Cardioprotective effect of histidine-containing dipeptides in pharmacological cold cardioplegia.

The cardioprotective effect of cardioplegic solution based on histidine-containing dipeptides was evaluated on isolated rat heart under conditions of hyporthermia and long ischemia. The use of natural dipeptides in cardioplegic solutions promoted an increase in the buffer capacity of myocardial cells and creation of an additional anti-ischemic effect under conditions of long ischemia and hypothermia.

[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.

[Study of peripheral blood circulation during continuous and pulsatile perfusion based on the data of transcutaneous pO2 and pCO2 monitoring]. / Sostoianie perifericheskogo krovoobrashcheniia pri postoiannom i pul'siruiushchem potoke perfuzii po dannym transkutannogo monitorirovaniia pO2 i pCO2.

The study was performed on 22 patients with congenital heart valve defects after hypothermic cardiopulmonary bypass surgery. Transcutaneous and arterial pO2 and pCO2 have been measured at different stages of investigation. Nonpulsatile flow was applied to 10 patients and pulsatile flow--to 12 patients. Pulsatile pressure was maintained at about 30 mmHg. Transcutaneous index, carbon dioxide gradient and transcutaneous oxygen shunt have been calculated. Perfusion caused a decrease in transcutaneous pO2 and transcutaneous index, as well as an increase in transcutaneous O2 shunt. The use of non-pulsatile flow caused the most marked peripheral vasoconstriction. Transcutaneous index demonstrates that peripheral circulation decrease in pulsatile flow is 3 times lower than in non-pulsatile flow. Calculation of transcutaneous index and O2 shunt based on transcutaneous pO2 and pCO2 values can characterize peripheral circulation prior to, during and following perfusion.

[Tissue oxygen metabolism, hemodynamics and microcirculation in vasorenal hypertension in patients with different types of blood circulation]. / Kislorodnyi rezhim tkanei, sostoianie gemodinamiki i mikrotsirkuliatsii pri vazorenal'noi gipertenzii u bol'nykh s razlichnymi tipami krovoobrashcheniia.

The authors examined 68 patients with vasorenal hypertension (VRH). In hyperkinetic type of VRH, the tissue hypoxia is caused by the increase in the cardiac index and rate of blood flow, changes in the microcirculation; in hypokinetic type--by decrease in the cardiac index, sharp increase in the specific peripheral vascular resistance and pronounced changes in all the links of microcirculatory channel as well is observed. Timely correction of the hyperkinetic type of VRH in patients leads to normalization of hemodynamics and elimination of tissue hypoxia. After correction of the hypokinetic type of VRH in patients, neither hemodynamics, nor impairment in the oxygen regimen of the tissues normalizes, even if the positive effect of treatment is noted.

[Non-invasive diagnosis of the degree of aortic coarctation]. / Neinvazivnaia diagnostika stepeni koarktatsii aorty.

Examined were 42 patients with aortal coarctation at the age of from 6 to 35 years. The differences in hemodynamics, microcirculation and oxygen regimen of tissues depending on the degree of aortal coarctation were revealed. To diagnose the degree of aortostenosis, it is suggested to use the transcutaneous monitoring of PO2 distally to the site of coarctation.

[Acid-base state and the electrolyte balance of young infants in the immediate postoperative period after radical correction of an interventricular septal defect under artificial circulation]. / Kislotno-shchelochnoe sostoianie i élektrolitnyi balans u detei rannego vozrasta posle radikal'noi korrektsii defekta mezhzheludochkovoi peregorodki v usloviiakh iskusstvennogo krovoobrashcheniia v blizhaishem posleoperatsionnom periode.

Acid-base equilibrium and electrolyte balance were studied in 80 infants in the immediate postoperative period after surgery for ventricular septal defect under conditions of extracorporeal circulation. Decompensated metabolic alkalosis was the most characteristic disorder of acid-base equillibrium in patients with an uncomplicated postoperative period, whereas decompensated respiratory alkalosis and metabolic acidosis were characteristic of patients with compensated and decompensated forms of cardiac insufficiency. Plasma hypokaliemia and hypochloremia attended by intracellular retention of sodium were typical disorders of the electrolyte balance in all forms of changes in the acid-base equilibrium.