[Tissue hypoxia in acute myocardial infarction and possible approaches to its correction]. / Tkanevaia gipoksiia pri ostrom infarkte miokarda i vozmozhnye puti ee korrektsii.

Gas exchange values were studied in 94 patients with complicated myocardial infarction. The degree of hypoxia correlated with the severity of complications during the acute stage of disease, which coincided with disorders in the myocardial contractile function. Hyperbaric oxygenation (HBO) in a sparing regimen, added to combined therapy of acute myocardial infarction, effectively liquidated tissue hypoxia and improved the contractile and pumping function of the heart. HBO in combination with antioxidants is the most effective in acute myocardial infarction after essential decrease of paO2 and pa-vO2 during the early postinfarction period in patients with signs of heart dilatation and decreased contractility; in addition, the efficiency of the method depends on the pattern of the preinfarction period.

[Combined anesthesia using Diprivan and ketamine in pediatric surgery]. / Kombinirovannyi narkoz s ispol'zovaniem diprivana i ketamina v detskoi khirurgii.

A total of 120 children aged 7-14 years were subjected to short-term elective and urgent interventions under combined intravenous anesthesia with diprivane and ketamine. The patients were divided into groups depending on methods of general anesthesia. Noninvasive monitoring of hemodynamic parameters and SaO2 was carried out during anesthesia and surgery and psychomotor functions were evaluated during the immediate postoperative period. Ketamine ensured stable hemodynamics during induction anesthesia. A combination of diprivane and ketamine levelled some untoward effects of these anesthetics.

[Ways to decrease blood loss during total hip joint endoprosthesis]. / Puti umen'sheniia krovopoteri pri total'nom éndoprotezirovanii tazobedrennogo sustava.

Total replacement (endoprosthesis) of the hip joint was carried out in 93 patients aged 18-60 years. Sixteen operations were performed under prolonged epidural blockade, 66 under neuroleptanalgesia, and 16 under ataralgesia. A deficiency of circulating blood volume was detected in all patients before surgery. The lowest mean arterial pressure was recorded in the prolonged epidural block group, while in the neuroleptanalgesia and ataralgesia groups the mean arterial pressure was virtually the same. Isovolemic hemodilution in patients with preoperative deficit of circulating blood volume decreased blood loss during long traumatic operations. Prolonged epidural blockade in combination with isovolemic hemodilution and spontaneous respiration led to a notable (70%) decrease of the true blood loss in comparison with the traditional neuroleptanalgesia.

[Use of laser irradiation in intensive care of children during the postoperative period]. / Ispol'zovanie lazernogo izlucheniia v intensivnoi terapii posleoperatsionnogo perioda u detei.

Homeostasis parameters, level of endotoxicosis, free radical lipid peroxidation, and antiradical defense were studied in young children administered laser exposures and antioxidants unithiol and vitamin E within the protocol of intensive case for pyoinflammatory diseases. The patients were divided into three groups with different protocols of treatment. Clinical and biochemical findings indicate the efficacy of laser therapy and antioxidants.

[Adenine nucleotide metabolism in acute myocardial infarct and the initiation of free-radical oxidation]. / Metabolizm adenilovykh nukleotidov pri ostrom infarkte miokarda i initsiatsiia svobodnoradikal'nogo okisleniia.

A close relationship between the ADN pool and one of the routes of free radical generation mediated by the xanthine oxidase system has been revealed during studies of changes in adenyl nucleotide metabolism in 140 patients with acute myocardial infarction. The metabolic disorders and changes in the activities of free-radical processes associated with them were found to correlate in patients with different forms of acute myocardial infarction during the acute stage of the disease. The authors consider that this correlation gives grounds for including antioxidative agents in the treatment protocols.

[Intensive care of respiratory insufficiency and hypoxia]. / Intensivnaia terapiia dykhatel'noi nedostatochnosti i gipoksii.

Analysis of the results of studies carried out in 1200 patients aged 1 day to 75 years hospitalized at reanimation and intensive care wards for critical and terminal states of different origin showed that respiratory insufficiency and hypoxia play the main role in the pathogenesis of critical states and cause generalized disturbances of metabolism which lead to disorders in the work of vital organs and systems. The major part in metabolic disorders is played by changes in free-radical lipid peroxidation and in the system of antioxidant defense. An original program of "metabolic reanimation" is proposed for correction of the disordered metabolic processes and their aftereffects caused by hypoxia.

[Metabolic components of anesthesiological provision in surgery of suppurative-inflammatory diseases of the abdominal cavity]. / Metabolicheskie komponenty anesteziologicheskogo obespecheniia operatsii pri gnoino-vospalitel'nykh zabolevaniiakh organov briushnoi polosti.

