[The risk factors for the development of the multiple organ failure syndrome in destructive pancreatitis]. / Faktory riska razvitiia sindroma poliorgannoi nedostatochnosti pri destruktivnom pankreatite.

The role of neutrophil leukocytes in the development of the polyorgan failure syndrome during an unfavorable course of destructive pancreatitis is discussed. The examinations of 52 patients demonstrated a high correlation of neutrophil functional activity tests (nitroblue tetrazolium reduction test and leukocyte-platelet aggregation) and disorders of microcirculation and hepatorenal involvement (detected clinically and by laboratory tests). The "critical mass" of leukocytosis has been estimated: at least 18 . 10(9)/liter, at which the risk of polyorgan failure appreciably increases. The authors discuss the advisability of selective cytopheresis in a complex of intensive care for critical states involving endogenous poisoning and leukocytosis.

[Theoretical possibilities of bivalvular prosthesis with moderate (28 degrees C) hypothermic protection]. / O printsipial'noi vozmozhnosti dvukhklapannogo protezirovaniia serdtsa v usloviiakh neglubokoi (28 gradusov C) gipotermicheskoi zashchity.

A method of bivalvular prosthesis of the heart without a perfusion is described. Operations were performed on 6 patients. One patient died. In 5 patients the aortomitral prosthesis was fulfilled, in one patient a mitral-tricuspid prosthesis was created. The article describes the technique of the operation and analyzes some anesthesiological aspects of maintaining a continuous occlusion of main vessels.

[Electroencephalography monitoring at total and managed hyperthermia to 44 degrees C]. / Elektroéntsefalograficheskii monitoring pri obshchei upravliaemoi gipertermii do 44 gradusov C

In 34 patients the abstinence syndrome was treated by hypothermia (HT) with the EEG monitoring. HT was carried out under the general propofol-fentanil anesthesia. HT was achieved in the "Hirana" bath. The temperature was increased gradually by 1 degree C per 5 minutes up to 44 degrees C. EEG was recorded before anesthesia, as well as during and after the procedure. On the initial EEG alpha- and beta-rhythms were predominant. Under the anesthesia both alpha-rhythm frequency and amplitude were enhanced, spikes and wave discharges appeared. Under HT (t = 40-42 degrees C) low voltage and wave slowing were recorded. In the range t degree--42.5-43.4 degrees C EEG registered the appearance of clinically significant "biological break point", which was followed by neuropeptide destruction. At t degree--43-44 degrees C acute suppression and, then, electrocerebral silence were observed in a majority of patients. At the end of the procedure (t = 39 degrees C) EEG returned to the initial recording.