[Characteristics of the dosage of sodium hydrocarbonate for correction of metabolic acidosis in surgical patients]. / Osobennosti dozirovki natriia gidrokarbonata pri korrektsii metabolicheskogo atsidoza u bol'nykh khirurgicheskogo profilia.

It has been established that in conditions of intraoperative blood and plasma loss base deficiency is determined not only by hypocarbonatemia, but also by hypoproteinemia, hypophosphatemia and HCO3 metabolism disturbances caused by anemia. Correction of metabolic acidosis in such patients should include infusions of NaHCO3, protein preparations, blood, phosphates. Mellemgaard and Astrup's technique presupposes correction of the deficiency of all buffer bases only with NaHCO3, which dramatically increases its dosage. Thus, it is evident that the technique should be revised. The comparison of the results of metabolic acidosis correction using a conventional and adapted techniques (hydrocarbonate dose in mmol or ml of a 8.4% solution is 24-SB.body weight.0.2%) in statistically homogeneous groups has shown that differentiated "polybuffer" correction of metabolic acidosis with adapted NaHCO3 dose 1.7 times more frequently normalized acid-base balance parameters, reducing the risk of the onset of post-correction metabolic alkalosis to minimum.

[Specifics of resistance dosing at expiration in spontaneous respiration with positive pressure at the end of expiration in the postoperative period in obese patients]. / Osobennosti dozirovaniia soprotivleniia na vydokhe pri spontannom dykhanii s polozhitelnym davleniem v kontse vydokha v posle- operatsionnom periode u bolnykh s ozhireniem.

The indications and regimens of spontaneous respiration with positive pressure at the end of expiration (SR with PPEE) in patients with morbid obesity are not established. The individual selection of resistance at expiration is necessary. In 53 patients, the selected resistance at expiration has proved to be the optimal, contributing to significant improvement of parameters of pulmonary ventilation without deterioration of hemodynamic indices. An inverse dependence of the values of optimal resistance at expiration and excess in ideal body mass was established. By multiplying the values mentioned, the K coefficient is obtained equal to 530.3 + 7.66. In patients over 60, K was 400.3 +/- 11.52. The use of a nomogram (in numerical and graphic versions) to dose resistance at expiration in patients with concomitant morbid obesity contributed to significant improvement of the indices of pulmonary ventilation and gas exchange without disorders in hemodynamics after seances of SR with PPEE.