[Early fibrobronchoscopy and the microbial flora composition of bronchoalveolar lavage fluid in patients with concomitant injury during treatment in intensive care units].

Resuscitative bronchofibroscopy in victims with severe injury and aspiration has been shown to be both a method for diagnosing damages to the bronchus and lung and that for recovering airway patency in them. The most common involvement (47% of cases) in chest injury has been noted to be the lower lung with the development of pyoinflammatory processes caused by etiologically significant microorganisms, such as Staphylococcus aureus and types of Enterobacteriacea, in most cases (more than 50%).

[Effects of surgical complications on trace element metabolism in patients with cardio-esophageal and esophageal cancer]. / Vliianie khirurgicheskikh ozlozhnenii na obmen mikroélementov u bol'nykh kardioézofageal'nym rakom i rakom pishchevoda.

The homeostatic features of trace elements were studied in 48 patients with cardio-esophageal and esophageal carcinoma in development of incompetence of the anastomosis sutures (17), peritonitis (19), and intestinal fistulas (12). The level of the trace elements was determined in the red cells, blood plasma, and urine by emission plasma spectrometry. With the development of surgical complications after operation on the stomach and esophagus, the metabolism of trace elements was sharply disturbed, catabolic processes prevailed and were manifested by the escape of essential trace elements from the cells and their excretion in the urine. The changes of trace elements metabolism were more profound in peritonitis and intestinal fistulas. Complex intensive therapy including artificial feeding corrected partly the metabolic disorders.

[Changes in the concentration of microelements in different body media during general anesthesia and surgery in patients with cancer of the stomach and esophagus]. / Izmeneniia kontsentratsii mikroélementov v raznykh sredakh organizma vo vremia obshchei anestezii i operatsii u bol'nykh rakom zheludka i pishchevoda.

Trace element (TE) content (zinc, copper, selenium, chromium) in different body media during surgery and anesthesia has been studied in 56 patients with esophageal and gastric cancer. It has been established that the components of modern analgesia have different effects on intra- and extracellular zinc, copper, selenium and chromium migration. Hexenal decreases TE blood plasma level and simultaneously increases their erythrocyte concentration. The administration of the first doses of depolarizing myorelaxants causes an increase in blood plasma and a decrease in erythrocyte zinc, copper, selenium and chromium content. Subsequent doses of depolarizing myorelaxants have no such effect. The most traumatic moment of the operation is accompanied by an increase in blood plasma and a decrease in erythrocyte TE content. Upon the operation and anesthesia the TE levels under study reach baseline values. In the first 24 hours after surgical intervention there is a decrease in TE erythrocyte concentration and an increase in their blood plasma and daily urine content.

[Disorders of trace element metabolism and their correction using artificial nutrition in patients with cancer of the esophagus in the preoperative period]. / Narusheniia obmena mikroélementov i ikh korrektsiia s pomoshch'iu iskusstvennogo pitaniia u bol'nykh rakom pishchevoda v predoperatsionnom periode.

Findings of research into disorders of the micronutrient exchange in esophageal carcinoma patients are overviewed. The micronutrient level in the plasma, erythrocytes, and urea was estimated by means of emission plasma spectroscopy. Patients with esophageal carcinoma were found to have pronounced changes in the micronutrient exchange on their admission into the clinic. These changes were corrected by means of artificial nutrition, which included preparations with directed action and micronutrients. After the course of therapy a tendency towards normalization of the micronutrient exchange was observed.

[Evaluation of metabolic disorders in surgical patients]. / Otsenka metabolicheskikh narushenii u khirurgicheskikh bol'nykh.

The paper treats the problems of metabolism derangement in surgical patients. Special emphasis is laid on the correction of metabolic abnormalities in the pre- and postoperative periods and on the use of parenteral feeding in surgical complications: incompetence of anastomosis sutures, peritonitis, intestinal fistulas, and so forth. The authors define the role of the drugs of directed action in such a severe pathology as hepatorenal insufficiency.