Post-resuscitation disease--a new nosological entity. Its reality and significance.

Experimental and clinical investigations of patients resuscitated after cardiac arrest or terminal states, testify to the fact that in the post-resuscitation period alongside processes of recovery and compensation, a number of new pathological phenomena develop. The latter differ substantially from those caused by ischemia and hypoxia. These post-resuscitation processes involve not only the CNS, but also the entire body and may lead to severe disability and even death of the seemingly successfully revived body.

Neurological aspects of reanimatology.

The science of resuscitation and correspondingly the more effective methods of death management have come up to the place of a century-old, as a rule, empirical struggle for the life of a dying human being. Mechanisms of dying and resuscitation have become the objects of comprehensive scientific research. Studies of the mechanisms of genesis of hypoxia and posthypoxic pathology of the brain have allowed us to reveal the whole complex of postischaemical factors participating in the development of post-resuscitation encephalopathies, among which the leading ones are the changes in the energy formation processes, disorders in protein and phospholipid metabolism, activation of proteolysis enzymes and changes in the state of membrane systems of neurons.

Postresuscitation disease.

The postresuscitation disease is a specific pathophysiologic state of vital organ systems early after ischemic anoxia. This report summarizes reviews of past research and makes suggestions for future research concerning revival of the cerebral cortex after clinical death, CNS stimulation vs. sedation, postischemic coma and pain, near-death experiences, and extracerebral derangements.

Reanimatology and its urgent problems.

Reanimatology is a science aimed at preventing central nervous system (CNS) destruction and completely restoring function after terminal states and clinical death. The most important present trends in reanimatology are the study of the limits of ischemic tolerance by cerebral cortical neurons and investigations into the basic mechanisms of pathology and viability during and after hypoxia. After terminal states there are changes in the content, electrophoretic patterns and physico-chemical properties of brain proteins, and in lysosomal and cytoplasmic hydrolase activities.

Resuscitation aspects of ultrafiltration and haemodialysis.

Results of using the method of sequential ultrafiltration with hemodialysis and that of hemodiafiltration in the treatment of 70 patients with acute and chronic renal failure in terminal states are described. The patients were under observation in the course of 202 procedures of hemodiafiltration and 175 sequential ultrafiltration with hemodialysis. Apart from this, 21 procedures of isolated ultrafiltration were carried out in patients with pronounced cardiac failure, irreversible pulmonary edema resulting from acute myocardial infarction and heart diseases.

Criteria of efficiency and safety of the defibrillating impulse.

The effectiveness and safety of the defibrillating effect of a bipolar impulse produced by a Soviet DK1-01 defibrillator and the Monopolar impulse Ed-Mark have been tested in 14 experiments on the anaesthetized dogs. A quantitative criterion to compare the safety of different defibrillators and an electro-therapeutic index of the defibrillating action are being suggested. It is defined as the ratio of the thresholds of energy in joules causing lesions to that causing defibrillation.

Experimental extracorporeal haemabsorption in the post-resuscitation period in dogs.

Experimental extracorporeal haemabsorption in dogs, administered in the post-resuscitation period after cardiac arrest due to electro-trauma, improved the blood chemistry and diminished the acidosis considerably.