[Echosemiotics of splenectomy zone in patients with traumatic injury of the spleen].

Currently, the complex of early diagnosis of splenic injury is widely used by ultrasonography (USG). Of particular importance it has in the diagnosis of complications after the splenectomy. Its application permit to conduct of early diagnosis intraabdominal bleeding, inflammatory infiltrates and abdominal abscesses, various inflammatory changes in the pleural cavity. In order to explore echosemiotics area splenectomized about traumatic injury of spleen analyzed the results of surgical treatment of 68 injuried persons.

[Ultraviolet autoblood irradiation in multimodal treatment of patients with diffuse peritonitis]. / Ultrafioletovoe obluchenie autokrovi v kompleksnom lechenii bol'nykh rasprostranennym peritonitom.

The influence of ultraviolet autoblood irradiation (UV-ABI) on the treatment of patients with disseminated peritonitis has been studied. 109 UVABI procedures in 35 patients have been done. The general blood toxicity, plasma toxicity, sugar, creatinine and urea blood concentrations have decreased after the UVABI. Positive changes of immune system were detected: an increase of the T-lymphocytes number (60%), B-lymphocytes number (10%), and M.G.A immunoglobulins. The number of the circulating immunocomplexes has decreased by 36.5%. The UVABI is recommended for clinical use as an effective method of detoxication and immunocorrection.

[Stimulation of the lymphatic drainage in intensive care of acute myocardial infarct]. / Stimuliatsiia limfaticheskogo drenazha pri intensivnoi terapii ostrogo infarkta miokarda.

Under study was reogluman efficacy in the acute period of myocardial infarction. Timely administration of the drug to myocardial infarction patients was conductive to reduction of the duration and intensity of the painful syndrome, was associated with a reduction and even disappearance of congestion in the lungs within the first 2 days. These changes were paralleled by a more rapid normalization of the activities of all the blood serum lysosomal enzymes in the patients treated with reogluman as against the reference patients.

[The concentrations of somatotropic hormone and insulin in the blood of heart surgery patients with a complicated course of the postoperative period]. / Kontsentratsii somatotropnogo gormona i insulina v krovi kardiokhirurgicheskikh bol'nykh pri oslozhnennom techenii posleoperatsionnogo perioda.

It has been shown that the course of the early postoperative period in cardiosurgical patients and its outcome is to a great extent related to adequate balance of adaptation hormones, whose levels and changes are determined by the functional state of compensatory-adaptive systems. Patients with favourable outcome of the complicated postoperative period along with synchronous activation of sympathoadrenal system (SAS), hypophyseoadrenal system (HAS) and an elevated somatotropic hormone (STH) level demonstrated adequately high blood insulin content, with the equilibrium in adrenalin/insulin and cortisol/insulin ratios retained, and moderate STH predominance over insulin. In 1/4 of patients with complicated postoperative period and unfavourable outcome an attenuated SAS response was accompanied by excessively high STH, ACTH, cortisol blood content and a lower insulin level, which determined relative insulin insufficiency.

[The effect of anesthesia on the neurohumoral regulation system and water-electrolyte balance during aortocoronary bypass]. / Vliianie anestezii na sistemu neirogumoral'noi reguliatsii i vodno-élektrolitnyi obmen vo vremia aortokoronarnogo shuntirovaniia.

Two methods of multicomponent general anesthesia distinct in the analgetic agent used to ensure analgesia have been compared. In group I (6 patients) analgesia was ensured by fentanyl at a dose of 10 micrograms/(kg/min), in group II (7 patients) it was ensured by pyritramide (dipidolor) at a dose of 2 mg/kg for the whole operative period. The study has shown that during aortocoronary bypass surgery in patients with ischemic heart disease analgesia is better ensured by pyritramide than by fentanyl administration. The latter technique of analgesia should be improved, as the current modification causes almost twice as great stress-reaction as the one employing pyritramide.

[Arterial hypertension of unclear etiology as a complication of anesthesia during heart surgery under conditions of artificial circulation]. / Arterial'naia gipertenziia neiasnoi étiologii kak oslozhnenie anestezii pri operatsiiakh na serdtse v usloviiakh iskusstvennogo krovoobrashcheniia.

The paper deals with causes of arterial hypertension in the early postperfusion and postoperative periods in treating congenital heart disease (CHD) under artificial circulation (AC). The hemodynamics and parameters of the renin-angiotensin-aldosterone system (RAAS) were examined clinically and biochemically in 100 patients. The findings showed that under hypothermic perfusion with nonpulsing blood flow, plasma renin activator and angiotensin converting enzyme became activated to affect the dynamics of mean arterial blood pressure. A method for RAAS blockage under AC has been developed, which includes administration of sodium thiopental and baralgin during AC. The method provides for reliable prevention of RAAS components activation and guarantees the normalization of the mean arterial pressure in the postperfusion and early postoperative periods.

[The course of the early postoperative period in heart surgery patients in relation to the state of humoral regulatory mechanisms]. / Techenie rannego posleoperatsionnogo perioda u kardiokhirurgicheskikh bol'nykh v zavisimosti ot sostoianiia gumoral'nykh mekhanizmov reguliatsii.

It has been shown that the course and outcome of the early postoperative period in cardiosurgical patients are to a great extent related to the functioning of the adaptation systems under study and their interrelations. An essential role of sympathoadrenal system (SAS) in the control over hormonal body status has been established. It ensures, provided its activity is retained, interaction of other hormonal systems as a uniform functional mechanism in postoperative stress. Decreased activity and intrasystemic coordination of SAS combined with low activity of renin-angiotensin-aldosterone system and excessively activated hypophyseal-adrenal system in patients with postoperative complications are indicative of adaptation mechanism damage and are of negative prognostic value.

[Is it practical to assess the functional state of the heart based on the shape of the Starling curves in intensive care units?]. / Real'na li otsenka funktsional'nogo sostoianiia serdtsa na osnove formkrivykh Starlinga v usloviiakh palat intensivnoi terapii?

21 patients have been monitored after open heart surgery. Clinical and model analysis of the genesis of statistical interrelations between the cardiac index (CI) and left ventricular (Plv) and right ventricular (Prv) filling pressure has been performed. It has been shown that CI dependence on Prv or Plv is characteristic of the cardiac performance only in case CI variation is mainly associated with changes in the preload. CI variations are caused mostly by changes in the corresponding half of the heart, while CI dependence on Prv (Plv) does not characterize the heart function and is not Frank-Starling's curve, with the value and angle of the regression slope failing to reflect the degree of the heart pump function damage. It is concluded that in most cases it is practically impossible to assess the cardiac function by the shape of Frank-Starling's curves in intensive care wards.