[Assisted blood circulation, efferent detoxication and hyperbaric oxygenation in the treatment of exotoxic shock]. / Vspomogatel'noe krovoobrashchenie, éfferentnaia detoksikatsiia i giperbaricheskaia oksigenatsiia pri lechenii ékzotoksicheskogo shoka.

Experimental and clinical data on the employment of assisted circulation with extracorporeal oxygenation of the blood, exchange replacement of the blood in high volumes, hemoperfusion, and hyperbaric therapy in the treatment of exotoxic shock caused by methemoglobin-forming and corrosive poisons demonstrate a high efficacy of assisted circulation in the normalization of central hemodynamics (which permits exchange replacement of the blood and hemoperfusion), of the hepatorenal function, hemostasis, and other parameters of the internal media in humans and animals. The method is recommended for wide use at large reanimation and toxicological centers.

[The effect of hemosorption and hyperbaric oxygenation on the indices of systemic hemodynamics and oxygen allowance in patients with septic shock]. / Vliianie gemosorbtsii i giperbaricheskoi oksigenatsii na pokazateli sistemnoi gemodinamiki i kislorodnogo obespecheniia bol'nykh septicheskim shokom.

The study of 34 patients with septic shock has shown that active detoxication with hemosorption leads to prompt stabilization of systemic hemodynamics with a considerable increase in oxygen delivery and consumption. When hemosorption was followed by HBO procedures the functional capacities of the cardiac muscle were improved, the elimination of anaerobic metabolism inversion facilitated, and the level of oxygen consumption normalized.

[Changes in the parameters of systemic and pulmonary blood circulation in patients with lung cancer during different types of anesthesia]. / Izmeneniia parametrov sistemnogo i legochnogo krovoobrashcheniia u bol'nykh rakom legkogo pri razlichnykh vidakh anestezii.

Central and pulmonary hemodynamic parameters have been studied by total body and transthoracic plethysmography in 60 patients before surgery, after surgery and on the 2nd, 4th and 9th day of the postoperative period. Neuroleptanalgesia and postoperative intramuscular analgesia with analgesics have been performed to control patients. Test patients during surgery and for 18 hours postoperatively have been subjected to upper thoracic epidural anesthesia with trimecaine and morphine. Marked stress hemodynamic reaction in control patients right after surgery and its following gradual inhibition with signs of right ventricular overload corresponded to a complicated clinical course. Reduced right ventricular afterload in test patients, minimum changes in right-ventricular performance and inotropic properties in combination with uncomplicated clinical course make it possible to consider the use of prolonged epidural anesthesia justified in thoracic cancer surgery.

[Perioperative dynamics of the parameters of acid-base equilibrium in patients with lung cancer in relation to the type of anesthesia]. / Perioperatsionnaia dinamika parametrov kislotno-osnovnogo ravnovesiia u bol'nykh rakom legkogo v zavisimosti ot vida anestezii.

Acid-base parameters of the venous blood have been studied in 60 patients with lung cancer randomized into two groups prior to and following lung resection and on days 2, 4 and 9 postoperatively. In group I multicomponent endotracheal anesthesia using controlled lung ventilation and postoperative intramuscular analgesia with non-narcotic and narcotic analgesics were employed. In group II anesthesia and controlled lung ventilation were supplemented by epidural anesthesia with 2.5% trimecaine solution combined with adrenaline and small morphine doses at the upper thoracic segment level, postoperative analgesia for 18 hours was performed likewise. Perioperative acid-base balance changes were found to be more favourable in patients of group II, which was manifested in weaker acidosis by the end of the operation and in the absence of remote pathological changes in the acid-base balance. In patients of group I gradual repeated increase in metabolic acidosis was observed, which by day 9 postoperatively assumed a complicated clinical course.

[The dynamics of perioperative coagulopathies in lung cancer patients depending on the type of anesthesia and on the change in the level of endogenous intoxication]. / Dinamika perioperatsionnykh koagulopatii u bol'nykh rakom legkogo v zavisimosti ot vida anestezii i izmeneniia urovnia éndogennoi intoksikatsii.

Serum medium-size molecules (MSM) and blood coagulation parameters have been studied before and after surgery in 60 patients randomized into 2 groups. Patients in group I were subjected to multicomponent endotracheal anesthesia with neuroleptanalgesia and cardiopulmonary bypass and to postoperative analgesia with non-narcotic and narcotic analgesics. Patients in group II were additionally subjected to epidural anesthesia into upper chest segments with trimecaine + adrenaline and low morphine doses. Prior to surgery many patients showed signs of the first-degree disseminated intravascular coagulation syndrome. Parallel changes in the postoperative clinical course, pathological shifts in coagulograms and changes in MSM levels (which were maximum on the fourth day postoperatively in both groups) have been established. Patients in group II were found to have a more favourable coagulation profile.

[Organization and volume of work in the department of anesthesiology and resuscitation in a central district hospital]. / Organizatsiia i ob"em raboty otdeleniia anesteziologii i reanimatsii tsentral'noi raionnoi bol'nitsy.

The experience accumulated during organization and functioning of an anesthesiology and intensive care unit in a central district hospital is described. The efficacy of anesthesiological aid and intensive care has been demonstrated in conditions of a rural region. The authors believe advisable the establishment of anesthesiology and intensive care units in large central district hospitals.