[Algorithm of cardiopulmonary resuscitation in a cardiological hospital]. / Algoritm serdechno-legochnoi reanimatsii v statsionare kardiologicheskogo profilia.

Recent comments and amendments to routine algorithm of P. Safar's cardiopulmonary resuscitation, known as the ABCD principle, are critically analyzed. The primary mechanisms of thanatogenesis in sudden death in the majority of cases are not respiratory problems (requiring ABCD algorithm), but cardiac rhythm disorders. Based on their studies and practical and training experience, the authors suggest a new algorithm of cardiopulmonary resuscitation: UNIVERSAL, with the following steps: precordial stroke, indirect massage of the heart, forced ventilation of the lungs, venipuncture, electrocardiography, defibrillation by electric pulse therapy, electrocardiostimulation, and injections of adrenalin, atropine, and lidocaine. Introduction of this algorithm decreased hospital mortality of acute coronary patients, increased the rate of reanimation of suddenly dead patients, and reduced the incidence of iatrogenic complications of resuscitation.

[Role of enteral feeding in nutritional support of surgical patients]. / Rol' énteral'nogo pitaniia v nutritsionnoi podderzhke bol'nykh v khirurgicheskoi praktike.

Main stages of artificial nutritional support (ANS) in the surgical clinic are considered as a scientific system of diagnostic and curative measures. Principle aspects of trophological screening of the surgical patient are elucidated. The algorithm of choice of the principle of ANS is presented: parenteral and enteral. Grounds are given to confirm the priority of the enteral method of ANS at the main stages of managing the surgical patient: before operation, during it, at the early and late postoperative periods.

[The significance of the material of vascular catheters in the development of thrombotic complications in cava catheterization]. / Znachenie materiala sosudistykh kateterov v razvitii tromboticheskikh oslozhenii pri kavokateterizatsii.

Based on 210 cases of putting polyurethane catheters through the subclavian vein the authors substantiate the significance of the catheter material for the development of the most frequent complications. In addition to the absence of clinically diagnosed thrombotic complications, the advantages of this material were confirmed in US investigation of tributaries of the vena cava superior in 27 patients with polyurethane cava catheters staying in the same position during 3 weeks. In all the patients there were no signs of a reaction of a central veins to the catheter.

[Empirical antimicrobial chemoprophylaxis and chemotherapy of infections in surgical patients]. / Empiricheskaia antimikrobnaia khimioprofilaktika i khimioterapiia infektsii u khirurgicheskogo bol'nogo.

Philosophy of antibacterial chemotherapy (ACT) in threatened and developing infection in surgical patients is formulated, based on clinical experience and analysis of published reports. Indications for ACT and choice of drugs during and after various surgical interventions are discussed. A variant of a protocol of antibiotic therapy is presented. Errors and inaccuracies in ACT are discussed.

[Principal indications and contraindications of the use of extracorporeal hemocorrection in psychiatry]. / Osnovnye pokazaniia i protivopokazaniia k ispol'zovaniiu metodov ékstrakorporal'noi gemokorrektsii v psikhiatrii.

Analysis of different aspects of application of extracorporeal hemocorrection (EH) in psychiatric practice allows to make a conclusion about the necessity of a differential approach to the use of isolated and combined procedures. The latter were assessed by the results of combined treatment of 226 patients. Indications and contra-indications for EH use in psychiatric practice are outlined.

[Prospects of the use of caudal epidural anesthesia]. / Perspektivy primeneniia kaudal'noi épidural'noi anestezii.

Caudal epidural anesthesia for interventions on the lower limbs and pelvic organs was used in 525 patients. A specific feature of the method is use of hypoosmolic local anesthetic solution (osmolality 260 mosmol/kg) containing lidocaine, 0.9% sodium chloride, and distilled water. Pathologic studies showed that in adult patients, at least 40 ml anesthetic should be injected into the caudal canal for adequate blocking. During surgery, caudal epidural anesthesia reliably protected from surgical trauma without side effects for respiration and circulation. The duration of analgesic effect was 3 +/- 0.5 h and even longer, if local anesthesia was potentiated with sedative drugs. No complications were observed, failures occurred in 5.2% cases. The method is simple and reliable and is recommended for practice.

[The strategy and current potentials of parenteral feeding in surgery]. / Strategiia i sovremennye vozmozhnosti parenteral'nogo pitaniia v khirurgii.

