[ASSESSMENT OF THE RISKS OF THE CARDIOVASCULAR COMPLICATIONS CONNECTED WITH NON- CARDIOVASCULAR SURGERIES. THE POSSIBILITIES OF CONTROLLING CARDIOVASCULAR RISKS (REVIEW)].

The present review is dedicated to the problem of assessment of cardiovascular risks connected with non-cardiovascular operations. It is essential to assess risks connected with both planned and urgent surgical operations in order to control these risks. The following parameters are applied for evaluating post-operation cardiovascular risks connected with non-cardiovascular operations- type of surgical operations (according to the cardiovascular risk), the assessment of the functional condition of the patient, clinical factor risks of the cardiovascular complications. In order to assess the summative risk of the post-operation complications, the scales of the assessment of cardiovascular complications of post-operation risks are presented, which take into consideration the independent data including the condition of the patient and type of surgical operations. The complex evaluation of the condition of the patient, the planned surgical operation, also the joint conclusion of the specialists are necessary for reducing cardiovascular post operation risks.

CORRELATION OF RED BLOOD FACTORS IN POLYTRAUMA INDUCED SEPSIS AND SEPTIC SHOCK PATIENTS.

In polytrauma induced sepsis/septic shock patients, early verification and diagnosing anemia, is an important factor for the outcome of pathology. The purpose of our study was: to study the dynamic correlation of the red blood markers and inflammatory indicators. We consider that knowing these mechanisms will be helpful in the management/treatment method selection and in making prognosis of the final outcomes of polytrauma induced sepsis /septic shock patients. The purpose of our study was to study the characteristic dynamic correlations of polytrauma induced red blood and inflammation indicators. The abovementioned information will play an important and crucial role in the management of hypoxemic changes in different types of anemia. The red blood markers and inflammatory indicators dynamic correlations were studied in 21 Polytrauma induced Septic Shock patients during the first 45 days after hospital admission. Pearson Scheme was used for data analysis. All the patients were adults and were treated by the International Guidelines for Management of Severe Sepsis and Septic Shock, considering the bacterial spectrum. In the initial period of polytrauma injury, the deficit of red blood markers was a result of trauma induced hemorrhage and sequential surgical interventions. The dynamic reduce in red blood markers were in negative correlation with the elevation of systematic inflammatory factors, indicating polytrauma induced septic complication. In the period of reconvalescence, the concentration of red blood markers was normalizing, in negative correlation with the specific inflammatory factors. Our study revealed, that non-specific inflammatory marker, like fibrinogen is in strong correlation with the tissue oxygenation. Also the study demonstrated the correlation of Oxymetric parameters with the inflammatory factor metabolites. In particular, the elevation of fibrinogen concentration is in positive correlation with the tissue oxygenation quality.

THE ROLE OF PROCALCITONIN AND BLOOD LACTIC ACID VALUES IN PROGNOSIS OF SEPSIS AND SEPTIC SHOCK IN POLYTRAUMA PATIENTS.

Recently, the role of biomarkers to assist in the diagnosis and management of infections has been extensively explored. Based on the studies, Procalcitonin and Blood Lactic Acid can provide supportive data to clinical assessment in Polytrauma induced infectious pathology prevention, early evaluation, management of complications and predicting outcomes. We studied the cases of 21 patients who developed Polytrauma induced Sepsis/Septic shock during different stages of hospitalization. We intended to study the dynamic level changes of Procalcitonin and Blood Lactic Acid in terms of Sepsis/Septic shock - induced by different types of trauma, in survived patients. At the initial stage Blood Lactate level in polytrauma patients was high, which was dynamically normalized after starting optimization of ventilation/oxygen therapy. It was totally different in case of Biomarker Procalcitonin. So we monitored the dynamic changes of it and made the correlation between the other factors/indicators. The data was registered during the first 45 days after the admission in the ICU (intensive care unit), as all the patients who survived during this period of time had good outcome. In order to see the dynamic changes, the levels of biomarkers were measured in every 5 days and were studied using Pearson correlation scheme. The study revealed that normalization of Blood Lactic Acid is in positive correlation with reconvalescence. Procalcitonin is an indicator of illness progression severity. It has strong positive correlation with White Blood Cells (WBC) and C-reactive protein (CRP) and negative correlation with Lymphocytes (LYM). In cases of Polytrauma induced sepsis or septic shock, the level started to increase within first 72 hours after traumatic injury, pick concentration was achieved within first 25 days high from the beginning and dynamically increases within first 25 days, the tendency of gradual decrease was seen after 30 days. C - reactive protein as a nonspecific indicator of severity in pathology progression, was manifested with high levels first, followed by the procalcitonin level changes. The systematic inflammation factors, like the number of Leukocytes and Lymphocytes, concentration of C-reactive protein are in correlation with procalcitonin and can play a significant role in early evaluation and management of polytrauma induced Sepsis and Septic Shock.

EFFECT OF FREE RADICALS ON CALCITONIN-GENE-RELATED PEPTIDE MEDIATED VASODILATION.

It is known that in some pathological conditions, due to the formation of a large number of free oxygen radicals, the cardiovascular system is severely affected. However, the effect of free radicals on CGRP-mediated vasodilation remains unclear. The aim of this work was to study the effect of free radicals on CGRP-mediated neurogenic vasodilation on preparations of an isolated rabbit lingual artery. The experiments were performed on the lingual artery preparations of 6 rabbits of the Chinchilla breed of both sexes. The contractile-relaxation activity of isolated preparations, both with intact endothelial layer and deendotelized, were studied in isometric mode on a strain-gauge unit using mechanotrons of the 6 MX1C type. Our experiments showed that free radicals can disrupt the reactivity of the vascular wall both in the presence and in the absence of endothelium-dependent relaxation factors and that is might be considered as a main conclusion of this study.