ensures, provided its activity is retained, interaction of other hormonal systems as a uniform functional mechanism in postoperative stress. Decreased activity and intrasystemic coordination of SAS combined with low activity of renin-angiotensin-aldosterone system and excessively activated hypophyseal-adrenal system in patients with postoperative complications are indicative of adaptation mechanism damage and are of negative prognostic value.

[Interrelation of changes in the levels of calcium, calmodulin and cyclic nucleotides in children with ectopic types of arrhythmia]. / Vzaimosviaz' izmenenii soderzhaniia kal'tsiia, kal'modulina i tsiklicheskikh nukleotidov pri ektopicheskikh vidakh aritmii u detei.

In 61 children with different patterns of ectopic arrhythmias (premature heart beat, paroxysmal and non-paroxysmal tachycardia), the peripheral blood leukocytes and myocardial tissues were examined for the content of calmodulin (CM), ionized calcium (Ca2+) and cyclic nucleotides (CN). The data obtained indicate that the CM-Ca2+ and CN system are involved in the genesis of arrhythmias in children and may be used as additional criteria in the diagnosis of cardiac rhythm abnormalities.

[Clinical significance of cyclic nucleotide metabolism and calcium level in children with arrhythmia]. / Klinicheskoe znachenie osobennostei obmena tsiklicheskikh nukleotidov i soderzhaniia ka'ltsiia pri aritmiiakh serdtsa u detei.

The cyclic nucleotides (CN) system and Ca2+ content were examined in children with various heart rhythm disorders (HRD). Marked changes were demonstrated which correlated to clinical manifestations of the arrhythmias: their type, phase, duration and favorable changes in their course. Antiarrhythmic therapy was associated with a normalization of the altered levels of cyclase components and Ca2+. The results suggest that intracellular metabolism regulation may be disrupted in HRD cases and play an important role in the development of arrhythmias.

[Metabolic effects of a glucose-insulin-potassium mixture in acute myocardial infarct]. / Nekotorye metabolicheskie éffekty gliukozo-insulino-kalievoi smesi u bol'nykh ostrym infarktom miokarda.

In order to limit the spread of myocardial infarction, 56 patients with acute myocardial infarction, admitted to hospital within 10 hours from the attack, were for two days treated with continuous intravenous drip infusion of glucose-insulin-potassium mixture (GIP) (300 ml glucose, 50 U common insulin, 60 meqv potassium chloride at the rate of 1 ml/kg/hour). The control group was composed of 48 patients who received intravenous drip infusion of physiological saline, at the rate of 20 drops per minute, for the same duration of time. The findings revealed an increased in glucose and potassium levels and serum osmolarity, and a drop in free fatty acids. It is suggested that GIP infusion to patients with myocardial infarction has a favourable effect on the metabolism of ischemized myocardium via a series of changes it produces in carbohydrate and lipid metabolism and blood electrolytic composition.

[Sympathetic-adrenal and enterochromaffin systems and homeostatic indices in open-heart surgical operations under morphine anesthesia]. / Simpatiko-adrenalovaia, énterokhromaffinnaia sistemy i nekotorye pokazateli gomeostaza pri kardiokhirurgicheskikh operatsiiakh na otkrytom serdtse v usloviiakh anestezii morfinom.

Catecholamine, serotonin and histamine metabolism and the level of acid metabolites and the activity of the enzymes lactate dehydrogenase and catalse in blood were studied in patients with congenital heart disease who were operated on under conditions of extracorporeal circulation and morphine anesthesia. The results obtained were compared with the values of acid-base balance, haemodynamics and volume of diuresis. It wwas found that the period of morphine induction was marked by a significant increase in the blood plasma noradrenalin content in the absence of essential changes in the other biochemical and hemodynamic indices studied. No significant changes were noted in the systems of neurohumoral and tissue regulation, indices of the redox processes and renal excretion in the most traumatic periods of the operation. The data obtained allow morphine to be accepted as an anesthetic which provides adequate protection of the organism from operative trauma.

[Aspects of a study of the blood enzymatic and isoenzymatic spectrum in different forms of ischemic heart disease]. / Nekotorye aspekty izucheniia fermentnogo i izofermentnogo spektra krovi pri razlichnykh formakh ishemicheskoi bolezni serdtsa.

Analysis of data obtained in the study of the blood enzymatic and isoenzymatic spectra (creatine phosphokinase and lactate dehydrogenase with simulatenous study of aspartate and alanine transaminases) in patients with various forms of ischemic heart disease showed the close correlation of the studied tests with the clinical picture of the disease, the degree and depth of myocardial involvement. The enzymatic tests studied are of diagnostic and prognostic importance and may be used in the differential diagnosis of various forms of ischemic heart disease.