Disorders in the Morphology and Nanostructure of Erythrocyte Membranes after Long-term Storage of Erythrocyte Suspension: Atomic Force Microscopy Study.

Disorders in the erythrocyte morphology and structure of their membranes during long-term storage of erythrocyte suspension (30 days at 4°C) were studied by atomic force microscopy. The morphology and nanostructure of erythrocyte membranes, biochemical parameters, ion exchange parameters, and hemoglobin spectra were recorded. The transformation of erythrocyte morphology and destruction of their membranes were observed throughout the storage period. Irreversible forms of spheroechinocytes and their fragments formed by the end of storage. The concentrations of potassium ions and lactate in solution of the blood preservatiive increased, while pH value decreased. Hemolysis detected by the erythrocyte "leakage" effect was observed starting from days 16-23 of storage.

[INFLUENCE OF EXTRACORPOREAL DETOXIFICATION METHODS ON TISSUE PERFUSION IN SEPTIC SHOCK].

OBJECTIVE: To improve the results of abdominal sepsis treatment by comprehensive application of extracorporeal detoxification methods controlled by tissue perfusion. SUBJECT AND METHODS: Fifteen patients with abdominal sepsis were examined, septic shock was diagnosed to all of them. Patients were divided into two groups. The first group (n = 7) consists of patients with acute renal failure, who had undergone adsorption of Lipopolysaccharide. The second group (n = 8) consists of patients with acute renalfailure, who had undergone prolonged hemofiltration regardless of the products of nitrogen metabolism level to terminate systemic inflammatory response. Dynamic monitoring of tissue perfusion was performed using Doppler ultrasound flowmeter methods. RESULTS: According to high frequency Doppler ultrasound results all the patients with abdominal sepsis have significant peripheral circulatory disorders maintaining in volumetric and linear blood flow velocity reduction. As a result of application extracorporeal detoxification methods indexes of tissue perfusion were improved. Performance of selective endotoxine hemosorbtion and hemofiltration provides substantially stabilizing effect on Doppler microcirculation indexes: average volumetric blood flow velocity (Qam) increased 4.5 times, end-diastolic linear blood flow velocity (Vakd)--increased to 85%, peripheral resistance index (RI) reduced 2.8 times. Doppler tissue perfusion indexes monitoring allows directly monitor extracorporeal detoxification methods effectiveness, supplementing system hemodynamic monitoring data. CONCLUSION: Timely application extracorporeal detoxification methods in abdominal sepsis can improve tissue perfusion.

[Topical problems of treatment of acute renal failure in crush syndrome].

The paper analyzes some experience in treating 203 victims with crush syndrome (CS). The victims' status is determined by the force and time of compression, the degree and magnitude of destructive muscular changes, accompanying by lesions and occurring complications. Varying renal dysfunction was revealed in 97 (47.8%) patients, 55 (27%) patients developed mild and severe acute renal failure (ARF) and 38 (18.7%) patients had mild AFR. Renal dysfunction was not detected in 106 (52.2%) patients. The development of severe AFR in CS is a marker of the severity of injury, the body's response to injury and shock; it dictates the tactics of intensive therapy using extracorporeal techniques of detoxification and active or delayed surgical removal of necrotic muscles, which permits prevention of prolonged severe endotoxication and pyoseptic and vital complications. Two-three-week persistent unremoved foci of muscle necrosis and endotoxicosis exhaust the body's adaptive mechanisms, cause severe dysfunction of other organs and systems, promote delayed renal function recovery and ARF resolution.