[Respiratory disorders in patients with acute arterial occlusion of legs and ischemic syndrome]. / Dykhatel'nye rasstroístva u bol'nykh s ostroí arterial'noí neprokhodimost'iu i ishemicheskim sindromom nizhnikh konechnosteí.

The analysis of postoperative period in 325 patients with acute lower extremities' arterial obstructions and in 100 patients with chronic obstructive diseases of the lower extremities' arteries has been done. Specific features of the external respiratory function, acid-base balance and arterial blood gases were tested in 70 patients. In patients with the acute ischemia of lower extremities the rate of pulmonary complications in the early postoperative period was 64%, in patients with chronic occlusive diseases--42%. Thromboembolic complications caused by hypoxemia and blood rheology disorders were predominant. Ventilation disorders were of combined (restrictive-obstructive) nature, and are mostly expressed on the 1st-3d postoperative day. Their rate is corvelated with the level and duration of preoperative ischemia. The pulmonary gas exchange function was damaged, as shown by persistentin arterial blood hypoxemia present during all early postoperative period.

[Effects of intravascular laser irradiation of blood on erythrocyte stereo-ultrastructure in the treatment of generalized suppurative peritonitis]. / Vliianie vnutrisosudistogo lazernogo oblucheniia krovi na stereoul'trastrukturu éritrotsitov pri lechenii razlitogo gnoinogo peritonita.

The authors analysed the course and the results of examination of peripheral blood in dynamics and study of red cell stereo-ultrastructure in dynamics before and after sessions of intravascular laser irradiation of blood (ILIB) and treatment in 120 patients with peritonitis, in 60 of them ILIB was applied in the complex of intensive therapy (main group). The control group was made up of 60 patients. The studies showed a favorable curative effect of ILIB: the morphological characteristics of red cells and peripheral blood in patients with peritonitis improves. The laser irradiated blood evidently stimulates the bone marrow and the organs in which blood elements are stored as a result of which their ejection into circulation intensifies. The favorable effect of ILIB is also manifested by increase of the number of intermediate and reduction of the number of prehemolytic and degenerating forms of red cells in various stages of peritonitis, i.e. ILIB affects mainly the retransformation of stomatocytes into discocytes but produces no marked effect on echinocytic transformation.

[The pulmonary distress syndrome during acute arterial occlusion of the lower extremities]. / Distress-sindrom legkikh pri ostroi arterial'noi neprokhodimosti nizhnikh konechnostei.

After surgery for acute arterial occlusion in the lower extremities 59 patients have developed tachypnea, respiratory alkalosis and arterial hypoxemia. These symptoms persisted over the whole postoperative period. In 66% of dead patients pulmonary changes have been observed and only in 34% of patients who died suddenly the lungs were unaffected. Morphological changes in the lungs are most marked in long-standing ischemia and have the signs of the "shock lung" (adult respiratory distress syndrome). Pronounced changes in the respiratory function, acid-base balance, blood gas composition can account for a more severe course of the disease, deteriorate the prognosis, predetermine multiorgan failure in the early postoperative period.

[Pathology of the lungs in patients with acute arterial obstruction in the lower extremities]. / Patologiia legkikh u bol'nykh s ostroi arterial'noi neprokhodimost'iu nizhnikh konechnostei.

The course of the early postoperative period has been analysed in 325 patients with acute thrombosis and embolism; the results of 104 autopsies have been reviewed and macro- and microscopic lung studies have been performed using light microscopy. It has been established that broncho-pulmonary complications are most frequently encountered in the early postoperative period. Morphological changes in the lungs are proportional to the duration and severity of acute ischemia. In durable and severe ischemia the changes are progressing and are characterized by the elements of the "shock" lung. The morphological changes observed specify mechanisms of the onset of acute respiratory failure and broncho-pulmonary complications. They must be taken into consideration during intensive therapy.

[Changes in erythrocytes, acid-base equilibrium and blood gases in acute thromboembolism of the aorta and major arteries]. / Izmeneniia éritrotsitov, kislotno-shchelochnogo ravnovesiia i gazov krovi pri ostrykh trombozakh i émboliiakh aorty i magistral'nykh arterii.

The article deals with the analysis of the course of the disease, the postoperative period, and complications in 293 patients and the results of study of the red cell ultrastructure and the acid-base equilibrium and blood gas composition in 33 patients with thrombosis and embolism of the main limb arteries. It was shown that the blood, its red cells, is the system which is mainly affected by endotoxins and high concentrations of biologically active substances occurring in the blood flow. According to the form of the red cells (normocytes, echinocytes, spheroechinocytes) and the quantitative relationship the depth of the pathological process can be judged. Shifts of the acid-base equilibrium in the direction of metabolic acidosis is compensated by intensified lung ventilation. Metabolic alkalosis appears in advanced cases. The revealed shift should be taken into account in applying intensive therapy.

[Improving the clinico-microbiological diagnosis and treatment of non-clostridial anaerobic peritonitis]. / Sovershenstvovanie kliniko-mikrobiologicheskoi diagnostiki i lechenia neklostridial'nogo anaérobnogo peritonita.

On the basis of clinico-microbiological examinations the presence of anaerobic flora was found in 104 out of 198 patients with peritonitis. The authors propose using intra-aortal++ transfusions of oxygenated blood in complex therapy of anaerobic peritonitis.

[Correction of pulmonary hypertension in heart surgery patients during the immediate postoperative period]. / Korrektsiia legochnoi gipertenzii v blizhaishem posleoperatsionnom periode u kardiokhirurgicheskikh bol'nykh.

Long-acting nitrates given to patients undergone mitral commissurotomy caused a decrease in pulmonary hypertension severity. With nitroglycerin, euphylline, and papaverine, pulmonary pressure and total pulmonary and pulmonary arterial resistances, which was followed by enhanced cardiac output, optimized ejection fraction, and mean left ventricular blood ejection rate.

[The pathogenesis of respiration disorders in acute ischemia of the lower extremities and their correction using hemosorption]. / [K patogenezu dykhatel'nykh rasstroistv pri ostroi ishemii nizhnikh koneshnestei i korrektsii ikh s pomoshch'iu gemosorbtsii.

The level of hormones, metabolites, toxins and biologically active substances that reflects the degree of endogenous intoxication increases drastically in acute ischemia and revascularization of the extremity and decreases upon hemosorption (HS). This can be accounted for by their adsorption on the sorbent. According to the data of electron microscopy this pathology is accompanied by morphological signs of the "shock lung". Upon HS dystrophic and destructive changes in lung capillaries and alveolar epithelium are minimum. It is believed that surfactant release from second type pneumocytes promotes to the extension of alveoli and decrease of atelectasis. The early application of HS is pathogenetically grounded.