[USE OF PROTECTIVE LUNG VENTILATION REGIMEN IN CARDIAC SURGERY PATIENTS.].

Background: In cardiac surgery, protective lung ventilation and/or preventive brdnchoscopy (PB) are able to decrease lung injury effects of cardiopulmonary bypass (CPB) and mechanical ventilation.

Objectives: define lung complication risks, evaluate the effect ofprotective lung ventilation (PLV) on lung functioning, and investigate the feasibility ofpreventive PB in higher pulmonary risk (PR) patients.

Materials And Methods: 66 patients participated in prospective randomized research.

[CLINICAL ASPECTS OF THE BLOOD LACTATE DYNAMICS DURING OPERATIONS ON THE HEART AND THE AORTA IN CONDITIONS OF CARDIOPULMONARY BYPASS.].

Background: The frequency and the causes for the development of hyperlactatemia during operations on the heart and aorta in conditions of cardiopulmonary bypass (CB) is not adequately described in the literature.

The Aim: To study the clinical significance of the lactate dynamics in arterial blood depending on the source ofpathology, stages of operation, basic parameters of cardiopulmonary bypass, the characteristics of the post-perfusion period, and to identify ways to prevent the development of intraoperative hyperlactatemia in surgical interventions on the heart and aorta.

Materials And Methods: 420 adult cardiac surgery patients operated on the heart and ascending aorta were examined.

[Transfusion supply optimization in multiple-discipline surgical hospital].

Aim: To define optimal variant of transfusion supply of hospital by blood components and to decrease donor blood expense via application of blood preserving technologies.

Material And Methods: Donor blood components expense, volume of hemotransfusions and their proportion for the period 2012-2014 were analyzed.

Results: Number of recipients of packed red cells, fresh-frozen plasma and packed platelets reduced 18.

[ANAESTHETIC MANAGEMENT OF RECONSTRUCTIVE SURGERY ON THE AORTIC ARCH: THE NUANCES OF ORGAN PROTECTION].

Unlabelled: Aortic arch reconstruction is one of the most difficult surgical procedures. Therefore the aims of our study were: to choose appropriate flow rate for antegrade cerebral perfusion and assess its adequacy in relation to cerebral metabolic demands; to evaluate safety of temperature settings during the surgery; to assess the effectiveness of chosen protocol for brain and visceral organ protection during aortic arch reconstruction surgery. Our study included 67 patients.

[MODERN TECHNOLOGIES OF THE SAVING OF PATIENT'S BLOOD AND REDUCTION OF THE USE OF DONOR BLOOD DURING OPERATIONS ON THE ASCENDING AORTA AND AORTIC ARCH].

Questions of saving of the patient's blood and limitation of the use of donated blood in the aortic surgery remain relevant in contrast with interventions on the valves of the heart and coronary arteries. In this regard, the aim of the study was to develop and introduce ofcomplex of technologies for saving the patient's blood in order to minimize transfusion of donor blood components during operations on the ascending aorta and aortic arch under hypothermic arrest. The study included 37 patients operated on the ascending aorta and aortic arch under cardiopulmonary bypass (CPB) and hypothermic cardiac arrest (CA) in 2013-2014 (Group 1).

[Strategy of transfusion in cardiac and aortic surgery].

Current trend in transfusion is a decreasing of the donor's blood use due to possible complications. The article deals with analysis of intraoperative blood loss in different surgeries on the heart and aorta and of a role of blood-saving factors in decreasing of the donor's blood transfusion. We found a correlation between the blood components need and type of surgery and assessed a preoperative provision of autoplasma and intraoperative autohemotransfusion with a blood sampling from the right atrium before the beginning of artificial circulation (Complex use of the blood-saving methods with a prophylactics and treatment of hemostasis disturbances allowed the significantly decreasing of the donor's blood use.

[Anaesthesia and monitoring in cardiac and aortic surgery at Russian Scientific Surgical Center].

Basic principles of anaesthesia management in cardiac and aortic surgery, elaborated in the Department of cardioan aesthesia of Petrovsky National Research Centre of Surgery are presented and discussed. Clinical, instrumental and laboratory data helped us to mark out main aspects of anaesthesia safety and efficacy improvement in cardiac surgery patients. These include: complex preoperative preparation for heart failure degree reduction, drugs selection for balanced anaesthesia, enhanced homeostasis monitoring, the effective protection of myocardium, brain and spinal cord, internal organs, pharmacological and mechanical cardiovascular support, haemostasis optimization etc.

