[Mechanic reinfusion in emergency surgery].

The article highlights techniques and effects of intraoperative mechanic blood reinfusion in patients with trauma and intraabdominal bleeding in extend, exceeding the self circulating blood volume. The high efficacy of the self blood reinfusion during the emergency operation allowed the 2-fold decrease of the hospital and overall mortality. The mechanic blood reinfusion proved to be a safe and clinically effective method of the globular blood volume deficiency compensation, especially in emergency surgery.

[The intraoperative auto- and allohemotransfusion by massive bleeding in emergency abdominal surgery].

The results of intraoperative hemotransfusion of 112 patients with abdominal injuries, complicated with bleeding and the loss of more then 70% of the circulating blood. The aim of the study was to compare the efficacy of auto- and allohemotransfusion. The first method allowed to decrease both the overall lethality (p=0.039) and postoperative lethality (p=0.018). The odds ratio by the predominate autohemotransfusion was 1.385 (95% 1.101-1.741), where as the odds ratio by the predominate allohemotransfusion was 0.403 (95% 0.183-0.885; p=0.011).

[Anesthetic provision of emergency surgical interventions].

Anesthetic provision of emergency surgery has a number of organizational and methodic features. The paper describes general principles in the organization of work of a team of emergency anesthetists. It also considers the problems of preoperative preparation, the choice of an anesthesiological procedure, and the tactics of intraoperative management of patients operated on, if there are emergency indications. Particular emphasis is laid on life-threatening stages of anesthesia.

[Role of starch preparations in the intraoperative correction of hypovolemia in patients with large-size uterine myomas].

The course of anesthesia during uterine extirpation for large and giant myomas depends on the efficiency of blood loss compensation and relative hypovolemia after rapid decompensation when a mass is removed. Thirty-five patients with a uterine myoma with the size corresponding to 18-40-week gestation were examined. Dextrans and voluven (hydroxyethylstarch 130/0.4) were used in Groups 1 (n = 20) and 2 (n = 15). The intraoperative administration of voluven reduced the volume of crystalloids and a need for sympathomimetics and maintained the normal amount of fluid and sectoral distribution.

[Cerebral metabolism and the exchange of biogenic amines in the brain of patients under various types of anesthesia in the surgery of intracranial aneurysms].

During intracranial surgical interventions, the major tasks of an anesthetic procedure are to maintain cerebral perfusion, adequate oxygen delivery, and brain tissue metabolism at all surgical stages. The authors have compared cerebral metabolism and the exchange of biogenic amines that regulate cerebral oxygen consumption and cerebral blood flow, by using neuroleptic anesthesia and balanced anesthesia on the basis of enflurane during operations on intracranial vessels. There is evidence for the equal efficiency of both types of anesthesias and for a unidirectional impact on the body's neurohumoral systems.

[Anesthetic support of operations on the hip joint in senile patients].

The impact of spinal anesthesia on a surgical stress response during prosthetic repair of the hip joint was studied in 56 senile patients (mean age 76 +/- 2.1 years). Hemodynamic changes, the time course of fluid distribution in different sectors, the activities of sympathoadrenal, cholinergic, serotoninergic, and histaminergic systems were analyzed. Studies were conducted in 4 steps: before a planned operation, before anesthesia, after the end of surgery, and 24 hours after intervention. The characteristic features of hemodynamic changes were elevated left ventricular filling pressure and high specific peripheral resistance, which was regarded as signs of latent heart failure and age-related vascular tone regulatory changes. Involutional tissue processes in senile patients appeared as decreased water levels in the cellular sector. The patients' sympathoadrenal and enterochromaffin systems were in a state of hypofunction. The adequacy of anesthesia supports no trend in the study neurohumoral regulatory parameters. The low level of hormones and mediators confirms the true depletion of the neurohumoral regulatory system.

[Cardiac arrhythmias during coronary bypass surgery without extracorporeal circulation].

Ventricular arrhythmias are recorded in most patients at coronary bypass surgery without extracorporeal circulation. The stages, such as the pulling of the sternal edges apart, the opening of the pericardium, the revision and dislocation of the heart, and revascularization of coronary arteries, are most dangerous due to the fact that they may lead to the development of arrhythmias. The major proarrhythmogenic factors at coronary bypass surgery without extracorporeal circulation are mechanical irritation of reflexogenic areas and myocardial ischemia, the mechanical factors playing the leading role in the development of ventricular arrhythmias.

[Risk factors of atrial fibrillation after aortocoronary bypass surgery with extracorporeal blood circulation]. / Faktory riska fibrilliatsii predserdii posle operatsii aortokoronarnogo shuntirovaniia s iskusstvennym krovoobrashcheniem.

Fibrillation of the atriums is registered in 20-40% of cases after the surgery of direct revascularization of the myocardium and runs alongside with impairments that are life-menacing. Seventy-six (76) patients were examined after direct revascularization of the myocardium, including 20 subjects with paroxysms of atrium fibrillation. The arrhythmia-related risk was shown to be increasing in persons (older than 60) with an impaired left column of the left coronary artery, in unstable angina pectoris diagnosed before surgery, malfunction of the left ventricle and in case of a rapid warming-up of a patient after the artificial blood circulation with cold cardioplegia is over.

[Noninvasive assisted lung ventilation during ambulatory laparoscopic cholecystectomy]. / Neinvazivnaia vspomogatel'naia ventiliatsiia legkikh posle laparoskopicheskoi kholetsistéktomii v usloviiakh otdeleniia khirurgii "odnogo dnia".

Both obstructive-restrictive respiratory disturbances along with hypercapnia and oxygen consumption rate and respiratory quotient increasing were proved to follow laparoscopic cholecystectomy. Non-invasive pressure assisted lung ventilation decreased the extent of both respiratory and metabolic deviations and provided the restoration of normal breathing pattern for 24 hours.