[Impaired blood coagulative properties in the early postresuscitation period and their prevention]. / Narusheniia koaguliatsionnykh svoistv krovi v rannem postreanimatsionnom periode i ikh profilaktika.

Experiments were conducted on 356 non-inbred albino rats that had experienced 8-min clinical death caused by acute hemostasis or mechanical asphyxia. Irrespective of the cause of the clinical death, the authors identified uniform phase coagulative disturbances. They appeared as reactive hypercoagulation occurring during clinical death and progressing within 3 hours after resuscitation, by transforming to hypocoagulation that peaked at hours 6 to 24 hours. On day 3, recurrent hypercoagulation developed. Dalargin and mildronate were found to prevent the activation of the vascular and thrombocytic links of hemostasis and the release of clotting agents.

[Arrest of the chronic pain syndrome using epidural analgesia in patients with disseminated prostate cancer]. / Vozmozhnosti épidural'noi analgesii pri kupirovanii khronicheskogo bolevogo syndroma u bol'nykh disseminirovannym rakom predstatel'noi zhelezy.

Treatments results of 22 cases of atypical generalized and local carcinoma of the prostate involving different cells and tissues and accompanied by persistent neuropathic pain are described in the paper. The method of continuous epidural analgesia by an opioid agonist ((a 2% morphine hydrochloride solution and a local anesthetic) and by a 0.5% anekain solution provides for a smaller single dose of the preparation and for a less number of injections that should be used; it also eliminates the pain stress and improves the life quality of patients.

[Effect of early post-resuscitation endotoxemia on the myocardial function]. / Vliianie rannei postreanimatsionnoi éndotoksemii na funktsiiu miokarda.

The impact made by serum (which was obtained in 30 minutes after resuscitation) on the cardiovascular system was studied in experiments with the total body as well as with isolated and isovolumetrically contracting hearts of white outbred male rats. A 5-minute clinical death was provoked by a severe blood loss. The "toxic" serum, when administered to the intact animals with the macrophage system blocked by trypan blue, was found to reduce the stroke and minute hearts volumes and to increase the general resistance of peripheral vessels. Lower force and velocity indices of the myocardium contractility, a higher consumption of glucose by the heart per a unit of a performed function, disassociation of the oxidation phosphorylation, activation of anaerobic glycolysis and increased discharges of cardiachystiocyte, lactate, pyruvate and of enzymes of different ultrasound localizations were detected in perfusion of the hearts isolated by Krebs-Henzelight solution containing the "toxic" serum.

[Cardioprotective effect of exogenous creatine phosphate in acute hemorrhage]. / Kardioprotektornoe deistvie ékzogennogo kreatinfosfata pri ostroi krovopotere.

Experiments on noninbred albino male rats under the conditions of the whole body and the isolated isovolumically contracting heart have shown that a substantial contribution to postresuscitative cardiac damages is made by energy deficiency that triggers a group of mechanisms of damaging cardiomyocytic membranes. Exogenous creatine phosphate (CP) reduces postresuscitative mortality rates, improves bioenergy, contractile and rhythmical functions of the heart, decreases the rate of myocardial lipid peroxidation, by showing as a whole a cardioprotective action. The latter is realized by directly protecting the cardiomyocytic sarcolemma and the improvement of energy metabolism is secondary. Despite the likely mediation of this effect, improved energy metabolism is undoubtedly a key point of the protective action of exogenous CP if the heart is postresuscitatively damaged.

[Effects of efferent therapy on the blood oxygen transporting function in diffuse suppurative peritonitis in patients with diabetes mellitus]. / Vliianie éfferentnoi terapii na kislorodtransportnuiu funktsiiu krovi pri razlitom gnoinom peritonite u bol'nykh sakharnym diabetom.

Twenty patients with non-insulin-dependent diabetes mellitus were treated in intensive care wards for diffuse purulent peritonitis developing during diabetes decompensation. Group 1 (10 pts) were treated by basic therapy after surgery, in group 2 (10 pts) basic therapy was supplemented by hemoquantum, efferent, and oxidative therapy with consideration for endotoxicosis phases. Basic therapy during the early postoperative period did not remove disorders in the blood oxygen-transporting function, while sessions of hemoquantum, efferent, and oxidative therapy supplementing basic therapy with consideration for the phases of endotoxicosis improved this function due to decrease of intoxication, diabetes compensation, and increase of cardiac output.

[Use of plasmapheresis for correction of metabolic disorders in patients with surgical sepsis]. / Ispol'zovanie plazmafereza dlia korrektsii metabolicheskikh narushenii u bol'nykh s khirurgicheskom sepsisom.

Twenty-four patients aged 16-67 years with surgical sepsis developing as a result of pancreonecrosis, gynecological diseases, urological sepsis. closed abdominal injury, and suppurative inflammation of soft tissues were examined. Endotoxemia caused pronounced disorders in metabolism, particularly purine metabolism, and the associated lipid peroxidation processes. Plasmapheresis exerted a positive effect in patients with high concentration of medium molecular-weight polypeptides (more than 0.32 arb. units) in the blood, decreasing the mortality by 40.5%. At lower concentrations of these polypeptides in the blood (less than 0.32 arb. units) plasmapheresis is inefficient.

[Role of disrupting the antioxidant status of the body in forming the endogenous intoxication syndrome in patients with toxic and terminal stages of peritonitis]. / Rol' narushenii antioksidantnogo statusa organizma v formirovanii sindroma éndogennoi intoksikatsii u bol'nykh v toksicheskoi i terminal'noi stadiiakh peritonita.

Fifty-one patients with diffuse peritonitis were treated. 40 of these presented with the toxic stage and 11 had terminal stage with lethal outcomes. Studies of the antioxidant status showed an important role of lipid peroxidation metabolites in the formation of endogenous intoxication during the early postoperative period, manifesting, among other things, by decreased albumin transporting function. Analysis of correlations showed some relationships in the studied parameters which can be used in complex with other values in clinical laboratory diagnosis of endotoxicosis severity in peritonitis and in evaluation of the time course of this condition during intensive care. It can serve as a prognostic criterion of peritonitis development and outcome.

[Disorders of purine metabolism in patients with peritonitis complicated by sepsis]. / Narusheniia metabolizma purinov u bol'nykh peritonitom, oslozhnivshimsia sepsisom.

Progressive hypoxia and cell destruction leading to increased production of active oxygen forms by xanthinoxidase and manifesting by an increased level of uric acid in the blood in parallel with inhibited pentose cycle reaction due to low activity of glucose-6-phosphate dehydrogenase determine the severity of peritonitis.

[Role of disorders of metabolism in rat myocardium and endotoxemia in the pathogenesis of post-resuscitation cardiodepression]. / Rol' narushenii metabolizma v miokarde krys i éndotoksemii v patogeneze postreanimatsionnoi kardiodepressii.

The model of 4-min clinical death due to acute blood loss was used to study cardiac contractility, myocardial metabolism and causes of endotoxemia in early postresuscitation period. The investigations were made on the whole body, isolated, isovolemically contracting heart and isolated papillary muscle. A marked reduction in functional myocardial reserves, maximal within the first 24 hours of postresuscitation, with dominant defects in relaxation was seen. Pathogenetic factors responsible for cardiodepression are the following: hypoxia, impairment of bioenergetics, hyperactivation of lipid peroxidation, acidosis, membrane destruction, endotoxemia.