[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.

[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.

[Contractile function of the myocardium in suppurative peritonitis in children]. / Sokratitel'naia funktsiia miokarda pri razlitom peritonite u detei.

On the basis of an analysis of findings of polycardiography in 55 children a conclusion is made that in patients with diffuse peritonitis without a demarcation of the process in the abdominal cavity changes in the contractile function of the myocardium were more pronounced and not infrequently persisted till their discharge from the hospital. Greater disturbances in cardiodynamics were found in children with a postoperative peritonitis. Special medication under the polycardiogram control is thought to be necessary. Age-related distinctions in the functional state of the myocardium were noted in the most critical group of patients.

[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.

[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.

[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.

[Hemodynamic disorders and their correction in peritoneal dialysis of children with acute renal failure]. / Narusheniia gemodinamiki i ikh korrektsiia pri peritoneal'nom dialize u detei s OPN.

Hemodynamic disorders occurring during acute renal failure (ARF) in children with the hemolytic uremic syndrome and the effects of peritoneal dialysis on hemodynamics were studied. A complex of electrophysiological methods was used: Integral whole body rheography, electrocardiography, and polycardiography, which permitted assessment of the severity and type of hemodynamic disorders in ARF. Three main types of hemodynamic changes were observed: hypodynamic, hyperdynamic, and normodynamic. The circulation regimen depended on the manifestation of extracardiac (hypovolemia, increase of the total peripheral resistance) and/or cardiac factors (reduction of the cardiac pump and contractile functions as a result of myo- or pericarditis, metabolic disorders in the myocardium). Specification of the hemodynamic diagnosis permitted a purposeful correction of the hemodynamic disorders (sympathomimetic amines, cardiac glycosides, vasodilators, infusion therapy). Peritoneal dialysis had an unfavorable effect on the hemodynamics of patients with impaired pump function of the myocardium and of those with hypovolemia, deteriorating at the same time the tolerance to volumic loading. Dopamine infusion reduced the hemodynamic disorders both "on an empty abdomen" and after filling of the abdominal cavity. Goal-oriented correction of the hemodynamics helped reduce the circulatory disorders during all stages of treatment of ARF.