[Reaction of the sympathoadrenal system in young children with congenital heart defects during cardiopulmonary bypass surgery].

Reactions of the sympathoadrenal system were studied during surgical interventions in children aged 1.5-3 years with congenital heart disease operated under conditions of artificial circulation and hypothermia. The state of the sympathoadrenal system was different in uneventful and complicated course of the operation, which may indicate a different efficiency of the neurovegetative blocking and antistress protection from surgical trauma.

[The central hemodynamic changes and reaction of the sympathoadrenal system with the use of an original Russian analgesic fenaridin as the analgetic component of general anesthesia during aortocoronary bypass operations in patients with chronic ischemic heart disease].

The effect of fenaridine on the central hemodynamics and sympathoadrenal system was studied in 12 chronic coronary patients subjected to aortocoronary shunting and administered this drug as an analgetic component of general anesthesia. A reduction of heart rate, systolic arterial pressure, pressure in the pulmonary artery, total pulmonary resistance, more expressed decrease of cardiac index and stroke index, and an increase of total peripheral vascular resistance were observed. Analysis of the results permitted us to propose vasodilating effect of the drug, leading to a moderate reduction of cardiac index, and followed by a compensatory increase of vascular resistance, as the basic mechanism of these changes.

[Concentration of beta endorphin in blood as a criterion of adequacy of general anesthesia].

Considering beta-endorphin as a sign of tension and adaptation, the changes in its level have been studied during operations and surgery in patients with congenital heart valve defects subjected to cardiopulmonary bypass surgery. The goal of the study was determination of beta-endorphin concentration for the assessment of general anesthesia adequacy. A step-by-step study of beta-endorphin blood concentration, central and peripheral hemodynamics, diuresis, changes in temperature taken in 3 spots, adrenalin, dopamine and noradrenaline blood levels has been performed in 12 patients aged 4 to 17 years.

[The concentrations of somatotropic hormone and insulin in the blood of heart surgery patients with a complicated course of the postoperative period].

It has been shown that the course of the early postoperative period in cardiosurgical patients and its outcome is to a great extent related to adequate balance of adaptation hormones, whose levels and changes are determined by the functional state of compensatory-adaptive systems. Patients with favourable outcome of the complicated postoperative period along with synchronous activation of sympathoadrenal system (SAS), hypophyseoadrenal system (HAS) and an elevated somatotropic hormone (STH) level demonstrated adequately high blood insulin content, with the equilibrium in adrenalin/insulin and cortisol/insulin ratios retained, and moderate STH predominance over insulin. In 1/4 of patients with complicated postoperative period and unfavourable outcome an attenuated SAS response was accompanied by excessively high STH, ACTH, cortisol blood content and a lower insulin level, which determined relative insulin insufficiency.

[The effect of anesthesia on the neurohumoral regulation system and water-electrolyte balance during aortocoronary bypass].

Two methods of multicomponent general anesthesia distinct in the analgetic agent used to ensure analgesia have been compared. In group I (6 patients) analgesia was ensured by fentanyl at a dose of 10 micrograms/(kg/min), in group II (7 patients) it was ensured by pyritramide (dipidolor) at a dose of 2 mg/kg for the whole operative period. The study has shown that during aortocoronary bypass surgery in patients with ischemic heart disease analgesia is better ensured by pyritramide than by fentanyl administration.

[Relations of catecholamine and prostaglandin contents in the blood of rats exposed to acute stress and during adaptation to stress].

In Wistar male rats, 1-h acute immobilization stress resulted in the increased plasma adrenalin, noradrenaline and dopamine in approximately 13, 8 and 23 times, respectively. Plasma PGF2 alpha increased in 3.5 times while PGE remained unchanged; this resulted in the decreased PGE/PGF2 alpha relation in 2.

[Total intravenous general anesthesia during radical correction of tetralogy of Fallot].

Three techniques of general intravenous anesthesia were compared, using mathematical parameters of the heart rhythm, hemodynamic and sympathoadrenal system responses, arterial blood Hb saturation with O2 (SaO2) and thermometry. It has been established that anesthesia with dipidolor ensures adequate protection against the operation stress both in patients with tetralogy of Fallot previously subject to interarterial anastomoses and patients with tetralogy of Fallot without anastomoses. Combined fentanyl and ketamine anesthesia ensures an adequate protection against the operation stress only in patients with tetralogy of Fallot without anastomoses.

[The effect of renal arterio- and phlebography on the function of the renin-angiotensin and hypophyseal-adrenal systems].

Based on the analysis of a RX-ray study and a selective blood test for the activity of the plasma renin, aldesterone, hydrocortisone and adrenocorticotropic hormone (ACTH) in 57 patients with arterial hypertension--14 persons without renal failure, 14 ones regularly treated by hemodialysis, 29 patients with left orthostatic varicocele--the authors demonstrated the impact of the renal arterio- and phlebography on the hormone levels studied. Arteriography resulted in an increase in the absolute value of the renal vein renin mean 2.1-fold, aldosterone, 3.

[Diagnosis and roentgeno-endovascular treatment of patients with renin-dependent arterial hypertension and secondary aldosteronism without damage to the main renal arteries].

Bilateral electrocoagulation of the central veins of the adrenals (ECVA) was performed in 13 patients with stable and malignant arterial hypertension (AH). The renin-dependent character of AH was supported by positive reaction of arterial pressure (AP) to the test dose of captopril (25 mg). The vasorenal origin of the impairment was excluded on the basis of the peripheral captopril test findings, pharmacorenography with captopril.

[The course of the early postoperative period in heart surgery patients in relation to the state of humoral regulatory mechanisms].

It has been shown that the course and outcome of the early postoperative period in cardiosurgical patients are to a great extent related to the functioning of the adaptation systems under study and their interrelations. An essential role of sympathoadrenal system (SAS) in the control over hormonal body status has been established. It ensures, provided its activity is retained, interaction of other hormonal systems as a uniform functional mechanism in postoperative stress.

[Angiotensin converting enzyme activity in atrial and cubital venous blood].

The relationship between the activities of the blood angiotensin-converting enzyme (ACE) and the site of the blood collection (radial artery, peripheral vein, left atrium) was examined in 15 patients with congenital heart diseases operated on with artificial circulation. No statistically significant differences in ACE activities in the blood from the vein, artery, or left atrium was detectable (p greater than 0.05).