[Postinfusion complications by acute blood loss].

Highs and lows of infusion therapy for the treatment of the acute blood loss were studied experimentally and in clinic. Colloid and crystalloid solutions, being hemodilutants, do not transport oxygen, causing, therefore, several complications in recipient's organism. Dilutional anemic and lead to heart insufficiency, which, by-turn, cause the so called dilutional circulatory hypoxia.

[The infusion therapy of the acute bleeding].

Intravenous colloid and crystalloid solutions are the mainstay of the acute bleeding therapy. Infusion therapy normalizes the blood circulation volume and improves its flow characteristics. The conducted study revealed that the method normovolemic hemodilution lead to an early unknown type of oxygen insufficiency called the dilutional anemic hypoxia. Authors set up and proved the hypothesis, that decompensated dilutional anemic hypoxia lead to cardiac insufficiency, leading finally to the so called dilutional circulatory hypoxia.

[Hypoxia of tissue peripheral shunting in massive transfusion of erythrocytes and whole donor blood]. / Gipoksiia tkanevogo perifericheskogo shuntirovaniia pri massivnom perelivanii éritrotsitov i tsel'noi donorskoi krovi.

In response to correction of lethal and sublethal blood loss with excessive quantities of donor blood two types of cardiovascular adverse reactions may occur immediately after transfusion: either increased or decreased minute blood volume. This conclusion was made after 65 dog experiments on hemodynamics and blood gases. Though the absolute value of cardiac output changes differently in both cases there are signs of oxygen insufficiency.

[Effectiveness of oxygen delivery to tissues during complete replacement of blood by bovine polyhemoglobin]. / Effektivnost' otdachi kisloroda tkaniiam organizma pri polnom obmennom zameshchenii krovi na poligemoglobin byka.

The study has been performed to test the hypothesis on feasibility of omitting pyridoxylation in production of bovine polyhemoglobin as compared to polyhemoglobin from human red cells. The model of a complete replacement of rabbit blood for polyglucin (Het approximately 2%) was used to compare efficacy characteristics for O2 delivery to tissues upon introduction of bovine polyhemoglobin against rabbit red cells. Immediately after the replacement, O2 release efficacy and that of circulation were identical, whereas 30 and 60 min after it, developing decompensation of hemodynamics indicated inability of bovine heterohemoglobin, unlike own red cells, to increase A-B difference by oxygen, probably due to metform rise.

[Disorder in the efficiency of oxygen release to the tissues from preserved human erythrocytes and the rate of its regeneration during their perfusion of the isolated heart]. / Narushenie éffektivnosti otdachi kisloroda tkaniam konservirovannymi éritrotsitami cheloveka i skorost' ee regeneratsii pri perfuzii imi izolirovannogo serdtsa.

The main hemodynamic and oxygen supply parameters of the isolated rat heart (128 experiments) were measured during its perfusion with human donor red cells differing by storage duration and kind of hemopreservatives. The degree of the reduction in efficacy of oxygen release to myocardial tissue and the speed of the release restoration depended both on the red cell storage time and the preservative composition. The authors advocate a new preservative citroglucophosphate with adenine as it proved superior to all the preservatives studied.

[The physicochemical and biological properties of the bovine hemoglobin polymer]. / Izuchenie fiziko-khimicheskikh i riada biologicheskikh svoistv polimera gemoglobina byka.

A study was made of bovine hemoglobin polymer obtained by a new method: intraerythrocytic polymerization of hemoglobin followed by isolation of hemoglobin polymer. The polymer obtained had weighted mean and numerical average molecular mass of 388 kD and 134 kD, respectively, P 32 mm Hg, arteriovenous difference 5.1 vol%, Hill's coefficient 2.14, oxygen output rate constant 55 sec, and it retained its activity during long-term storage. Its solution in a concentration of 9-10 g/dl has a viscosity of 2.34, and an oncotic pressure of 240 mm water. Bovine hemoglobin polymer is nontoxic and capable of long-term circulation in the blood. Its safety and clinical effectiveness should be studied in an extended biological experiment.

[The oxygen system of an isolated heart during its perfusion with a suspension of human erythrocytes after different periods of their preservation in a solution containing adenine]. / Kislorodnyi rezhim izolirovannogo serdtsa pri perfuzii ego vzves'iu éritrotsitov cheloveka raznykh srokov khraneniia, konservirovannykh na rastvore s adeninom.

Seven series of experiments (68 tests) were conducted on an isolated rat heart with the functioning left ventricle during its coronary vessels perfusion with suspension of human erythrocytes of different storage terms preserved in the solution containing citroglucophosphate with adenine. The main parameters of hemodynamics and oxygen regimen were evaluated. The results of the study have shown that washed human donor erythrocytes preserved in the above solution after 1, 7, 14, 21 and 28 days of storage present a highly efficient gas-carrying medium under conditions of acute anemic hypoxia.

[Comparative characteristics of the effectiveness of oxygen delivery to the tissues by human erythrocytes preserved with glugicir and citroglucophosphate]. / Sravnitel'naia kharakteristika éffektivnosti otdachi kisloroda tkaniam éritrotsitami cheloveka, konservirovannymi na gliugitsire i tsitrogliukofosfate.

The main parameters of hemodynamics and oxygen regimen were investigated in isolated rat heart (130 tests) during its perfusion with red blood cells preserved in glugicir (GGC) and citroglucophosphate (CGP). Short-term storage red blood cells did not show disorders in O2 transport to tissues. Long-term storage red blood cells (both in GGC and CGP) showed disorders in hemodynamics that were associated with appearance of free hemoglobin in the perfusion medium due to disruption of some red blood cells by the perfusion apparatus.

[The oxygen supply of the isolated rat heart during perfusion with a suspension of human erythrocytes prepared on the blood preservative citroglucophosphate]. / Kislorodnoe snabzhenie izolirovannogo serdtsa krysy pri perfuzii ego vzves'iu éritrotsitov cheloveka, zagotovlennykh na gemokonservante tsitogliukofosfat.

The isolated rat heart with the functioning left ventricle was used to measure the main parameters of hemodynamics and oxygen supply (60 experiments). Perfusion of the coronary vessels of the heart was performed with washed human red blood cells preserved for varying times (for 1, 7, 10, 14 and 21 days), stabilized on citroglucophosphate. The authors succeeded for the first time in demonstrating under artificially made conditions where the sole variable responsible for oxygen supply of the isolated organ was hemoglobin affinity for oxygen that there was no difference in the function of the isolated heart perfused with human red blood cells preserved for 7, 10 and 14 days as compared with freshly obtained ones. During perfusion of the heart with red blood cells preserved for an insignificant period of time (for 7 and 10 days), no physiological signs evidencing the impairment of oxygen supply to myocardial tissues were revealed.