The authors analyze the experience gained with the use of multicomponent intravenous anesthesia and epidural anesthesia in combination with a synthetic opioid dalargin, protease inhibitor trasylol, and sulfhydryl group donor unithiol. The studies were carried out in 164 patients operated on for pyoinflammatory diseases of the abdominal and small pelvis organs. Under study were the parameters of central hemodynamics, oxygen-transporting system, and lipid peroxidation. Use of the before-said metabolic components of anesthesia promoted an appreciable reduction of fentanyl and lidocaine doses (almost five- and twofold, respectively) with an adequate antistress defense being the same, hemodynamics and oxygen transport stabilized, and a membrane protective effect observed.

[Use of the method of food deprivation in preoperative care of patients with concomitant obesity]. / Primenenie metoda alimentarnoi deprivatsii dlia predoperatsionnoi podgotovki bol'nykh s soputstvuiushchim ozhireniem.

Alimentary deprivation was used in preoperative treatment of 86 surgical patients with obesity. Body mass was reduced by 10 to 20%, on an average, and the course of concomitant diseases was corrected. Findings of clinical, instrumental, and laboratory studies showed that alimentary deprivation was well tolerated by surgical patients, improving their resistance to surgical stress.

[Effects of hyperoxia regimes on the state of lipid peroxidation and hemostasis in patients with lesions of the central nervous system]. / Vliianie rezhimov giperoksii na sostoianie perekisnogo okisleniia lipidov i gemostaz u bol'nykh s porazheniiami tsentral'noi nervnoi sistemy.

Lipid peroxidation and some parameters of hemostasis were studied during exposure to various hyperoxia schemes combined with heparin therapy before and after treatment in 124 patients aged 16 to 69 with CNS involvement which developed as a result of atherosclerosis and essential hypertension, 60 of whom presented with initial manifestations of cerebral circulation insufficiency (IMCCI), 33 with posthypoxic encephalopathies (PE), and 31 with ischemic stroke (IS). Hyperoxia mechanisms were differently directed in the studied groups of patients, this necessitating a differentiated approach to the choice of schemes of hyperbaric oxygenation. Use of a short course of hyperbaric oxygenation (up to 3 sessions at 1.2 to 1.25 atA) is recommended for patients with IMCCI and PE. For patients with IS in the acute period hyperbaric oxygenation at 1.4 atA is advisable combined with heparin therapy in doses of 150 to 300 U/kg b.w. a day.

[Intensive intralymphatic and lymphotropic therapy in children]. / Intensivnaia éndolimfaticheskaia i limfotropnaia terapiia u detei.

Study of the effect of endolymphatic therapy with antibiotics and antioxidants on lipid peroxidation and endotoxicosis level in children in critical state showed that endolymphatic infusion of nonenzymatic antioxidants (vitamin E, unithiol) and wide-spectrum antibiotics noticeably reduced the activity of free-radical lipid peroxidation and accelerated detoxication in comparison with the control group.

[Use of the therapeutic starvation method in preoperative care of patients with concomitant obesity]. / Primenenie metoda lechebnogo golodaniia v predoperatsionnoi podgotovkebol'nykh s soputstvuiushchim ozhireniem.

A method of therapeutic starvation was employed in preoperative preparation of 63 surgical patients with morbid obesity. The authors managed to achieve average reduction in body weight of the patients by 10-20% with correction of concomitant diseases. Good tolerance to therapeutic starvation of the patients and increase in their resistance to the operative stress were noted.

[Hyperbaric oxygenation and antioxidants in the complex intensive therapy of severe forms of pneumonia in children]. / Giperbaricheskaia oksigenatsiia i antioksidanty v kompleksnoi intensivnoi terapii tiazhelykh form pnevmonii u detei.

Hyperbaric oxygenation (HBO) was used in a complex intensive therapy of 194 children, aged 3 days to 3 years, with severe pneumonias. Initially the patients have revealed intensification of free radical processes (FRP) with a simultaneous decrease in the level of enzyme and non-enzyme protection and a drastic increase in gluco- and mineralocorticoid adrenal function. HBO and antioxidants (unithiol and alpha-tocopherol) yielded excellent and good results (a drop in FRP level and activation of enzyme antioxidant protection) in 75.8% of patients. HBO was ineffective in 17% of cases, in 7.2% of patients signs of the developing oxygen intoxication have been revealed. Control over the indexes of erythrocytes resistance to peroxide, extra-erythrocyte hemoglobin, total peroxidase plasma activity during HBO procedure makes it possible to detect early preclinical signs of acute oxygen intoxication onset.

[Intensive therapy of diabetic (ketoacidotic) coma]. / Intensivnaia terapiia diabeticheskoi (ketoatsidoticheskoi) komy.

Complex intensive therapy involving daily procedures of hyperbaric oxygenation combined with antioxidants in patients admitted to hospital in condition of ketoacidotic coma allows prompt elimination of hypoxia, acidosis, hyperglycemia and makes it possible to enhance resistance of cellular membranes and normalize free-radical parameters of lipid peroxidation.