The combination of Euroscore II with a new variable "Nongraftable coronary artery lesions" improves the discriminating power of the test in surgical patients with postinfarction ventricular septal defect and ventricular aneurysm.

Background: We aimed to establish whether Euroscore II can be used for the prediction of hospital mortality in surgical patients with postinfarction intraventricular septal defect (PIVSD) and ventricular aneurysm (VA), and coexisting coronary artery lesions (CALs), and identify perioperative mortality risk factors to improve the discriminating power of Euroscore II.

Methods: This was a retrospective observational study. The inclusion criterion was PIVSD.

Complete anatomic surgical myocardial revascularisation during postinfarction ventricular septal defect and ventricular aneurysm repair is associated with improved short- and long-term outcomes.

Background: Coronary artery bypass grafting (CABG) is recommended during acute postinfarction ventricular septal defect (PIVSD) repair, but clinical benefits of surgical revascularization in patients with subacute PIVSD have not been established. We aimed to evaluate the association of primary complete anatomic surgical myocardial revascularization (CASMR) during PIVSD and ventricular aneurysm (VA) repair on patients' short- and long-term outcomes.

Methods: This was a retrospective observational study.

[The peculiarities of the comprehensive study of buprenorphine].

The authors describe the methods of pharmaceutical and criminalistics analysis that are finding the increasingly wider application for the drug expertise (identification) and elucidation of the circumstances conducive to the commission of an offence. The special emphasis is laid on the buprenorphine studies with the use of the colour chemical reactions, thin-layer chromatography, gas chromatographic analysis, high-performance liquid chromatography, IR spectrometry, and other modern techniques. The methods based on the recent achievements in pharmaceutical and criminalistics sciences can be employed in the activities intended to control the illegal drug circulation.

[LEVOSIMENDAN--THE FIRST 10 YEARS IN CLINICAL PRACTICE].

The article deals with a survey of the main pharmacological effects of levosimendane. Special attention is paid to cardiac and organ protective properties of the medication. The article reviews literature data on the efficacy of levosimendan in various fields of medicine and in the experiment and highlights the problem of heart failure and low cardiac output syndrome treatment in cardiology and cardiac surgery.

Prevention of infectious complications after heart surgery in children: procalcitonin-guided strategy.

Introduction: Infectious complications remain a significant problem of modern cardiac surgery. New prevention strategies, based on the pathogenesis of such complications occurring after cardiopulmonary bypass (CPB) procedures, should be evaluated.

Aim Of The Study: To evaluate the effectiveness of a procalcitonin (PCT)-guided strategy involving the use of IgM-enriched intravenous immunoglobulins (IVIGs) in children with congenital heart disease with systemic inflammation during the early postoperative period.

[Cases of successful treatment of heart failure after cardiac surgeries].

Unlabelled: Low cardiac output syndrome (LCOS) is a leader in the structure of complications and mortality in patients after cardiac and vessels surgery. LCOS causes circulatory hypoxia. Opportunity to use of new inotropic drug draws attention of anaesthesiologists, and ICU physicians of cardio-surgical centers.

[Diagnosis and correction of thrombohemorrhagic complications in cardiosurgical patients in the early postoperative period].

The methods of the prevention, diagnosis, and correction of hemostatic disorders are discussed in cardiosurgical patients. Prevention of hemorrhages requires hemostatic history data collection that allows identification of patients with concomitant hemophilia and those, taking antithrombotic drugs. The benefits of an extended study of blood coagulation disorders are shown in neonates and babies of the first year of life due to the physiological features of the hemostatic system and the pattern of heart disease.

[Intensive care for newborns and babies of the first year of life with acute heart failure after cardiosurgical interventions].

After cardiosurgical interventions, the incidence of low cardiac output syndrome (LCOS) is 3-10% depending on age and surgery. The basis for management of patients with LCOS and high pulmonary hypertension is to maintain low total peripheral vascular resistance and to exclude volume overload. Due to the fact that the Russian Federation lacked phosphodiesterase (PDE) III inhibitors that are basic intensive care drugs in pediatric surgery in the West, levosimendan was used as an inodilator in the complex intensive care for postoperative LCOS in 75 infants aged 3 days to 2 years 10 months in October to December 2007.

[The initial period in the formation of cardiac resuscitation service at the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences (1948-1973)].

The paper describes and analyzes the initial period in the formation of cardiac resuscitation service at the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences, from the first heart operation performed in the USSR to the setting up of the resuscitation-anesthesiology department.

[The use of assisted circulation in cardiosurgical clinic].

The first experience with the use of different artificial circulation systems for the treatment of critical cardiac insufficiency in A. N. Bakulev Research Centre of Cardiovascular Surgery is described.

[The arsenal of extracorporeal circulation systems in pediatric cardiosurgery].

The paper presents the arsenal of extracorporeal circulation systems used in the surgical treatment congenital cardiac diseases. It provides some experience in using the extracorporeal circulation systems, indications for and contraindications for their use, and a working classification of extracorporeal circulatory techniques. Their methodological features, criteria for the adequate use of extracorcopreal techniques, and the results of their application are described.

[Acute respiratory distress syndrome in pediatric cardiosurgery].