[Vascular reactions during cardiac surgery].

Treatment results of 96 patients with ischemic heart disease, operated on with the use of artificial blood circulation and polycomponent anesthesia, were analyzed. The modified protocol of infusion therapy and functional tests (passive limb elevation and volume load test) were used to assess the dynamic vascular reaction among patients of the main group (n=54). Patients from the control group (n=42) received only standard infusion therapy.

[Efficiency and controllability of esmolol (breviblock)-induced adrenergic blockade during the heart and aorta surgery].

This article contains analysis of retrospective and prospective studies of use of selective ultrashort Beta-blocker esmolol during intraoperative period in cardiac surgery patients in recent years. The drug is highly effective and controlled the means for prevention and treatment of tachycardia, arising as a result of the sympathoadrenal system activation during anaesthesia induction (laryngoscopy, trachea intubation) and intraoperative period (during heart and aorta manipulations). It should be considered that the use of esmolol has dose-dependent effect.

[The role of magnesium in the implementation of vascular reactions during anesthesia in cardiac surgery patients].

Unlabelled: The purpose of the study is to examine the relationship between the concentration of magnesium in plasma and vascular reactions during cardiac surgery.

Materials And Methods: The study included 77 patients with coronary artery disease who underwent myocardial revascularization surgery. In the first group (n = 44) during the entire operation infusion solution "potassium and magnesium asparginate" (Berlin-Chemie) was carried out at a rate of 1.

[Unintended cooling, active warming, and microcirculation in cardiosurgical patients].

The study was undertaken to compare various methods to maintain a patient's body temperature and to evaluate their impact on microcirculation during myocardial revascularization under normothermal extracorporeal circulation (NTEC). The study enrolled 50 patients with NYHA Functional Classes III-IV coronary heart disease, who underwent aortocoronary bypass surgery under NTEC. A HICO-AQUATHERM 660 water-warming unit (Hirtz, Germany) was used in Group 1 patients (n=30).

[Anesthetic maintenance during myocardial revascularization in patients over 70 years of age].

The authors performed a comparative retrospective analysis of preoperative and intraoperative periods in 50 patients aged 70-83 years with coronary heart disease (CHD). A control group comprised the similar patients aged 40-59 years. The geriatric patients showed a higher incidence of arterial hypertension, respiratory and central nervous system diseases, cardiac arrhythmias, and anemia as an outcome.

Antiamnestic effects of antibodies to glutamate in experimental Alzheimer's disease.

Experiments on rats showed that neurodegenerative brain damage caused by administration of neurotoxic fragment of β-amyloid protein Aβ25-35 in a dose of 2 μg into Meynert giant cell nucleus leads to long-term memory impairment in rats. Intranasal administration of antibodies to glutamate in a dose of 300 μg/kg 1 h after damage restores learning capacity of the experimental animals in the conditioned passive avoidance paradigm.

[Optimization of anesthetic maintenance using two-channel laryngeal masks Proseal during endovascular correction of congenital defects in infants and young children].

The paper analyzes the efficiency of the authors' procedure for anesthetic maintenance based on a combination of inhalational (sevoflurane) and intravenous (1% propofol) anesthesia on spontaneous breathing through a ProSeal laryngeal mask airway in the X-ray endovascular correction of congenital heart diseases in infants and young children. The study included 118 children aged 2 to 7 years with secondary atrial septal defect, who had undergone endovascular defect correction, by applying an Amplazer septal occluder. The key points of the anesthetic maintenance proposed by the authors are: (1) substitution of routine pharmacological premedication for psychological (the presence of parents); (2) inhalational (sevoflurane) anesthesia in the induction of anesthesia; (3) replacement of an endotracheal tube by a ProSeal laryngeal mask; (4) refusal of myorelaxants and respiratory support without artificial ventilation.

[Impact of preoperative levosimendan therapy on the volemic status and vascular tone of patients with chronic heart failure during anesthesia].

The impact of preoperative levosimendan therapy on the volemic status and vascular tone was studied in patients with chronic heart failure (CHF) during anesthesia and the ways of correcting the occurring changes were defined. The study included 21 patients with CHF in the presence of dilated cardiomyopathy, who underwent mitral valve replacement and tricuspid valvoplasty. Group 1 patients (n = 11) were given levosimendan (Simdax) in a dose of 0.

[Clinical aspects of autologous blood donation in cardiosurgery].

