[Biologically active substances during treatment of pulmonary hypertension with ATP infusions immediately after general anesthesia and surgery of hypervolemic congenital heart defects]. / Biologicheski aktivnye veshchestva v usloviiakh terapii legochnoi gipertenzii infuziiami ATF v blizhaishem periode posle obshchei anestezii i likvidatsii gipervolemicheskikh vrozhdennykh porokov serdtsa.

In 95 patients with hypervolemic congenital heart valve defects (42 with interventricular and interatrial septal defects, and 53 with patent ductus arteriosus) mixed venous blood levels of serotonin, histamine, adrenalin, noradrenaline, total 11-hydroxycorticosteroids were studied using spectrofluorimetry, cyclic adenosine- and guanosine monophosphate (cAMP and cGMP), prostaglandins E + A and F2 alpha and their interaction were assessed using radioimmunoassay and correlation analysis, respectively. Immediately after general anesthesia and surgical correction of septal defects using cardiopulmonary bypass adrenalin level was increased, while noradrenaline, cAMP, cGMP, prostaglandin E + A levels remained high. Similar pattern was observed in patients after arterial duct ligation. Mean pulmonary artery pressure was elevated in both groups of patients (above 4 kPa). Effective therapy of pulmonary hypertension with intravenous ATP infusions immediately after general anesthesia and elimination of septal defects (20 patients) was accompanied by a decline in noradrenaline, cGMP and total 11-hydroxycorticosteroid level (with adrenalin level increased), while after open arterial duct ligation (20 patients) it was followed by a drop in noradrenaline and prostaglandin F2 alpha level (with adrenalin level increased) and the activation of the interaction of biologically active substances aimed predominantly at attenuation of vasoconstrictor reactions in the lungs.

[Biologically active substances in patients with hypervolemic congenital heart defects undergoing general multicomponent anesthesia]. / Biologicheski aktivnye veshchestva u bol'nykh s gipervolemicheskimi vrozhdennymi porokami serdtsa v usloviiakh obshchei mnogokomponentnoi anestezii.

In 95 patients with hypervolemic congenital heart diseases (42 with interventricular and interatrial septal defects, and 53 with patent ductus arteriosus) mixed venous blood levels of serotonin, histamine, adrenalin, noradrenaline, total 11-hydroxycorticosteroids were studied using spectrofluorimetry, cyclic adenosine- and guanosine-monophosphate (cAMP and cGMP), prostaglandins E+A and F2 alpha and their interaction were assessed using radioimmunoassay and correlation analysis, respectively. Before surgical treatment the patients showed higher (than in the control) concentrations of histamine, adrenalin, noradrenaline, cAMP, and cGMP, prostaglandins E+A. During anesthesia including fentanyl, morphine, diazepam, N2O:O2 in patients with heart valve defects cGMP level was increased and in patients with patent ductus arteriosus cAMP level was increased during analogous anesthesia with morphine replaced by halothane.

[Treatment of pulmonary hypertension in the immediate period after general anesthesia and surgical correction of patent ductus arteriosus and heart septal defects]. / Terapiia legochnoi gipertenzii v blizhaishem periode posle obshchei anestezii i khirurgicheskoi korrektsii otkrytogo arterial'nogo protoka i defektov peregorodok serdtsa.

Surgical correction of the arterial duct and defects of the cardiac septa is followed in the nearest period after surgical correction by lung hypertension which considerably aggravates the postoperative period. The observation of 74 patients has shown that infusions of 1% solution of phosphobion (0.05 mg/kg/min) in the pulmonary artery decrease the pressure in the pulmonary artery, pulmonary-vascular resistance, make the incidence of disturbed heart rate less frequent, reduce the concentration of noradrenaline and prostaglandins.

[Vasoactive hormone metabolism in the lungs of patients with congenital heart defects]. / Metabolizm nekotorykh vazoaktivnykh gormonov v legkikh u bol'nykh vrozhdennymi porokami serdtsa.

The role of pulmonary metabolism of adrenaline, noradrenaline (NA), serotonin and histamine in the pathogenesis of hemodynamic disorders was examined in relation to the magnitude of intracardiac discharge (ID) in 30 patients with septal defects. Irrespective of the magnitude of arteriovenous ID, pulmonary tissue deactivation of NA is shown to be disrupted. Where ID averages 7.7 +/- 2.1 1/min, venous blood NA level is 59.8% higher (p less than 0.05) than that of patients with average ID of 3.1 +/- 0.7 1/min. A positive correlation (r = 0.51) is demonstrated between venous NA levels and ID in the latter group. The data obtained suggest that high ID values are associated with disturbed pulmonary metabolism and increased arterial levels of serotonin and NA, a significant contribution to the development of functional and morphologic vascular disorders of systemic and pulmonary circulation.