[The functional state of components of the hemostatic system in patients with acute intraoperative blood loss].

Thrombotic and hemorrhagic events are one of the most common and menacing complications in the postoperative period. This may be attributable to the fact that therapy is by no means always performed by keeping in mind the pattern of dysfunction of the components of the hemostatic system. The purpose of the study was to define the pattern of hemostatic disorders occurring in the intra- and postoperative periods in the presence of significant hemorrhage, the feasibilities of their monitoring and correction. Thirty-seven patients with traumatic surgical interventions for cancer were examined in 4 steps: before surgery, after final intraoperative bleeding arrest, and on days 1 and 3 postoperatively. Intraoperatively, analysis of changes in the functional state of components of the hemostatic system identified 2 types of hemocoagulative responses to surgical trauma and blood loss. These included hypo- and hypercoagulative types. This let the authors make timely and goal-oriented correction of revealed hemocoagulative disorders and achieve positive results on postoperative day 3.

[Choosing of scale for determining the condition severity in patients with acute blood loss]. / Vybor shkaly dlia otsenki tiazhesti sostoianiia patsientov s ostroi krovopoterei.

Inefficiency of therapy for massive blood losses and hemorrhagic shock can be partially explained by inability to identify, as early as possible, the risk groups. The purpose of our case study was to investigate the significance of diagnostic systems in evaluating the condition severity of patients. One hundred and nine male patients (mean age 41.6 +/- 8.1) were examined within the randomized prospective study. Examinations were made at admission and in 24 and 72 hours after injury according to the protocols of condition severity evaluation--APACHE-II, III (Acute physiology and chronic health condition) and SAPS (Simplified Acute Physiology Score). The scales used in the study are described by a high reliability degree in differentiating the severity conditions of patients (p < 0.0001). The direct linear relation was observed in all cases between the severity condition of patients and the lethality rate (correlation factor r(X,Y) > 0.89). The highest specificity was noted for the APACHE-III diagnostic system.