[Use of orthostasis during artificial pulmonary ventilation in patients with acute parenchymal pulmonary lesion]. / Primenenie ortostaza v usloviiakh IVL u bol'nykh s ostrym parenkhimatoznym porazheniem legkikh.

The paper contains the results of a study involving an inclined body positioning (45 degrees orthostasis) under the conditions of artificial pulmonary ventilation applied to patients with acute parenchymatous pulmonary lesion of different etiologies. The impact of the method produced on pulmonary gas exchange, hemodynamics, transport and consumption of oxygen as well as its efficiency and disadvantages, indications and contraindications are in the focus of attention.

[Dynamics of prekallikrein and kallikrein inhibitors in development of acute pulmonary lesion (experimental study)]. / Dinamika prekallikreina i ingibitorov kallikreina pri razvitii ostrogo povrezhdeniia legkikh.

The reaction of the kallikrein-kinin blood system was studied in an experimental acute pulmonary lesion caused by a prolonged intravenous infusion of thrombin solution. It was established that the progressing of the acute pulmonary lesion brings about an increasing activation of the kallikrein-kinin blood system with a limited check by the lungs. It is displayed by lower levels of prekallikrein and its inhibitors observed first in the venous and later in the arterial blood. Bradykinin was shown to exhaust and impair the metabolic pulmonary activity. The conclusion is that the indices of the kallikrein-kinin blood system reflect the integrity of the pulmonary metabolic activity and can be biochemical markers of an acute pulmonary lesion.

[Sodium hypochlorite in the detoxification therapy of postresuscitation states]. / Gipokhlorit natriia v detoksikatsionnoi terapii postreanimatsionnykh sostoianii.

The experiments on dogs recovered after a 10-min clinical death of acute blood loss have shown possible effective use of 300-500 mg/l sodium hypochlorite solution at a dose of 7-10 ml/kg for detoxication in the early postresuscitation period. A significant reduction in the level of toxemia within 3 hours of postresuscitation period, as compared to the control, promotes an increase in the percent of the animals survived and a more complete recovery of the neurological status. It has been shown in vitro than detoxication of lymph in septic patients was more effective using electrochemical oxidation, as compared to sorption on a carbon CKH sorbent, with lymph protein loss being significantly less. The technique of electrochemical liquid oxidation can be recommended as an alternative detoxicating technique in critical conditions.

[The use of hypertonic sodium chloride solutions in resuscitation, intensive therapy and disaster medicine]. / Primenenie gipertonicheskikh rastvorov natriia khlorida v reanimatologii, intensivnoi terapii i meditsine katastrof.

The review of Russian and foreign literature published in 1939 to 1993 has demonstrated possible use of small doses of isotonic salt solution for prompt correction of hemodynamic parameters in severe traumas, massive blood loss, most severe stages of shock and critical conditions. The best effect can be achieved with the use of isotonic salt solutions in combination with hyperoncotic solutions (sodium chloride and low molecular weight dextran). The principal mechanism of action is attraction of the liquid from the interstitial spaces into the vascular bed, stimulation of vascular osmoreceptors and neurogenic reflex mechanisms. High efficacy, simplicity and acceptability of the technique make it possible to recommend it for the use at prehospital stage, immediately on the spot of the accident, during transportation and at hospital stage when there are numerous patients with severe traumas and shortage of infusion-transfusion media.

[Role of initial hemodynamic status and rate of blood loss replacement in postresuscitation changes in blood circulation and animal mortality]. / Rol' iskhodnogo gemodinamicheskogo statusa i tempov vozmeshcheniia krovopoteri v postreanimatsionnykh izmeneniiakh krovoobrashcheniia i gibeli zhivotnykh.

In 43 experiments performed on narcotized dogs after 10 min clinical death induced by exsanguination, the peculiarities of postresuscitation changes in the blood circulation associated with the initial hemodynamic status, the rate of the blood loss replacements after restoration of cardiac activity, and the use of infusion therapy by albosorb (specifically processed albumin) were studied. The effect of the initial level of stroke index (SI) on the pronouncement of postresuscitation derangements in the central hemodynamics (CHD) and on the resuscitation outcome was determined. With the initial value of SI being mean, the maintenance of a moderate blood deficit (10 to 15 ml/kg) within the first hour of restoration was accompanied by an improvement in the survival rate of the animals as compared with a rapid and complete replacement of the blood. The infusion of albumin and creation of a moderate overtransfusion by the first hour post resuscitation removed the prognostic value of the initial SI.

[Post-resuscitation toxemia and possibilities of its correction by albosorb]. / Postreanimatsionnaia toksemiia i vozmozhnosti ee korrektsii al'bosorbom.

Albumin with enhanced sorption capacity (albosorb) was infused in animals after 10 min long clinical death caused by blood loss to correct endogenic intoxication. The albosorb infusion enhanced the blood plasma astringency both with respect to hydrophobic and hydrophilic molecules.

[The use of highly adsorbent albumin in severe endogenous intoxication]. / Primenenie al'bumina povyshennoi sorbtsionnoi emkosti pri tiazheloi éndogennoi intoksikatsii.

The efficacy of albumin pretreated on carbohydrate adsorbents as a means of sorption detoxication was assessed in experimental postresuscitation toxemia and burn-induced trauma complicated by endogenous intoxication. It has been established that the use of highly effective "Albosorb" prevented the onset of intoxication in the early period of experimental pathologies by increasing binding protein capacity, and namely that of animal plasma albumin, to various types of ligands.

[Toxic activity of the blood plasma in the early postresuscitation period]. / Toksicheskaia aktivnost' plazmy krovi v rannem postreanimatsionnom periode.

The time course of blood plasma toxicity was studied in dogs in the early postresuscitation period 10 minutes after clinical death because of acute hemorrhage. The duration of dying, the rate of the recovery of the main vitally important body functions were discovered to affect the rate of accumulation in the blood of substances with different molecular weights. There were 3 phases in blood plasma toxicity accumulation. The first phase is marked by the overflow of blood vessels with low-molecular substances, the second one by relative lessening of the content of low-molecular metabolites and an increase in the content of medium-molecular substances. The second phase is in agreement with the maximal rise of blood plasma toxicity. The third phase that develops by the 60th minute of the postresuscitation period is characterized by reduction of the peak activity of all substances under study and by overt toxicity with relative normalization of the main body functions.

[Membrane damage in brain subcellular structures in terminal states and in the postresuscitation period]. / Povrezhdenie membran subkletochnykh struktur golovnogo mozga pri terminal'nykh sostoianiiakh i v postreanimatsionnom periode.

Animal experiments were made to study and compare enzymatic activity of brain tissue mitochondria and microsomes treated and untreated with Tween-80 and Triton-X-100. In Mongolian gerbils, the 10-minute brain ischemia induced by bilateral carotid occlusion led to the labilization of the membranes of microsomal fractions, which did not return to normal an hour after resuscitation. The destructive effect of ischemia combined with clinical death from mechanical aspnyxia was similar to that of Triton-X-100. The ten-minute clinical death from ventricular fibrillation due to electroshock in dogs labilized lysosomal membranes. During the first hour after resuscitation and especially during the first 24 hours, the treatment of crude mitochondria with Tween-80 did not activate alkaline phosphatase and plasminogenic activator as compared with the control group.