[Morphological signs of acute lung lesion in patients with caseous pneumonia].

The authors conducted light optical and electron microscopic studies of caseum-free resected lung parenchymal portions from 11 patients with caseous pneumonia. All cases were found to have severe vascular bed permeability impairments, developed extensive intraalveolar edema, destruction of both type 1 respiratory alveolocytes and surfactant-producing type 2 alveolocytes. Release of plasma proteins into the intraalveolar space and their interaction with extracellular phospholipoproteins gave rise to hyaline masses.

[Critical state medicine. Surfactant therapy of adult respiratory distress syndrome (results of multicenter studies)]. / Meditsina kriticheskikh sostoianii. Surfaktant-terapiia respiratornogo distress-sindroma vzroslykh (rezul'taty mnogotsentrovykh ispytanii).

The paper provides evidence for the pathogenetic approach to treating acute lung lesion (ALL) and adult respiratory distress syndrome (ARDS). An algorithm of the use of Russian lung surfactant preparations: CT-HL and CT-BL has been developed. In involves earlier (the first days following the onset of respiratory failure) use of surfactant, its combined bolus intratracheal or intrabronchial administration in doses of 200-400 mg/m2, followed by continuous (5-day) aerosol inhalation in doses of 20-30 mg/h for children and 30-75 mg/h for adults until pronounced clinical and X-ray effects are shown. Fifty three patients were found to develop ALL and ARDS in the presence of severe pneumonia, postperfusion lung disorders, reperfusion syndrome, pulmonary embolism, long-term artificial ventilation, combined car accident injury and gunshot wounds of the chest, heroine intoxication, septic shock, sepsis, postoperative sequels in cancer patients, and after hepatic transplantation or massive aspiration of gastric contents. Fifty patients were overcome their critical status, 44 survived. The duration of artificial ventilation (AV) ranged from 1 to 6 days. Earlier use of the drugs made it possible to transfer patients to safe AV regimens and to eliminate ALL and ARDS rapidly and to significantly reduce mortality due to critical states.

[Use of perfluorane in the transfusion therapy of tuberculosis and other bronchopulmonary diseases]. / Primenenie preparata "Perftoran" v transfuzionnoi terapii tuberkuleza i drugoi bronkholegochnoi patologii.

The paper presents the first experience with the Russian blood substitute Perfluorane at pulmonectomy and pleuropulmonectomy in patients with pulmonary tuberculosis. In the patients operated on, the use of PF during simultaneous administration of red blood cells ensures stable hemodynamics, better blood rheological properties and red blood cell metabolic characteristics. Hemostatic events developed in none of 5 cases. PF used in a patient with severe chronic respiratory failures provided a beneficial clinical effect, improved the rheological properties and bioenergy of red blood cells; however, the latter showed an increase in lipid peroxidation.

[Myocardial contraction and intensive therapy in phthisiosurgical patients]. / Sokratitel'naia sposobnost' miokarda i intensivnaia terapiia u ftiziokhirurgicheskikh bol'nykh.

The changes in myocardial contractility were studied in 88 patients operated on for pulmonary tuberculosis in pre- and postoperative periods using echocardiography. It was found that among patients operated on for acute and common forms of pulmonary tuberculosis tahere was a considerable proportion of those with hypo- and hyperkinetic types of central hemodynamics which were characterized by unstable hemodynamic parameters and needed corrective therapy both in pre- and postoperative periods. Strategy of preoperative preparation and postoperative management of patients was elaborated by the status of the central hemodynamics.