[Evaluation of metabolic disorders in surgical patients]. / Otsenka metabolicheskikh narushenii u khirurgicheskikh bol'nykh.

The paper treats the problems of metabolism derangement in surgical patients. Special emphasis is laid on the correction of metabolic abnormalities in the pre- and postoperative periods and on the use of parenteral feeding in surgical complications: incompetence of anastomosis sutures, peritonitis, intestinal fistulas, and so forth. The authors define the role of the drugs of directed action in such a severe pathology as hepatorenal insufficiency.

[Correction of osmotic-volume status by parenteral feeding of patients with stomach cancer]. / Korrektsiia osmovolemicheskogo statusa sredstvami parenteral'nogo pitaniia u bol'nykh rakom zheludka.

The paper discusses the interrelationship between osmo-volume parameters of homeostasis as well as the role of adequate parenteral nutrition in correction of surgery-associated disorders in gastric cancer patients. The study included 123 such cases. The baseline circulating blood volume and that of blood components was found decreased whereas blood serum osmotic index elevated. The above parameters correlated with each other and depended upon site and extent of tumor. Advanced cases with depleted reserves do not always respond to correcting therapy which may influence the outcome of surgery.

[The effect of surgical trauma on the metabolism of essential fatty acids in patients with cancer of the esophagus and stomach]. / Vliianie operatsionnoi travmy na metabolizm nezamenimykh zhirnykh kislot u bol'nykh rakom pishchevoda i zheludka.

The dynamics of levels of essential fatty (linolic and arachidonic) acids in blood plasma and erythrocytes as well as that of free fatty acids fraction versus duration of surgery was assessed by gas chromatography in 49 patients with cancer of the esophagus and gastric cardia. Surgical procedures lasting longer than 5 hours are followed by overmobilization of essential fatty acids from body lipids their endogenous store being depleted. As a result, a double increase in the level of free arachidonic acid, an immediate prostaglandin precursor, develops to satisfy the body's augmented requirements in essential fatty acids due to application of aggressive surgical procedures.

[The use of artificial feeding during the resuscitation of heart surgery patients]. / Ispol'zovanie iskusstvennogo lechebnogo pitaniia v reanimatsionnom periode u kardiokhirurgicheskikh bol'nykh.

The data on the use of various schemes of artificial nutrition (AN) are reviewed in 137 patients with postoperative complications after cardiopulmonary bypass surgery. It has been established that AN as part of a complex therapy of patients in the early postoperative period has a correcting effect on metabolism and promotes the improvement of the patients' clinical condition. Rational combination of parenteral and enteral tube nutrition ensures adequate AN of cardiosurgical patients in the early postoperative period.

[The effect of parenteral feeding on the metabolism of arachidonic acid in patients with cancer of the esophagus and the stomach]. / Vliianie parenteral'nogo pitaniia na metabolizm arakhidonovoi kisloty u bol'nykh rakom pishchevoda i zheludka.

Blood plasma and erythrocyte level of arachidonic acid (C20:4) and blood plasma level of its two metabolites (6-keto-PGF1 alpha and TXB2) have been investigated in 24 patients with esophageal and gastric cancer. In the preoperative period and during 8-10 days postoperatively 12 patients were on "glucose" energy supply (group I) and 12 patients were on "lipid" energy supply (group II). Daily calorie intake was 30-35 kcal/kg. In the preoperative period Lipofundin-S infusions produced a significant increase in C20:4 blood plasma and erythrocyte levels. An increase in TXB2 concentration was accompanied by a certain increase in 6-keto-PGF1 alpha content. At the same time in group I parenteral feeding caused no significant changes in the above parameters. Surgical trauma and anesthesia caused a considerable increase in 6-keto-PGF1 alpha blood plasma level in both groups (P less than 0.05), with a certain decrease in TXB2 level (P greater than 0.05). In the postoperative period, unlike "glucose", "lipid" energy supply stabilized C20:4 content in the erythrocyte membrane and favourably affected 6-keto-PGF1 alpha/TXB2 ratio. This is confirmed by a considerable increase in 6-keto-PGF1 alpha/TXB2 ratio, which in the course of the postoperative period was significantly higher in group II than in group I.

[Parenteral feeding during radiotherapy of oncological patients]. / Parenteral'noe pitanie pri luchevoi terapii onkologicheskikh bol'nykh

Radiotherapy is found to induce a number of metabolic changes in oncological patients. These are manifested in the loss of intracellular elements: kalium, nitrogen and retention of extracellular elements: sodium and water. An adequate parenteral feeding with calories rich fat emulsions and readily absorbed aminoacid mixtures might correct metabolic shifts occurred as a result of radiotherapy and provide for a complete course of radiation treatment.