[Assessment of severity of the state and intensive care of newborns in the intensive care units]. / Otsenka tiazhesti i intensivnaia terapiia novorozhdennykh v otdelenii reanimatsii.

A point-based evaluation of the severity condition was made on the bases of an analysis of clinical findings (cardiovascular, respiratory, central nervous, urinary and gastrointestinal systems) for 130 newborns who were admitted to the intensive care and resuscitation unit: 3-5 points--severe condition, 6-10 points--highly severe condition and 12-15 points--extremely severe condition. The severity assessment scale as applicable to newborns and based only on the clinical findings enables the practitioner to optimize the conducted therapy in accordance with a severity degree.

[Substitutive hemotransfusion in newborns with surgical pathologies]. / Zamestitel'naia gemotransfuziia u novorozhdennykh s khirurgicheskoi patologiei.

Transfusion of blood components is not a method of choice at anemia, at the same time, hemotransfusion turns out often vitally indispensable at a pronounced reduction of hemoglobin especially in newborns. Indications for the transfusion of blood components demand that many factors of individual approach should be taken into consideration. Phenotyping of the blood of donor and of patient by using the standard serum methods and gel technology make it possible to avoid transfusion complications.

[Peritoneal dialysis in acute renal failure in children]. / Peritoneal'nyi dializ pri ostroi pochechnoi nedostatochnosti u detei.

Data on the treatment of infants with acute renal failure are presented. Indications for renal substitute therapy are enumerated and hemodialysis and peritoneal dialysis are compared. Complications of peritoneal dialysis are discussed and methods for their treatment are presented. The authors demonstrate that peritoneal dialysis is an effective, safe, and available method for treating acute renal failure in infants.

[Possibilities of assessment of the volume of extracellular fluid in children by integral conductometry]. / O vozmozhnosti opredeleniia ob"ema vnekletochnoi zhidkosti u detei metodom integral'noi konductometrii.

The aim of this research was to specify M. I. Tischenko's formula (1978) for the estimation of the volume of extracellular liquid on the basis of integral resistance so as to use it in children. Simultaneous assessment of the volume of extracellular fluid by thiosulfate dilution method and registration of the basal integral resistance with data processing helped correct the formula for use in practical pediatrics. The technique of assessment of the volume of extracellular fluid is simple, does not involve intravenous infusions of drugs or blood collection, rapid, and reproducible under any conditions. It may be used for assessment of the volume of extracellular fluid in children with the edematous syndrome associated with renal diseases (acute renal failure, glomerulonephritis), liver diseases, circulatory insufficiency. Repeated studies give valuable information about the state of water-salt metabolism in patients with hyper- or dehydration and help assess the therapy efficacy.

[Evaluation of the functional state of the circulatory system in children using postural volume-load test]. / Otsenka funktsional'nogo sostoianiia sistemy krovoobrashcheniia u detei s pomoshch'iu postural'noi ob"emno-nagruzochnoi proby.

A postural volume-load test (PVLT) is an informative technique for the evaluation of the function and identification of latent disturbances of cardiovascular work which are difficult to diagnose using conventional techniques. It is a noninvasive procedure, analogous in its results to a more complex infusion volume-load test. In PVLT cardiac pump function is mainly assessed, as the basic test criterion is the direction of stroke volume changes. If cardiac pump function is intact, one can predict the response to the volume load and optimal conditions for infusion therapy are created. Negative, as well as weakly expressed positive reaction or its absence during PVLT indicate the presence of heart failure or the danger of its onset and require the use of drugs with positive inotropic effect (sympathomimetics, glycosides). In patients with heart failure PVLT makes it possible to control the efficacy of the therapy conducted. Test simplicity and sufficient informative value makes advisable its use in all critical patients of intensive care units, as well as in patients who are to be exposed to surgery threatened with great blood loss.

[Status of the cardiovascular system in children with funnel chest]. / Sostoianie serdechno-sosudistoi sistemy u detei s voronkoobraznoi deformatsiei grudnoi kletki.

Results of examinations of the cardio-vascular system (ECG, integral rheography of the body, longitudinal rheography of the leg, polycardiography, ECG-orthostatic test) in 20 children with funnel deformity of the chest aged from 4 to 14 years are presented. The timely correction of the funnel deformity of the chest in children allows the factors resulting in disturbance of cardio-vascular activity in future to be excluded.

[The use of sodium nitroprusside in the treatment of heart failure in critically ill children]. / Primenenie nitroprussida natriia pri lechenii serdechnoi nedostatochnosti u detei v kriticheskikh sostoianiiakh.

Sodium nitroprusside was used in 18 children aged 1 to 13 years with clinical and hemodynamic signs of low cardiac output syndrome secondary to septic pancarditis, lung edema, thromboembolism of pulmonary artery branches. Central and peripheral hemodynamics has been studied by impedance plethysmography prior to and during the first day of sodium nitroprusside infusion. A considerable improvement of hemodynamic parameters and the patients' conditions has been established. Effective dosages and indications for the drug use in children have been elaborated.

[Continuous intravenous administration of fentanyl during multicomponent anesthesia in children]. / Nepreryvnoe vnutrivennoe vvedenie fentanila pri mnogokomponentnoi anestezii u detei.

136 anesthetic procedures during planned and emergency surgery in children have been analysed. It has been demonstrated that non-stop intravenous fentanyl injection with an automated syringe of "Lineomat" type ensures an adequate analgesia over a 2-10 h period. The adequacy of anesthesia was confirmed by the data of central and peripheral hemodynamics monitoring, acid-base balance, temperature gradient and clinical course. Non-stop injection of the analgesic made it possible to reduce the drug expenditure by 30% on average as compared to the theoretically calculated dose, as well as to free paramedical personnel and decrease their exposure to blood.

[Potentials of rheovasography in assessing circulatory disorders in the postoperative period in children]. / Vozmozhnosti reovazografii v otsenke narushenii krovoobrashcheniia v posleoperatsionnom periode u detei.

Clinical investigations have shown possibilities of using rheovasography of the leg for the complex assessment of alterations of the peripheral blood circulation in children after surgical interventions. A direct relationship between the decreased stroke volume of the heart and the value of the systolic rheographic index on the leg has been established and great informative significance of leg rheography has been proved for the assessment of peripheral disorders as compared with other vascular zones (forearm, finger). The use of leg rheovasography is recommended for the assessment of peripheral blood circulation and choice of a correcting therapy.

[Pathogenesis and surgical tactics in the extrahepatic form of portal hypertension in children]. / Patogenez i khirurgicheskaia taktika pri vnepechenochnoi forme portal'noi gipertenzii u detei.

The correlation analysis of different parameters of the oxygen regimen of the liver, its blood circulation and angioarchitectonics were used in 44 patients in order to reveal different ways of the compensation of blood flow depending on the form of blockade (in thrombosis of the portal vein--at the expense of the hepatic artery, in its malformation--at the expense of the formation of porto-portal collaterals). The operation of choice is thought to be gastrotomy with ligation of varicose veins of the stomach and esophagus from the side of mucosa. It was used in 110 patients and in 88% of the cases recurrent bleedings were prevented for the period up to 15-20 years.