PREDICTORS OF FATAL OUTCOME IN PATIENTS WITH HEMORRHAGIC SHOCK IN GASTROINTESTINAL BLEEDING.

This work aimed to reveal the statistically reliable clinical and laboratory markers, which are associated with fatal outcomes in patients with hemorrhagic shock of the III degree on the stage of hospital treatment. It was stated that decrease of body temperature (till 35,9 °C), pH of venous blood (till 7,19) and content of ionized calcium (till 0,32 mmole/l) in venous blood and increase of lactate content (up to 4,1 mmole/l) in venous blood and rise of activated partial thromboplastin time (up to 59 sec) are connected with fatal outcomes.

[Case report of successful treatment of the patient with stab wound of the neck complicated with massive blood loss and shock].

The article deals with a case report of successful treatment of patient with massive blood loss and shock. The observation showed that use of balanced crystalloid solution and modified gelatin 4% in the program of infusion therapy effectively corrects systemic haemodynamics and effect on haemostasis, electrolyte and acid-base balance.

[Association of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock].

UNLABELLED: Endothelial dysfunction is a universal mechanism of pathogenesis of many critical conditions. Goal of the study was to assess a relation of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. MATERIALS AND METHODS: 17 patients with hemorrhagic shock 3 were involved in the study. All patients received infusion therapy, artificial lung ventilation after tracheal intubation and symptomatic treatment in prehospital period. Common volume of blood loose was 2900 +/- 200 mL. The patients received infusion, transfusion, inotrope, antibacterial, respiratory and symptomatic therapy in ICU after surgical treatment. Cardio-vascular system parameters were assessed by Tischenko method of integral reography. Number of red cells, hemoglobin, lactate, endotelin-1 and Wb-factor of venous blood were studied before surgery, in 12 and in 24 hours after. Morphological study of the omentumbiopsy was carried out. RESULTS: Performed correlation analysis showed statistically significant relations of cardiovascular system and endothelial dysfunction indicators in patients with hemorrhagic shock. Endothelial dysfunction occurs in patients with hemorrhagic shock 3. The endothelial dysfunction correlates with parameters of cardio-vascular system and tissue perfusion.

[Comparative study of infusion therapy options in patients with hemorrhagic shock].

This work presents the results of treatment of 60 patients with 2nd degree hemorrhagic shock at pre-hospital and hospital stages by different variations of infusion therapy. It is established that balanced infusion therapy in patients with 2nd degree hemorrhagic shock helps to stabilize the system hemodynamic and improve the general condition. The balanced infusion therapy does not lead to unfavorable changes in acid-alkaline and electrolyte balance.

[The homeostasis assessment by hemorrhagic shock].

The comparative analysis of different protocols of infusion therapy of the hemorrhagic shock stage III was performed. The infusion of the colloid solution of hydroxiethylstarch 200/0.5 and non-balanced crystalloid 0.9% solution of natrium chloride leads to the development of negative changes in homeostasis. Whereas infusion of the 4% solution of the modified gelatin and balanced crystalloid solition (sterofundin) allows to avoid the registered changes in electrolyte and alkaline balance.

[Clinical significance of the parameters of a systemic inflammatory response, leukocytic intoxication index, and procalcitonin test in the diagnosis of pyodestructive pyelonephritis of pregnant women].

The clinical significance of the parameters of a systemic inflammatory response, leukocytic intoxication index, and procalcitonin test were studied in 63 patients with pyodestructive pyelonephritis of pregnant women. The blood concentration of procalcitonin was measured in 15 patients, by using the semiquantitative analysis. The authors revealed the high sensitivity and specificity of the method and the high prognostic value of positive results and the low frequency of false-positive results for procalcitonin and the leukocytic index of intoxication.

Synaptic plasticity of the neocortex of white rats with diffuse-focal brain injuries.

Studies on white mongrel rats addressed the reorganization of the synaptoarchitectonics of layer I of the cerebral cortex in diffuse-focal injuries. The experiments used models of acute arrest of the systemic circulation (clinical death) resulting from exposure to mechanical asphyxia for 6 min, clamping of the common carotid arteries for 20 min (ischemia), and imposition of sublethal rotatory trauma by the Noble-Collip method (craniocerebral trauma). Electron microscopy and morphometric analysis showed that reductions in the total number density of synapses were accompanied by changes in the relative and absolute contents of the major types of synaptic apparatuses. There were increases in the numbers of large simple and perforated contacts and synapses with invaginated synaptic membranes, mitochondria, and spine apparatuses. These changes were interpreted as the structural basis for the mechanisms of synaptic plasticity in diffuse-focal brain injuries.

[Synaptic plasticity of neocortex of albino rats in diffuse-focal injuries of the brain].

In an experiment conducted using mature albino rats, the regularities of reorganization of synaptic architectonics of cortical layer I of the brain were studied in the areas of diffuse-focal injuries. The models of acute break of systemic circulation (clinical death) as a result of 6-minute-long mechanical asphyxia, compression of common carotid arteries for 20 min (ischemia) and rotatory sublethal injury according to Noble-Collip method (cranial trauma), were used. Using the methods of electron microscopy and morphometric analysis, it was shown that a reduction in a general numerical density of synapses was accompanied by the changes in relative and absolute numbers of major variants of synaptic organization. The content of large simple and perforated contacts was increased, as well as of synapses with invaginated synaptic membranes, containing mitochonria and spine apparatus. The changes detected are considered as a structural basis for realization of the mechanisms of synaptic plasticity in diffuse-focal injuries of the brain.