[Central hemodynamics and prognostic significance of circulatory hyperdynamics after interventions for esophageal cancer]. / Sostoianie tsentral'noi gemodinamiki i prognosticheskoe znachenie giperdinamiki krovoobrashcheniia posle onkologicheskikh operatsii na pishchevode.

Central hemodynamic parameters were studied by direct catheterization of the pulmonary artery in 70 patients with cancer of the esophagus and cardial portion of the stomach during the early postoperative period after extensive or extensive-combined interventions through the thoracoabdominal access. Analysis of the mean initial and intraoperative parameters at different stages of the operation showed no essential deviations from the norm. Studies of heart production at different stages showed that during transfer of patients from the operation room into intensive care ward, one-third of patients developed low ejection syndrome and another one-third hyperdynamic syndrome, while the mean values looked satisfactory. On days 3-5, circulatory hyperdynamia was detected in 60% patients, which was observed over the entire period of observation in 75% patients. It is noteworthy that polyorgan failure was 4-fold more often observed in patients with normal cardiac output than in those with the hyperdynamic syndrome. Probable causes of this phenomenon are discussed.

[Problems and advances in anesthesiology and intensive care in oncologic surgery]. / Problemy i dostizheniia anesteziologii i reanimatologii v onkokhirurgii.

Numerous problems are to be solved by anesthesiology and reanimatology in modern oncosurgery: to protect weak exhausted patients from severe and extremely severe surgical injury, to carry out rational infusion/transfusion therapy and intensive care in massive blood loss, perioperative organ and polyorgan failure, and sepsis. Combined analgesia is used in highly traumatic oncological operations: inhalation narcosis with fluorine drugs with epidural analgesia and anesthesia. Good results were obtained in the treatment of very grave patients. Mortality from highly traumatic operations with blood loss higher than 50% of total circulating blood decreased to 10%. Modern methods of intensive care, such as intraoperative reinfusion of autoerythrocytes, extracorporeal detoxication, immunocorrection for preventing and treating sepsis, etc., are widely used with good effect.

[Severe sepsis and multiple organ failure in surgical patients in intensive care unit of oncological profile]. / Tiazhelyi sepsis i poliorgannaia nedostatochnost' u khirurgicheskikh patsientov otdeleniia reanimatsii onkologicheskogo profilia.

Forty-seven cases with grave sepsis and multiple organ failure in patients operated on for malignant tumors of different localizations and treated in intensive care wards of Cancer Research Center in 1996 are analyzed. In 35 patients sepsis developed due to pyoseptic complications of surgery and led to multiple organ failure, in 12 sepsis complicated multiple organ failure of other origin. Four or five organ systems were involved in 2/3 of patients with "primary" sepsis and in almost all patients with "secondary" sepsis. Sepsis and multiple organ failure in surgical cancer patients are believed to differ much from those in general surgical patients, which is explained by the scope of intervention, a tendency to decrease the number of indications for surgery, and by profound impairment of immunity and metabolism.

[A new method of studying blood aggregation in geriatric surgical patients]. / Novyi metod izucheniia agregatsii trombotsitov u gerontokhirurgicheskikh bol'nykh.

A new technique of nephelometry based on the determination of optic radius of platelets and their aggregates has been tested in surgical patients of very advanced age with abdominal pathology. The technique in question makes it possible to use subthreshold inducer doses compatible with their real concentration in vivo. The nature of changes in platelet aggregation at preoperative stage has been described, postoperative course of hyperaggregation syndrome has been followed and qualitative disorders in aggregate forming processes have been specified. It has been shown that intravascular blood irradiation with low-intensive laser is effective for the correction of high platelet sensitivity.