[Hemostasis in patients operated on for abdominal hemorrhage. 4. Conception of hemostasis changes]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 4. Kontseptsiia izmenenii gemostaza.

Studies of haemostasis changes in the dynamics of early post-operational period permitted revealing the tendency to the growth of fibrinogen concentration, decrease in the fibrinogen self-assembling rate, weakening of thrombinemia, disturbances in fibrinogen degradation products (FDP) elimination, increase of inhibitors activity and/or weakening of blood coagulation factors activity, intensification thrombocytes aggregation. Hypercoagulation has been registered under acute haemorrhage and the haemorrhage time exceeding 24 h before the operation, the weakening of hypercoagulation response was observed, notwithstanding the possibility of haemorrhage continuation. The letter is underlined by the changes in the balance between the coagulation factors and inhibitors up to the absence of typical hypercoagulation response to surgical interference.

[Hemostasis in patients operated on for abdominal hemorrhage. 2. Characterization of the process of activation of blood coagulation system factors. Coagulation inhibitors]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 2. Kharakteristika protsessa aktivatsii faktorov sistemy svertyvaniia krovi. Ingibitory svertyvaniia.

Haemostasis indexes were estimated in four groups of patients which were isolated by the cluster analysis and operated for abdominal haemorrhages. A tendency or explicit hyperfibrinogenemia have been fixed which are connected with the syndrome of the system inflammation response of the patient in the critical state. The correlation between the indexes of the prothrombin time, activated partial prothrombin time and protein C activity is shown. An analysis of anticoagulants effect suggests it possible to consider the antithrombin III to be the main, stable blood anticoagulant, while protein C is responsible for the operational response of the organism on the part of haemostasis. The decrease of ancystron and thrombin time was recorded in 50% of patients notwithstanding the hyperfibrinogenemia and presence of fibrin fibrinogen degradation products. It is supposed that the acceleration of fibrin polymerization in the examined groups of patients is the mechanism of the organism protection from the blood loss under the given pathology.

[Hemostasis in patients operated on for abdominal hemorrhage. 3. Boundary deviations of hemostasis]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. 3. Krainie varianty otkloneniia gemostaza.

The fibrinolytic process in the plasma of patients operated for abdominal haemorrhages have been investigated. The results allowed to conclude that the blockade of fibrinolysis did not effect on the course of the disease. The high level of the inhibitors and of the platelets hypoaggregation can be considered as a cause increased of the recurring gastrointestinal haemorrhages. It was demonstrated that the probability of DIC-syndrome development increased at the aggravation of the patient's state after the operation.

[Hemostasis in patients operated for abdominal bleeding. I. Estimation of the relationship of hemostasis parameters according to data of the correlation coefficient and factor analysis]. / Gemostaz u bol'nykh, operirovannykh po povodu abdominal'nykh krovotechenii. I. Otsenka sviazi pokazatelei gemostaza po dannym koéffitsienta korreliatsii i faktornogo analiza.

The work was aimed to estimate the interrelation and indexes which define the main alterations of hemostatic deviations in the patients with abdominal bleeding. For this reason the authors have analysed interrelations between 31 hemostasis indexes in 30 patients after operations. Fourteen groups of interrelated indications have been revealed. They are as follows: 1. Prothrombin index, activated partial thromboplastin index; 2. Prothrombin's inactive forms (prethrombin-1, decarboxylated prethrombin etc.), ecamulin index; 3. Velocity bend of distraction of fibrin clot, velocity bend of forming of fibrin clot, height of clot using turbidimetric method; 4. Half-lysis time, lysis time, time of fibrin clot using turbidimetric method; 5. Velocity, Intensity, remainder of platelet aggregation induced by ADP 10 mcg/ml, 2.5 mcg/ml, 1.9 mcg/ml; 6. Thrombin time; 7. Protein C; 8. Fibrinogen; 9. Platelet count; 10. Soluble fibrin; 11. Ancystron time; 12. X factor; 13. Antithrombin-III; 14. Fibrin(ogen) degradation products. It was shown how different groups affect hemostasis. The authors have suggested to use the data of mathematical analysis and laboratory tests for the estimation of hemostatic deviations.

[The relative critical threshold of erythrocyte hemoglobin concentration in isovolemic hemodilution]. / Vidnosnyi krytychnyi porih kontsentratsiï hemohlobinu erytrotsytiv pry izovoliumichnii hemodyliutsiï.

The purpose of our research was register the relative critical threshold of erythrocyte hemoglobin concentration: that criteria, on basis of which was possible to be determined, whether the parameters of red blood for maintenance of oxygen delivery are sufficient in each particular case. Have compared two groups patients afterwards surgical stoppage gastro-intestinal bleeding and urgent intravascular volume replacement; 1) hemotransfusion was accompanied decrease of concentration patient's lactate level; 2) hemotransfusion was not accompanied decrease of concentration patient's lactate level. Have generated the algorithm of indications for transfusion of homologous blood in kind pyramid, in basis are incorporated sensitive, but underspecifically symptoms: the decrease of hemoglobin concentration, especially less 6 g/dl; the decrease of oxygen pressure, degree of hemoglobin saturation with oxygen in venous blood; the increase of blood lactate level; the relative increase cardiac output for account frequency of stroke volume and/or value of stroke volume; positive "oxygen cost" of hemotransfusion.

[The patterns of oxygen metabolism in the early posthemorrhagic period]. / Zakonomirnosti obminu kysniu v rann'omu pisliahemorahichnomu periodi.

Investigated all links of oxygen homeostasis of patients in early period afterwards surgical stoppage gastro-intestinal bleeding and urgent intravascular volume replacement. Macrodelivery of oxygen (DO2) was reduced in two and more time in comparison with norm predominant in connection with anemia. In spite of the infringement of transport of oxygen through alveolar-capillary membrane (especially in patients with complications and death in early postoperative period), little affected of degree of hemoglobin saturation by oxygen. Despite decrease of erythrocyte zeta-potential, largely expressed in cases of lethal outcome, considerable infringement of passage through microcirculation vessels is fixed was not. The increase of degree of morbidity and anaerobic metabolism in early postoperative period was accompanied of hyperdynamic hemodynamic reaction. The increase of degree of morbidity was accompanied of increase oxygen deficit owing to infringement of oxidoreduction in fabries also.