[The correction of metabolic disorders in severely burned patients by enteral hyperalimentation].

An investigation was carried out of the metabolic processes, and some procedures for standardizing them, for patients with severe burns receiving uniformly distributed dosified high-calorie catheter alimentation, i.e. enteral hyperalimentation, in addition to the hospital's daily diet.

Enteral hyperalimentation of burned patients: the possibility of correcting metabolic disorders by the early administration of prolonged high calorie evenly distributed tube feeds.

Metabolic processes and the ways they may be treated were investigated in severely burned patients receiving prolonged high calorie evenly distributed tube feedings. It was shown that in critically ill patients the absorption of nutrients in the upper regions of the intestine was slightly impaired but the ability to absorb was preserved, which made it possible to provide prolonged evenly distributed tube feeding. For these purposes we used the nutrient mixture 'Combustal'.

[Intra-abdominal hemorrhages in the early postoperative period and their diagnosis].

In the period from 1977 to 1987, after 13,306 operations carried out on the abdominal organs in the clinic, intra-abdominal hemorrhages occurred in 34 (0.25%) patients which had to de managed by emergency relaparotomy. From analysis of case records (28 taken from the archives and 6 of patients who were under observation) of the relationship between the large number (195) of signs represented by a block of clinico-laboratory and radiological data, an integral diagnostic criterion of intra-abdominal hemorrhages was obtained.

[Indications for relaparotomy in acute postoperative intestinal obstruction].

For the period of 1977-1987, operations on the abdominal organs were performed in 13,306 patients. Of them, 115 (0.86%) developed 1 to 21 days after the operation acute ileus requiring the performance of emergency relaparotomy.

[Myocardial infarct in motor transport drivers and the results of long-term observations].

As many as 283 drivers with a history of acute myocardial infarction were examined. In the long-term postinfarction period, the number of the able-bodied accounted for 22.8%, the number of persons with restricted work fitness was 43.

[Prognosis in the outcome of relaparotomy].

The analysis and processing with the use of a special method of 54 direct observations and 342 case records of the patients with early postoperative intraabdominal complications were carried out. A method for syndrome prediction of the outcomes of relaparotomy has been developed. The syndromes of the most significant predictive value have been revealed: those of intoxication, respiratory and hepatorenal failure, impaired hemodynamics and electrolytic metabolism, hemocoagulation.

[Primary peritonitis in children].

The results of treatment of 219 children with "primary peritonitis" are analysed. Most patients (73.5%) were under 7 years of age.

[Optimization of diagnosis of postoperative peritonitis].

The syndrome approach to diagnosis of the postoperative intraabdominal complications was used. Analysed were 170 case records and 15 observations of the patients with postoperative peritonitis. The data were registered in a specially compiled for every patient formalized card.

[Incidence of development and the results of treatment of post- operative peritonitis].

In the clinic at the period of from 1977 to 1987 after 13,006 operations on the abdominal organs, 185 patients (1.4%) ranging in age from 16 to 89 years developed peritonitis. The lethality after relaparotomy performed within the first 24 hours of the complication development was 15.

[Occlusion pressure P100 as a criterion of the central regulation of respiration in respiratory insufficiency and anesthesiological care].

Measurement of occlusion pressure in the airways within the first 100 msec of the inspiration (P100) is a simple noninvasive test for estimating the central inspiratory activity in patients. This test does not require any sophisticated diagnostic equipment, it is not burdensome and does not demand the patient's cooperation. The P100 criterion noticeably varies in healthy subjects, in patients with exacerbation of chronic respiratory failure, and in the immediate postoperative period.

[A modification of the leukocyte migration inhibition test in vivo].

Estimation of the degree of leukocyte migration inhibition in the oral cavity, following exposure to allergen solution, is a test widely used to assess a subject's allergy to drugs. To simplify this test and make it more effective, the authors suggest placing the samples in plate wells and drying them there; optically transparent polystyrene plates for enzyme immunoassay are employed. Effective adsorption of the cells on the carrier and the possibility of analyzing the samples with the help of multiple magnification permit a reliable detection of the migration inhibition.

[Characteristics of the wound process in patients with burns treated by tube hyperalimentation].

Time course of burn wound healing was studied in 32 patients with severe thermal trauma during tube hyperalimentation (TH). Similar study was conducted in 20 patients of the control group who did not receive TH. Early inclusion of TH in the complex of therapeutic measures stimulated some of the links of burn wound histogenesis: the formation of the demarcation swelling and rejection of the necrotic tissue occurred sooner, the leucocytic-macrophagal reaction was activated, and granulation and epithelialization processes were intensified.

[Lipid metabolism in patients with burn disease during nasogastral tube hyperalimentation].

A study was made of lipid metabolism in burn disease patients who received prolonged nasogastral feeding. The main alterations were discovered in phospholipid fractions of blood plasma and red blood cell membranes. In patients receiving nasogastral feeding, the alterations returned to normal more rapidly than in those who did not receive such a feeding.

[Choice of the size and shape of a mitral valve prosthesis].

The authors discuss the results of mitral valve replacement in 438 patients with intraoperative selection of the prosthesis and in 77 patients with preoperative selection by means of an original method based on two-dimensional echocardiography. The intraoperative selection proved to be insufficiently effective: in the postoperative periods 13.9 +/- 2.