[Optimization of antisecretory component of severe acute pancreatitis intensive management].

Aim: Improvement of complex intensive care of severe acute pancreatitis with use of continued intravenous infusion of octreotid.

Methods: 85 patients with severe acute pancreatitis were involved into the investigation, were divided into 2 groups. Patients of the control group (44 patients) got an intensive care according to severe acute pancreatitis treatment.

[Problems in emergency care for concomitant injury in the Saratov region].

The paper deals with the topical problem in emergency care delivered to patients with severe concomitant injury at its all stages (prehospital, hospital, and interhospital transportation ones). The authors analyze the activities of anesthesiological-and-resuscitative units of therapeutic-and-prophylactic facilities in Saratov and its region from 1993 to 2003. The paper presents principal schemes of delivering emergency care in severe concomitant injury and considers the problems (material, logistic, professional, and organizational) hampering the delivery of emergency care, interhospital transportation, and the rendering of various medical aids at different-leveled hospitals.

[Prognosis and intensive care for massive obstetric blood loss].

The study covered 235 obstetric patients having varying blood loss (1.8 to 55.7%) at labor.

[Acute multiple organ dysfunction syndrome in peritonitis].

The laws of logic and logical research methods were made use of to assess the already published definitions of "polyorgan insufficiency" and "systemic inflammatory response". Many of them were proven to be far from being perfect; hence, the authors' independent understanding of such notions was suggested.

[Psychoemotional status of patients with endogenous intoxication in peritonitis].

While holding a complex neuropsychological testing of 60 patients with disseminated peritonitis, we encountered a problem of a secondary reactive somatopsychosis due to metabolic encephalopathy. It is noteworthy, that the severity of psychoemotional disorders expectedly progressed depending on a degree of endogenous intoxication. Such circumstance must be duly considered in composing and implementing an intensive care scheme for the discussed patients' category.

[Cerebral homeostasis disorder in patients with severe craniocerebral trauma during acute period].

Liquor distension, disorders of the cerebral hemodynamics as well as vegetative disorders and changes of immune reactivity in patients after a severe craniocerebral trauma are discussed. The examination of patients during the initial 10 days after trauma pointed at the relation of a cerebral trauma type with liquor distension, cerebral perfusion pressure, changes of the vegetative balance and with disorders of the auto-immune status. The most profound changes were observed in a severe craniocerebral trauma involving a severe cerebral contusion and compression.

[Immune status in the perioperative period in gestosis].

Search for new methods for the earliest possible diagnosis of pre-eclampsia for timely purposeful correction of the consequences of developing disorders remains the central problem of obstetrics. We evaluated the viability of some organs by measuring specific antibody titers. The study was carried out in healthy women and patients with severe gestosis.

[Premedication with different groups of hypotensive drugs in preparation of patients with concomitant arterial hypertension to planned surgical treatment].

Investigation of hemodynamic changes in 180 women liable to operations of supravaginal amputation were carried out in order to chose the optimum method of curative premedication in patients with essential arterial hypertension. The results obtained show that Adalat in dosage 60 mg daily during 7 days is most effective in cases with concomitant border-line hypertension. Anaprilin in dosage 160 mg daily and Adalat in dosage 60 mg/day during 7 days have the best hypotensive effect at the first stage of essential hypertension.

[The prevention of the hemorrhagic and pulmonary complications of extracorporeal detoxification in the multiple organ failure syndrome].

Based on an analysis of results of treatment of 216 patients with the syndrome of polyorganic insufficiency the authors have developed a method of extracorporal detoxication without using heparin. It includes preoperative haemodilution, administration of antithrombic deaggregating drugs. It leads to less amount of complications in efferent therapy of polyorganic insufficiency.

[Effect of heparin on the pulmonary surfactant system in experimental studies].

Experiments were performed in 9 dogs and 20 rats. The effect of heparin (3-4 mg/kg of the body weight) on the lung surfactant was studied under conditions of bacterial endotoxic shock. Heparin was found to decrease the surfactant content in lungs by 57.

[Gas exchange and metabolic functions of the lungs in endotoxic shock].

The experiments were carried out in 27 dogs with endotoxic shock under conditions of the artificial ventilation of the lungs and barbital anesthesia. It was established that under the above conditions the metabolic functions of the lungs were the first to be impaired. The artificial ventilation of the lungs fails to prevent the development of the impairment of the surfactant-synthesizing function of the lungs as well as the serotonin-inactivating function of the lungs.

[Effect of the type of anesthesia and the parameters of single-lung ventilation on the extent of venous shunt in lung surgery].

As a result of the studies, carried out upon 30 patients following lung operations, it has been found that an optimal hyperventilation of a single lung with an increased oxygen level in the respiratory mixture prevents the occurrence of hypoxemia and hypercapnia.