[The dynamics of the physiological indices of servicemen during intermittent alpine adaptation]. / Dinamika fiziologicheskikh pokazatelei u voennosluzhashchikh v protsesse preryvistoi gornoi adaptatsii.

Comparative assessment of changes in the main physiologic indices during intermittent (fluctuation) mountain adaptation was conducted in servicemen with various values of physical development and different stability to hypoxic hypoxia. Concrete scientific-and-methodical recommendations on prophylaxis and treatment of dysadaptations which occur during intermittent (fluctuation) mountain adaptation were formulated.

[The role of middle-molecule peptides in the pathogenesis of traumatic disease]. / Rol' srednemolekuliarnykh peptidov v patogeneze travmaticheskoi bolezni.

On the basis of study of mass-spectrum of blood plasma ultrafiltrate in 21 injures with severe associated trauma during first four posttraumatic days and in healthy persons one can suggest that combinations with molecular weights of 300-1050 Da are to be one of the important regulatory mechanisms of posttraumatic adaptative processes. With increasing of the injury gravity reorientation of the levels of adaptative reactions management and level enhancing of mediomolecular regulators are found to be occurred.

[A resuscitation aid in the first aid and medical care for the victims of severe trauma received in emergency situations]. / Reanimatologicheskoe posobie pri dovrachebnoi i vrachebnoi pomoshchi postradavshim s tiazhelymi travmami, poluchennymi v chrezvychainykh situatsiiakh.

On the basis of their own experience in combat casualty staging, emergency situations and various publications the authors theoretically substantiate the necessity to reinforce the structures of pre-medical and medical care with reanimation teams which must be equipped with adequate assets capable to meet with emergency situations. The article contains information about training, equipment and organic structure of these teams. Taking into account the pathophysiological mechanism of severe injuries the authors give characteristics of the volume of medical care provided by these teams at various periods of casualty staging. The article stresses the necessity to combine the conduction anesthesia with central analgesia. The authors substantiate the necessity of the quest for a new analgetic as a drug of choice at the pre-hospital period, and describe its desired characteristic features: effective analgesia without breathing depression or circulatory iatrogenic disorders; long-term analgetic effect which gives the possibility to perform evacuation to the secondary care medical unit; possibilities for national fabrication of this drug in large quantities, impossibility of addiction to this drug.

[Anesthesia in severe combined gunshot and mine blast injuries]. / Anesteziia pri tiazhelykh sochetannykh ognestrel'nykh i minno-vzryvnykh raneniiakh.

An experience with 350 anesthesias in severely wounded patients is analyzed. Two main tasks had to be solved for successful treatment. The first one is the creation of compensation by the infusion-transfusion therapy. The second one is the defense of compensatory processes from the inhibition by pathological afferentation. The second task was being solved by combination of conductive anesthesia and rationalization of analgesia with phentanyl. This approach resulted in 13% less lethality of the patients.

[The diagnosis and treatment of respiratory and circulatory disorders in the acute period of gunshot chest wounds]. / Diagnostika i lechenie rasstroistv dykhaniia i krovoobrashcheniia v ostrom periode ognestrel'nykh ranenii grudi.

Principle and method for gravity estimation of wounds, as well as the efficiency index of treatment of breathing and circulatory disorders in patients with chest gunshot injuries were elaborated on the basis of integral body rheography with mathematical modelling. The application of this method gives the possibility to make an opportune estimation and prognostication of the gravity of clinic outcome of chest gunshot injuries, choose the most rational scheme of treatment of breathing and circulatory disorders. The application of integral body rheography increases the quality of secondary surgical care at the phases of medical evacuation.

[Postoperative intensive therapy in penetrating gunshot wounds of the abdomen]. / Posleoperatsionnaia intensivnaia terapiia pri ognestrel'nykh pronikaiushchikh raneniiakh zhivota.

The authors show that application of anticipated postoperative intensive care gives the possibility ot obtain more complete effect of compensation. The basic components of this therapy are the following: removal of hypovolemia and anemia, combined (central and regional) anesthesia, prevention of pneumonia, normalization of salt and water exchange, removal of excessive catabolism, adequate ensuring of organism with energy and plastic material for long-time compensation, prophylaxis and treatment of paresis of digestive tract, chemoprophylaxis of wound infection. The proposed program of intensive therapy gives the possibility to minimize the lethality among wounded with penetrating abdominal gunshot injuries and can be used as a basic one for the development of various schemes of intensive therapy for other categories of wounds.

[Preservation by anesthesia management of the normal functioning of the external respiration system following surgery of the upper abdominal organs]. / Sokhranenie anestesiologicheskim posobiem normal'nogo funktsionirovaniia sistemy vneshnego dykhaniia posle operatsii na organakh verkhnego étazha briushnoi polosti.

The impact of different variants of neuroleptanalgesia (NLA) on respiration immediately after gastric resection and cholecystectomy has been studied in two homogeneous groups of patients (30 persons each) after operations on the upper abdominal organs. In patients of group I NLA was performed using fentanyl (initial dose--7.5 micrograms/kg, maintenance dose--100 micrograms) supplemented with epidural blockade and isovolemic hemodilution. In patients of group II NLA was performed with graded administration of 100-200 micrograms fentanyl. In patients of group I right after surgery gas exchange during room air inhalation was unimpaired, while in patients of group II hypoxemia due to inadequate ventilation and metabolic acidosis were registered. It is concluded that the type of anesthesia management suggested has a protective effect on respiration in the earliest postoperative period.

[Postaggressive metabolism in severe mechanical trauma]. / Postagressionnyi obmen veshchestv pri tiazheloi mekhanicheskoi travme.

Posttraumatic adaptive reactions are divided by the authors into three periods: the period of "urgent" adaptation (1-2 days), intermediate period (3-7 days) and the period of "long-term" adaptation (after 7 days). The period of "urgent" adaptation may be considered to be more favorable for surgical interventions under conditions of adequate anesthesiological maintenance. A critical associated trauma unlike an isolated one was found to cause more pronounced and continuous strain of the endocrine and metabolic reactions related with the "urgent" adaptation which influences the frequency of complications and lethal outcomes.