The prognosis in acute respiratory distress syndrome (ARDS) is poor; its mortality is generally 40-60%. The mortality in patients with ARDS is more commonly associated with the sequels of sepsis and multiple organ dysfunction than with respiratory failure although the latest papers on protective ventilation suggest that death in these patients directly results from lung lesion in a number of cases. There have been encouraging data on the reduced mortality rates due to acute lung lesion/ARDS in the past decade.

[Intensive care for newborns and infants after anatomic correction of transposition of great vessels].

A retrospective study was made in 48 babies undergone an arterial switching operation at the Bakulev Research Center of Cardiovascular Surgery in January 2004 to September 2005. Their age at surgery was 5 days to 11 months; body weight, 3.9 +/- 1.

[Use of the exogenous surfactant curosurf in combined therapy for acute respiratory failure in children after cardiosurgical interventions].

This study was undertaken to evaluate the effectiveness and safety of use of an exogenous surfactant in combined therapy for acute respiratory failure in children after cardiac surgery. In 2003 to 2004, the A. N.

[Intensive therapy for multiple organ dysfunction in neonatal infants after cardiosurgical interventions].

This study was undertaken to evaluate the efficiency of complex intensive therapy for multiple organ dysfunction syndrome (MODS) after cardiosurgical interventions at the resuscitative and intensive care unit of the A. N. Bakulev Research Center of Cardiovascular Surgery, Russian Academy of Medical Sciences.

[Experience with rotation of basic antibiotics in intensive care unit of cardiosurgical hospital].

Clinical and microbiological efficacies of antibiotic rotation in the intensive care unit of the Hospital were evaluated. The results of the local microbiological monitoring of the profile of the acquired resistance of gramnegative nosocomial pathogens (n = 151) isolated from adult patients with artificial ventilation of the lungs for more than 3 days after the open heart operations (n = 150) were analysed. Three 6-month cycles of cephalosporins rotation in the following order were performed: cefoperazone--ceftazidime--cefepime.

[The effect of long-term UV radiation exposure on the skin autonomous microflora and on body nonspecific resistance].

Hairless mice of strain HRS were exposed to vertical UV-B-irradiation (280-320 nm) at daily doses of 1 or 2 kJ/m2 (biologically effective doses 200 and 400 J/m2) five days a week for 13 and 6 weeks. As the length of exposure increased, the abundance of automicroflora of the dorsal skin first decreased, then exceeded the control value, was normalized, and remained at the normal level until the end of the experiment. The rates of effect appearance and disappearance, just as its amplitude, increased with the daily doses.

Biospecific haemosorbents based on proteinase inhibitor. III. Biospecific antiproteinase haemosorbent 'Ovosorb' in complex therapy of acute destructive pancreatitis.

Analysis was carried out of the results of complex therapy in 32 patients with acute destructive pancreatitis for which haemosorbtion on Ovosorb, a biospecific antiproteinase haemosorbent containing an immobilized ovomucoid, was used. The clinical efficiency of haemosorbtion was displayed as a decrease in gravity of endogenous intoxication and related functional and metabolic disturbances, as well as in a reduction of lethality from 24.7% to 6.

Biospecific haemosorbents based on proteinase inhibitor. II. Efficiency of biospecific antiproteinase haemosorbent 'Ovosorb' in complex treatment of experimental generalized purulent peritonitis and acute destructive pancreatitis in dogs.

The biospecific antiproteinase haemosorbent (BAH) 'Ovosorb' containing, in the bulk of polyacryamide gel, the ovomucoid from whites of duck eggs, was used for a complex treatment of the experimental generalized purulent peritonitis and acute destructive pancreatitis in dogs. The efficiency of BAH was manifested in the significant reduction of lethality of the experimental animals, a more rapid liquidation of proteinasaemia, normalization in plasma of alpha 1-proteinase inhibitor and protein metabolism. Thus, by eliminating proteinases from circulation, Ovosorb contributes to the cessation of imbalance in the proteinase-inhibitor system and is efficient in the therapy of pathological states related to this imbalance.

[Effectiveness of the biospecific antiproteinase hemosorbent "Ovosorb" in the comprehensive treatment of diffuse suppurative peritonitis and acute destructive pancreatitis in dogs].

The authors examined the efficacy of the biospecific antiprotease hemosorption Ovosorb containing ovomucoid from duck egg protein as part of polyacrylamide gel, which was used in the multimodality treatment for experimental diffuse pyoperitoneum and acute destructive pancreatitis in dogs. Ovosorb effectively diminished proteasemia, restored the plasma inhibitory potential by eliminating dysproteinemia, suppressed the production of secondary peptide endotoxins. These effects of the hemosorbent promoted the regression of endotoxicosis and the significant reduction in experimental animal deaths.

[The use of a biospecific antiproteinase hemosorbent in the combined treatment of acute destructive pancreatitis].

Results of treatment of 32 patients with acute destructive pancreatitis are presented. Hemosorption on biospecific antiproteinase hemosorbent "OVOSORB" possessing the property of extraction of the excess of serine proteinases from blood plasma was used. High efficiency of the sorbent for treatment of destructive pancreatitis was shown.