[Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia]. / Osobennosti razvitiia dykhatel'noi nedostatochnosti v rannem posleoperatsionnom periode posle operatsii po povodu raka pishchevoda i kardii.

Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods.

[An evaluation of the effect of certain factors on the hemodynamics during anesthesia induction in stomach cancer patients]. / Otsenka vliianiia nekotorykh faktorov na gemodinamiku v period induktsii v anesteziiu u bol'nykh rakom zheludka.

Hemodynamic response to induction to anesthesia and tracheal intubation was assessed in 132 patients with gastric cancer divided into groups depending on the method of induction. Group I was administered thiopental sodium at a dose of 4-5 mg/kg, group II--thiopental sodium at the same dose and fentanyl (1.5 micrograms/kg), group III--thiopental sodium at the same dose with local laryngeal anesthesia using a 10% lidocaine solution, group IV--propanidid (4-5 micrograms/kg), and fentanyl (1.5 micrograms/kg), group V--thiopental sodium at the same dose and fentanyl (3-5 micrograms/kg), group VI--diazepam (15-20 mg) and fentanyl (3-5 micrograms/kg). Tracheal intubation followed dithylin injection without premedication. It has been established that adequate analgesia achieved by fentanyl (3-5 micrograms/kg) administration is the main factor that has a stabilizing effect on circulation during induction to anesthesia involving tracheal intubation. Lower drug doses and local laryngeal anesthesia proved effective in less than one third of patients. Circulatory response to pressor-depressor induction factors depends significantly on the baseline cardiac output and BP values and to a lesser extent on circulating blood volume (CBV) deficiency. Preoperative volume expansion with 12-15 ml/kg infusions stabilizes circulation parameters even in the absence of CBV deficiency, which confirms the functional nature of hypovolemia in patients with gastric cancer.