[Possibility of early operations in severe traumatic shock under the protection of assisted circulation]. / O vozmozhnosti rannykh operatsii pri tiazhelom travmaticheskom shoke pod zashchitoi vspomogatel'nogo iskusstvennogo krovoobrashcheniia

The results of treatment in 28 patients with extremely severe multiple injuries are analysed: 21 of them had open, comminuted, crushed fractures or tearing of 44 extremities. After a failure of antishock measures an assist extracorporeal circulation with oxygenation was instituted, and surgery was performed. In 128 experiments on dogs a explosive bullet wound was inflicted on the knee joint: a comminuted intraarticular fracture of 2-3 bones was produced, followed by 25-30% bloodletting and additional trauma of the damage site. In 23 control experiments without using the heart-lung machine but with routine antishock measures 83% of animals died after the amputation and 17%--survived. A conclusion is made on the rationale and efficacy of an assist extracorporeal circulation in severe traumatic shock, that would make is possible to perform an early operation and to eliminate "the trigger mechanism" of shock.

[Parellel blood circulation with oxygenation of blood in severe poisoning with carbon monoxide fumes]. / Parellel'noe krovoobrashchenie s oksigenatsiei krovi pri tiazhelykh otravleniiakh ugarnym gazom

The authors present an analysis of treatment in 141 patients with acute carboxyhemoglobinemia, in 110 of them severe intoxication was noted. All these patients were treated taking into account the degree of intoxication, the period of time elapsed since the moment of the intoxication till the onset of therapy, and the presence of biochemical shifts in blood. In 31 patients being in an extremely poor comatous state with considerable disorders in gas balance, persistant hemodynamic disturbances and manifest humoral shifts a parallel perfusion with extracorporeal oxygenation of blood was performed with medical drug therapy in the background. The immediate effect was found to be quite favourable, however, 19 patients died in different terms as a result of subsequent complications, most frequently due to pneumonia and meningoencephalitis.