[Intralymphatic administration of antibiotics in the complex treatment of suppurative complications in patients with neurosurgical pathology]. / Endolimfaticheskoe vvedenie antibiotikov v kompleksnom lechenii gnoinykn oslozhnenii u bol'nykh s neirokhirurgicheskoi patologiei.

The efficacy of endolymphatic route of gentamicin and ceporin administration was studied in 89 patients with neurosurgical pathological processes complicated by acute pneumonia (80 patients) and meningoencephalitis (9 patients) usually after ineffective antibiotic therapy according to the routine methods. The antibiotics were used in accordance with the antibiograms of the causative agents isolated from the bronchial tree or CSF. The endolymphatic use of gentamicin or ceporin once a day in doses of 80 mg or 1 g respectively provided rapid sanation and arresting of the inflammatory foci, lowering of the intoxication level, more rapid promotion of the positive time course of the clinico-roentgenological and laboratory indices and decreasing of the recovery periods by 1.5-2 times in 86 per cent of the patients with pneumonia. The endolymphatic administration of gentamicin in a dose of 80 mg twice a day or ceporin in a dose of 1 g twice a day allowed one to maintain the antibiotic therapeutic levels in the cerebrospinal fluid and to obtain satisfactory clinical results in the combined treatment of meningoencephalitis. The endolymphatic administration of the drugs was well tolerated by the patients and no adverse reactions were observed. This route of administration of antibiotics and in particular broad spectrum antibiotics may be recommended for urgent antibacterial therapy of especially severe neurosurgical patients with pyo-inflammatory complications and patients who did not respond to the routine antibiotic therapy.

[Types of hemodynamic response in patients with severe injuries of the skull and brain during the postoperative period]. / Tipy gemodinamicheskikh reaktsii u bol'nykh s tiazheloi travmoi cherepa i golovnogo mozga v posleoperatsionnom periode.

The main values of central hemodynamics were studied in 20 patients in the acute period of injury with severe contusion of the brain and compression of intracranial hematoma. Three main types of circulatory reactions to the injury were revealed according to the values of the minute circulation volume. The hyperdynamic type of reaction was characterized by a rise of the main values of central hemodynamics; in the hypodynamic type of the circulatory reaction the cardiac output and the volume of circulating red cells were considerably reduced while the peripheral resistance was increased. The normodynamic type was characterized by essentially unchanged main values of central hemodynamics except for a reduced cardiac output and was interpreted as an inadequate reaction of circulation to the injury.