[Status of the blood coagulation system in traumatic disease]. / Sostoianie sistemy gemokoaguliatsii pri travmaticheskoi bolezni.

Under examination there were 198 patients with severe mechanical traumas at their admission to the clinic and on the 1st, 3d, 7th, 14th and 21st days by 25 hemocoagulation parameters determined by common present-day methods. The direction and degree of hemocoagulation alterations were found to be related with the severity of trauma, blood loss volume and severity of shock. It was shown that disseminated intravascular coagulation (DIC) of the II and III degree was developing in critical associated traumas, massive blood loss and severe shock in acute period of the disease. The acute form of DIC with reactive fibrinolysis was established in the lethal outcome during the shock period, latent (slow) DIC with local fibrinolysis took place in lethal outcomes in later periods.

[Characteristics of the pathogenesis of suppurative-septic complications of severe trauma]. / Osobennosti patogeneza gnoino-septicheskikh oslozhnenii tiazheloi travmy.

The article analyzes results of examination of 261 patients with severe mechanical injuries. The examinations were performed at different periods after the trauma by biochemical and immunological methods. It was established that a number of indices (content of blood glucose, activity of aspartate aminotransferase, alanine aminotranspherase and T-lymphocyte content) were reliably different depending on the clinical course and the outcome of the trauma disease.

[Indications, methods and results of amputations of the extremities in isolated, multiple and associated traumas]. / Pokazaniia, sposoby i rezul'taty amputatsii konechnostei pri izolirovannykh mnozhestvennykh i sochetannykh travmakh.

An analysis of 246 observations has shown that in patients with crushed extremities accompanied by shock the amputation is the most important antishock measure. The amputation performed by the method of primary surgical treatment of the wound is the method of choice. The amount of postoperative complications can be considerably reduced by using the primarily delayed suture, carbon sorbents on the stump wound, temporary immobilization of the extremity stump.

[Potentials of infusion therapy in enhancing the detoxification effect of hemosorption in patients suffering from suppurative-septic complications of mechanical injury]. / Vozmozhnosti infuzionnoi terapii v usilenii detoksikatsionnogo éffekta gemosorbtsii u postradavshikh s gnoino-septicheskimi oslozhneniiami mekhanicheskoi travmy.

Under study was the application of microvasoplegia as a method of preoperative management in fulfilling hemosorption in patients with pyo-septic complications of a severe mechanical trauma. The method of infusion and medicamentous therapy used before hemosorption is described. Laboratory examinations of the enzyme toxemia level have shown pathogenetic grounds of the complex method of treatment. Positive clinical results were obtained.

[Immunological status and somatotropic activity of the pituitary in combined abdominal injuries complicated by peritonitis]. / Sostoianie immuniteta i somatotropnoi aktivnosti gipofiza pri sochetannoi travme zhivota, oslozhnennoi peritonitom.

Associated injuries of the abdomen result in peritonitis twice more often than isolated ones, the peritonitis having more severe course and being the cause of lethal outcomes in 57% of the victims. The immune deficient state is thought to be one of the causes responsible for the reduced resistance to infection and the development of peritonitis in the postshock period. Patients with associated traumas show a considerable inhibition of the immune system within several hours and an impairment of its regulation which grows during the next day. So, even at the early terms the operative methods must be similar to those used in operations for the developed peritonitis.

[Characteristics of various parameters of homeostasis in suppurative-septic complications of severe trauma]. / Kharakteristika nekotorykh parametrov gomeostaza pri gnoino-septicheskikh oslozhneniiakh tiazheloi travmy.

In pyo-septic complications of a severe mechanical isolated trauma there are regular changes in homeostasis. The direction and degree of the changes of biochemical and immunological parameters within the first 3 days may be a prognostic criterion of the clinical course of the postshock period whether complicated or noncomplicated.

[Free-radical oxidation and the hemostatic system in the dynamics of traumatic disease]. / Sostoianie svobodnoradikal'nogo okisleniia i sistemy gemostaza v dinamike travmaticheskoi bolezni.

Growing hypercoagulation is revealed in patients with a critical mechanical trauma parallel with a pronounced prolonged activation of lipid peroxidation. The disorders in the lipid metabolism and hemostasis system are most pronounced in a complicated course of the trauma disease and its unfavorable outcome.

[Traumatic disease and metabolism]. / Travmaticheskaia bolezn' i metabolizm.

The authors have established that the traumatic disease is accompanied by phasic nonspecific changes of metabolism correlating with the trauma severity as well as with its specific features and outcomes. Within the first 3-7 days catabolic processes are found to prevail and metabolic acidosis develop. Later, anabolic processes become activated in the non-complicated course of the disease. Normalization of most biochemical processes is accomplished within 15-21 days. More pronounced and prolonged disturbances of metabolism are observed in complications and lethal outcomes.

[Hemosorption in the treatment of toxemia and septic conditions after severe mechanical trauma]. / Gemosorbtsiia v lechenii intoksikatsii i septicheskikh sostoianii posle tiazheloi mekhanicheskoi travmy.

Under study was the significance of hemosorption in complex therapy of patients with complications resulting from a severe mechanical trauma. Lethality was found to decrease from 68% to 45%. The results obtained allow the use of hemosorption to be recommended for the treatment of endogenous intoxication in patients with complications of a severe mechanical trauma.

[Structure and sorption properties of regenerated hemosorbent SCN]. / Struktura i sorbtsionnye svoistva regenerirovannogo gemosorbenta SKN.

Stepwise desorption of protein components from the hemosorbent SCN after hemoperfusion was studied, and their molecular weights were determined. It was found that hard alkaline regeneration and oxidation with nitric acid do not affect the hemosorbent structure, composition and potentiometric characteristics. The regenerated hemosorbent can be successfully used for adsorbtion of extraneous low- and medium-molecular weight components to clarify microbiological liquids.

[Correction of metabolic changes in preserved donor blood using hemosorbents]. / Korrektsiia metabolicheskikh sdvigov v konservirovannoi donosrskoi krovi gemosorbentami.

The investigation of the effect of perfusion through the activated charcoal upon the biochemical and morphological parameters of the donor blood stored with the glucose-cytrate conservant during 14-21 days has shown normalization of the acid-base status, increased oxygen-transport function and energy balance of erythrocytes. So, blood continuously stored and purified with the help of sorbents is quite suitable for massive transfusions.

[Post-traumatic disease]. / Travmaticheskaia bolezn'.

On the basis of an analysis of the many-years clinical examinations of patients with severe mechanical traumas the author suggests that the trauma disease be recognized as a special nosological unit including four different periods in its course, each of them requiring appropriate methods of treatment.

[Various immunologic aspects of craniocerebral injuries]. / Nekotorye immunologicheskie aspekty cherepno-mozgovoi travmy.

The authors analysed cellular and humoral immunity in 104 patients with different types of craniocerebral injury. It was found that the T system immunity reflects the state of the main mechanisms of the organism's nonspecific resistance while its changes are determined by the level of the brain injury. A marked decrease in the T system values in the acute period of the injury with subsequent rapid restoration reflects an adequate total adaptational reaction of the organism and is characteristic of mild and moderate brain contusion. A normal or high level of cellular immunity values in the acute period of the injury with subsequent profound and prolonged immunodepression is evidence of the absence of this reaction and, consequently, of the deficiency of the nonspecific resistance mechanisms resulting from damage to the brain structures regulating these processes. Such reaction of the immune system was disclosed in severe brain contusion. The periodical character of changes in the organism's immune system after injury may serve as the basis for the therapeutic tactics.