[Immunological indices of "drainage" blood used for compensation of blood loss].

The authors discuss experience in compensation for blood loss in patients with ischemic heart disease after aortocoronary shunting using drainage blood without or with donor blood (80 persons) and donor blood alone (60 persons). Mild changes of immunity cell factors were revealed and no differences in the concentration of class A, M, and G immunoglobulins and phagocytosis as compared to the indices recorded before the operation and 24 hours after it. Analysis of postoperative infectious-inflammatory complications showed their incidence to be less in patients who received drainage blood without or donor blood (23%) than in those given transfusion of only donor blood (55%).

[Current approaches to the prevention of infectious complications in heart surgery].

Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation.

[The prostacyclin-thromboxane system and platelet hemostasis following aortocoronary bypass with an uncomplicated postoperative course].

Prostacyclin-thromboxane system and platelet hemostasis have been studied in 56 patients upon aortocoronary bypass surgery with uncomplicated early postoperative period. It has been established that cardiopulmonary bypass surgery leads to a considerable increase in 6-keto-PGF1 alpha and TXB2 levels per platelet, as compared to preoperative values. By hour 18 postoperatively 6-keto-PGF1 alpha to platelet number ratio returns to baseline, while TXB2 to platelet number ratio remains higher than preoperative values, which determines a shift in 6-keto-PGF1 alpha to TXB2 ratio towards TXB2, thus ensuring, probably, enhanced platelet aggregation properties.

[The role of lactate acidosis and enzyme hyperactivity in evaluating hypoxic organ disorders in patients following cardiopulmonary byøass].

One hundred and fifty patients after cardiopulmonary bypass surgery have been examined. It has been shown that overall enzyme activity should be taken into consideration when determining the genesis of postoperative hyperenzymemia and diagnosing the topical (organic) damage. High lactate level (6-8 mmol/l) reflects profound circulatory hypoxia and shows a great likelihood of secondary damage of parenchymatous organs in patients after cardiopulmonary bypass surgery.

[The prostacyclin-thromboxane system and thrombocytic-vascular hemostasis in patients with ischemic heart disease in the preoperative period].

Prostacyclin-thromboxane system (PTS) and platelet-vascular hemostasis have been studied in the preoperative period in 35 ischemic patients. A marked PTS disbalance with predominance of plasma thromboxane has been found. It has been established that in patients with postinfarction cardiosclerosis plasma prostacyclin content was significantly higher than in patients without myocardial infarction.

[Effect of hyperbaric oxygenation on central hemodynamics and oxygenating function of the lungs in open-heart surgery].

The dynamics of some oxygenating pulmonary function (OPF) indices has been studied in 33 patients with coronary cardiac disease and rheumatic lesions of cardiac valves 4-6 hours after surgery in response to a single hyperbaric oxygenation (HBO) session (1.5 ata, 45 min) in the immediate postoperative period. It is found that in the presence of slight or, on the contrary, pronounced arterial hypoxemia, no significant negative OPF changes were observed.

[The status of the renin-angiotensin-aldosterone system in patients in the early period following aortocoronary bypass surgery].

The state of renin-angiotensin-aldosterone system has been studied in 43 patients after aortocoronary bypass surgery. Renin activity, angiotensin II and aldosterone content have been studied, using radioimmunoassay, in comparison with hemodynamic findings and water-electrolyte balance parameters. The study was performed in patients with uncomplicated postoperative period and in patients with acute circulation disturbances just after surgery and 3, 6, 18 and 48 hours after surgical intervention.

[Various aspects of the status of humoral immunity in patients after surgical correction of rheumatic heart defects under artificial circulation].

The serum concentrations of immunoglobulins A, M, and G were studied in 70 patients with rheumatic heart diseases and in 72 patients with spontaneous and pokeweed mitogen-induced production of these immunoglobulins and mononuclear peripheral blood cells. The investigations were done before and 1-2 and 7-8 days after surgery. Some patients received myelopid in the early postoperative period in addition to the conventional methods of therapy.

[Dynamics of the level of plasma vasopressin and its role in the regulation of water-electrolyte metabolism in patients following aortocoronary bypass].

Changes in plasma vasopressin, K+, Na levels, osmolality in blood and urine samples, as well as hemodynamic parameters, cardiac output and circulating blood volume including, have been assessed in 38 patients 3, 6, 18 and 48 hours after aortocoronary bypass surgery. It has been found that vasopressin blood level in the postoperative period is considerably (5-7 times) higher than physiological hormone level. The main reasons for vasopressin blood level increase are surgical stress, increase in blood plasma osmolality, hypokalemia, a drop of the arterial blood pressure and central venous pressure elevation.

[Disorders of O2 transport and their correction in heart surgery patients].

Basic factors of O2 transport disturbances and mechanisms of their compensation have been studied in 1200 patients after cardiac surgery. It has been shown that O2 transport decrease is induced by damages in oxygenating blood function, decreased cardiac performance and hemoglobin blood level, oxyhemoglobin dissociation curve deviation and changes in Hb affinity to O2 with regard to 2,3-DPG content. The causes of arterial O2 transport damage affect the treatment procedures, including oxygen therapy, controlled lung ventilation, erythrocyte mass transfusion, inotropic drug administration, hypothermia.

[Clinical use of tramal in patients in the early postoperative period].

Tramal was given to 204 patients who were operated on the lung, heart, abdomen. During pain therapy, good and satisfactory results were on average obtained in 75% patients operated on the lung, in 77%, on the heart, in 89%, on the abdomen, in 70%, on the great vessels. The absence of the inhibitory effect of the drug on the respiratory center and its slightly marked sedative effect allow one to recommend the agent for application in the early period following the surgery when narcotic analgesics still retain their effect and a real risk of their overdosage exists.

[Current methods of assessing hemodynamics in the intensive care unit (comparative aspects)].

The paper deals with comparative characterization of validity shown by current techniques for assessing hemodynamic parameters such as radiocardiography, echocardiography, Doppler cardiography, electroimpedance indicator separation, alveolar gas carbon dioxide concentration change technique, tetrapolar chest rheography and their potential role in the practice of intensive care and resuscitation units.

[Diagnostic value of laboratory indicators in various states of oxygen transport function of the blood in patients, operated on under conditions of cardiopulmonary bypass].

Changes in oxygen and acid-base balance have been studied in 86 patients with different oxygen transport function after cardiopulmonary bypass surgery. It has been shown that diagnostic value of such indexes as SO2 and pO2 in mixed venous blood, O2 consumption and transport, blood and erythrocyte acid-base balance, lactate concentration depends on the cardiac pump function, microcirculatory patterns, pulmonary oxygenation and cell metabolism. In case of acute circulatory disturbances in the early postoperative period the prognostic value of each laboratory finding is in close correlation with the degree of circulatory failure.

[Use of sympathomimetic agents in the treatment of acute circulatory insufficiency in the immediate postoperative period of heart surgery patients].

Sympathomimetic agents: isoproterenol (novodrin), dopamine, noradrenalin, adrenalin were used in 137 patients with acute circulatory insufficiency. Their hemodynamic effects were assessed, using catheterization of heart chambers and radiocardiography, and studies of circulating blood oxygen transport, acid-base state and metabolic product levels. A differential approach to sympathomimetic treatment has been developed.