[Structural changes in metabolism in the early postoperative period and the methods for their correction]. / Strukturnye izmeneniia metabolizma v rannem posleoperatsionnom periode i metody ikh korrektsii.

Surgery and general anesthesia involve changes in adaptive compensatory mechanisms manifesting by homeostasis disturbances, specifically metabolic disorders. This report describes the dynamic characteristics of structural metabolic disorders and the external respiratory function during the immediate and early postoperative period after surgery of different duration under different anesthesias and metabolic infusions. The results indicate that general anesthesia and any surgery involve structural disorders in energy expenditures during the early postoperative period. The duration of anesthesia and surgery and methods of anesthesia determine the metabolic disturbances and external respiratory changes during the postoperative period. Addition of opioids and hypertensive glucose infusions to general anesthesia and postoperative period decreases the severity of structural metabolic disorders and external respiratory function during the early postoperative period.

[Effectiveness of tube feeding in neurosurgical patients]. / Otsenka éffektivnosti zondovogo pitaniia u neiroreanimatsionnykh bol'nykh.

The results of the early use of gastrogavage in 24 neuroresuscitation patients are analysed. The dosage of the feeding and control over its efficacy was exercised by means of appraising energy expenditures and their structure with the use of indirect calorimetry as well as according to the nitrous balance data, biochemical criteria of the alimentary status, and the total lymphocyte count. It is shown that neuroresuscitation patients manifested appreciable changes in energy expenditures and their structure as well. It is fairly embarrassing to meet the energy requirements of such patients with the aid of the routine hospital diet. The early use of gastrogavage with the aid of dry, readily reducible mixtures of the Ensure type, that meet the neuroresuscitation patients' requirements, make intensive care more efficacious.

[Evaluation of the basal metabolic requirements of patients with grave brain lesions]. / Otsenka obshchikh metabolicheskikh potrebnostei u bol'nykh s tiazhelym porazheniem golovnogo mozga.

Basal metabolism (BM) was studied in 26 patients with a brain lesion treated at the neuro-resuscitation department. The complex of examination methods included dynamic appraisal of total energy expenditure and contribution of carbohydrates, fats, and proteins to the total energy expenditures by indirect calorimetry in combination with tests for daily nitrogen excretion, determination of biochemical indices characterizing BM: total lymphocyte count, concentration of blood total protein, albumin, blood urea nitrogen, and creatinine. It is shown that the character and degree of changes of BM depend on the clinico-neurological features of the disease in the postoperative (posttraumatic) period. Aspontaneity of various genesis leads to reduction of total energy expenditure by 18-25% of the normal values. Increased motor activity and the spasmodic syndrome increase total energy expenditure by 30-50%. Concurrent development of infectious complications increases total energy expenditure and changes its structure at the cost of increase of protein expenditure (proteins become responsible for up to 50% of energy expenditure). Indirect calorimetry in combination with tests for daily nitrogen losses is recommended for the evaluation and correction of BM disorders in patients requiring intensive therapy.