Based on the literature data the author analyzes the potentials, indications and principles of the parenteral alimentation of surgical patients. Possible complications and measures for their prevention are discussed.

[Multiple organ failure syndrome in critically ill patients]. / Sindrom posledovatel'nykh organnykh povrezhdenii u patsientov v kriticheskikh sostoianiiakh.

A new approach to defining the notion of multiple organ failure is proposed. It is based on division of the organ humoral injuries at the stages of dysfunction, insufficiency, and failure. Criteria of these stages are defined for the central nervous and cardiovascular systems, lungs, liver, kidneys, and gastrointestinal tract.

[The possibilities, realities and outlook for artificial enteral feeding in the surgical clinic]. / Vozmozhnosti, real'nosti i perspektivy énteral'nogo iskusstvennogo pitaniia v khirurgicheskoi klinike.

The key problems are pointed out depending in their solution on the understanding by clinicians of different aspects of enteral artificial nutrition (EAN) as a variant of nutritional maintenance in practical surgery. These problems are: maintenance of performing EAN with the creation of the optimum nutrition tract; choice of the nutrition substrate sources for EAN; medicines accompanying EAN. The tasks of its maintenance are to provide the access to digestive tract, supply and equipment for EAN. The basic, actual and subsidiary variants of the nutritional maintenance are considered from the viewpoints of choosing means for EAN. Six classes of nutritional mixtures are described as means for the basic nutritional maintenance. Main directions for medicamentous support are presented: optimization of properties of the nutritional mixture and overcoming possible functional complications of EAN.

[The multimodal therapy of surgical sepsis]. / Mnogokomponentnaia terapiia khirurgicheskogo sepsisa.

The data of clinical current of sepsis in 239 wounded with syndrome of system inflammatory reaction (SIR) are investigated. Frequency of sepsis in complications of gun-shot wounds has made 5.4%. At the same time syndrome SIR is diagnosed in 23.4% of cases, that was the indication to realization of the whole complex of antiseptic treatment. Therapy of sepsis included some components: drainage and removal of the septic center; the system antibacterial therapy; the controlled hypocoagulation; immunotherapy; active detoxication; power and trophic support on the basis of balanced feed. The used principles of early diagnostics and multicomponent therapy of surgery of sepsis have allowed to lower lethality up to 29.3% and in sepsis of wound--up to 9.1%.

[Extracorporeal blood correction in the therapy of drug-resistant mental disorders]. / Ekstrakorporal'naia gemokorrektsiia v terapii farmakorezistentnykh psikhicheskikh rasstroistv.

544 patients resistant to pharmacotherapy were treated by different methods of extracorporal hemocorrection (EH). Positive changes in mental state were achieved in more than half of the patients by means of EH without any psychopharmacologic drugs. These changes were caused by antipsychotic and antidepressive effects of EH as well as by its ability to normalize biochemical, immunological and rheological blood indices

[New potentials for assessing the efficacy of extracorporeal blood correction methods in treating patients with acute suppurative destructive diseases of the lungs and pleura]. / Novye vozmozhnosti otsenki éffektivnosti ékstrakorporal 'nykh metodov gemokorrektsii v lechenii bol'nykh s ostrymi gnoino-destruktivnymi zabolevaniiami legkikh i plevry.

Integral mathematical analysis of changes in the peripheral blood formula was used in multiple-modality treatment of 19 patients with acute infectious destructions of the lungs and pleura. Extracorporeal methods of hemocorrection were used in the treatment. The leukocytic formula entropy, number of tension signs, degree of adaptation reaction, and leukocytic index of intoxication were assessed. Changes in the analyzed parameters were found to depend on the initial severity of patient's status, type of extracorporeal perfusion, and disease outcome. The authors came to a conclusion about the informative value of mathematical integral parameters which permit outlining the approaches to prediction of the disease outcome and plan individual treatment.

[Sacral epidural anesthesia in operations for varicose veins of the lower extremities]. / Sakral'naia épidural'naia anesteziia pri operatsiiakh po povodu varikoznoi bolezni nizhnikh konechnostei.

The method of sacral epidural anesthesia was used in 162 patients in surgical interventions for varicose disease of lower extremities. This method of anesthesia was proved to be adequate, technically simple and harmless for the patients.