[Effects of high doses of aprotinin on intra- and postoperative blood loss in surgery with artificial circulation]. / Vliianie bol'shikh doz aprotinina na intra- i postoperatsionnuiu krovopoteriu pri operatsiiakh s iskusstvennym krovoobrashcheniem.

A total of 100 patients subjected to multiple aortocoronary shunting under artificial circulation were examined. All of them were administered aprotinin or placebo in standard doses in a double blind test. The drug was infused over the entire course of the operation, total dose being 6 million KIU. The groups of patients did not differ by duration of artificial circulation and aorta clamping, or by the number of shunts used. The data permit a conclusion that prolonged intraoperative infusion of aprotinin in a dose of 6 million KIU resulted in a twofold reduction of the blood loss during and after the operation, thus permitting less frequent and lower in volume transfusions of donor blood during the operation and in the early postoperative period.

[Evaluation of adequate heparinization during artificial circulation in the framework of prolonged intraoperative administration of high doses of aprotinin]. / Otsenka adekvatnosti geparinizatsii pri iskusstvennom krovoobrashchenii na fone intraoperatsionnogo prolongirovannogo vvedeniia bol'shikh doz aprotinina.

The aim of this research was to evaluate the effect of high aprotinin doses on activated coagulation time (ACT) in patients with aortocoronary bypass. A total of 100 patients were examined. All of them were administered in a double blind test either aprotinin or placebo in standard doses. Our results permit a conclusion that adequate heparinization during aprotinin therapy can be achieved at ACT values more than 750 sec and protamine sulphate dose should be estimated from initially administered heparin dose. With ACT values exceeding twofold the usual ones there was no evidence of excessive heparinization leading to marked thrombocytopenia and bleeding.

[Practical aspects of cardioplegia]. / Nekotorye prakticheskie voprosy kardioplegii.

Concentrations of the ingredients have been analysed in a nonstandard cardioplegia solution (CS) and CS from St. Thomas Hospital at the outset before CS introduction into the coronary vessels of patients under cardioplegia. It has been shown that the use of nonstandard CS was accompanied by undesirable variability in ingredient concentration, which to some extent may be accounted for by the use of incompletely unfrozen CS. The use of CS from St. Thomas Hospital could be accompanied by moderate hypermagnesiumemia, which did not lead to the onset of vascular insufficiency. It is stressed that plasma magnesium content should be controlled when this CS is used.

[The Soviet colloid modegel as a component of a perfusion medium used in surgery with extracorporeal circulation]. / Otechestvennyi kolloid modezhel' kak komponent perfuzionnoi sredy dlia operatsii s iskusstvennym krovoobrashcheniem.

The results of the application of a new Soviet colloid solution modegel in cardiopulmonary bypass surgery in 50 patients have been analysed. The data obtained have been compared to those of control patients who were administered gelatinol instead of modegel. Modegel ensures optimal basic plasma electrolyte content, colloid-osmotic pressure and osmolality during perfusion.

[Activated coagulation time and the concentration of heparin in assessing the level of blood heparinization during operations using artificial blood circulation]. / Aktivirovannoe vremia svertyvaniia i kontsentratsiia geparina v otsenki urovnia geparinizatsii krovi pri operatsiiakh s iskusstvennym krovoobrashcheniem.

Blood heparinization was assessed, using two techniques (activated coagulation time--ACT and heparin concentration) in 31 patients during cardiopulmonary bypass surgery. It has been shown that ACT-technique, not always revealing heparin concentration, may serve as a criterion for blood heparinization adequacy during cardiopulmonary bypass, as in every case it reflects individual changes in anticoagulant blood activity.