The paper presents auto donation protocols and a procedure for autodonor plasmapheresis used in cardiosurgical patients, complications, and their preventive measures on the basis of an analysis of 308 autodonor plasmapheresis procedures performed at the Russian Surgery Research Center, Russian Academy of Medical Sciences, in 2007. The preoperative autoblood preservation safety concept envisaging the safety of autodonors during blood donation, the correct storage and issue of autocomponents, and the prevention of adverse reactions to blood exfusion in patients was introduced. The rate of the reactions was 6.

[Changes in hemodynamics and volemic status during intraoperative blood exfusion in patients with chronic heart failure].

Forty-five patients with dilated cardiomyopathy, NYHA Functional Classes III-IV chronic heart failure with left ventricular ejection fraction 26.98+/-7%, who had undergone surgical left ventricular remodeling using an extracardiac conduit in combination with mitral or tricuspid valve correction and blood exfusion, were examined. Central hemodynamic monitoring was performed, by using a Swan-Ganz catheter in all the patients at surgery.

[Effects of systemic administration of glutamate antibodies on acute convulsive reaction of C57B1/6 mice].

The impact of a single intraperitoneal injection of antibodies to glutamate (AG) on acute generalized epileptic activity provoked by systemic introduction of pentilentetrasol was studied in C57B1/6 mice. It was found that AG in doses 10, 25 and 50 mg/kg 1.5 and 24 hours after AG injection produced an anti-epileptic action by raising thresholds of clonic convultions and tonic phase of convultions with lethal outcome and by extending a latent period of their appearance.

Autoantibodies against glutamate, gamma-aminobutyric acid, and norepinephrine in mechanisms of neuropathic pain syndrome.

The production and role of autoantibodies against neurotransmitters glutamate, gamma-aminobutyric acid, and norepinephrine were studied in rats with experimental neuropathic pain syndrome induced by sciatic nerve transection. Nerve transection in rats was followed by behavioral reaction of autotomy (self-mutilation of the operated limb), which often accompanies neuropathic pain syndrome. The development of neuropathic pain syndrome was accompanied by increased production of autoantibodies against glutamate, gamma-aminobutyric acid, and norepinephrine.

[Use of a potassium and magnesium asparaginate solution to maintain the balance of potassium and magnesium during cardiosurgical interventions under extracorporeal circulation].

The study included 42 patients with coronary heart disease operated on the coronary arteries. A potassium and magnesium asparaginate (PMA) solution, 450-1000 ml, was injected in 30 patients for 5-7 hours; other crystalloid solutions was used in a control group (n = 12). The concentrations of potassium and magnesium were measured prior to surgery, following initial anesthesia, before and after extracorporeal circulation (EC).

[Ways of reducing donor blood components during reconstructive surgery of the heart valves under extracorporeal circulation].

Blood loss and transfusion tactics were analyzed in 131 patients who had undergone correction of one, two, and three cardiac valves under general balanced anesthesia and extracorporeal circulation. The volume of intraoperative blood loss was 869+/-298 ml with the range of 700 to 2000 ml. Packed red cells (PRC) were transfused to 9% of patients; fresh frozen plasma (FFP) in 10%, PRC and FFP were transfused to 17% patients.

Effect of systemic treatment with antibodies against glutamate on the seizure response of C57Bl/6 mice after pentylenetetrazole kindling.

We studied the effect of single intraperitoneal injection of antibodies against glutamate on acute generalized epileptiform activity induced by intravenous injection of pentylenetetrazole in kindled C57Bl/6 mice. We found that in animals at various stages of kindling, administration of antibodies against glutamate in a dose of 25 mg/kg 1.5 h before testing increases the threshold of clonic seizures and tonic phase of seizures with lethal outcome and latency of seizure development, i.

Immunobiological specificity of antibodies against glutamate and gamma-aminobutyric acid.

Experiments on C57Bl/6 mice showed that chronic epileptization of the brain (pharmacological pentylenetetrazole kindling) is accompanied by induction of autoantibodies against glutamate and GABA. Immunohistochemical similarity of antibodies against glutamate and GABA was demonstrated. Study on the model of pentylenetetrazole-induced acute generalized epileptiform activity showed high immunobiological specificity of intraperitoneally injected antibodies against GABA and glutamate: antiepileptic effect of antiglutamate antibodies and proepileptic effect of antibodies against GABA.

Dynamics of dopamine and norepinephrine contents in the dorsal hippocampus of rats during immunization with dopamine conjugate.

The dynamics of dopamine and norepinephrine contents in the dorsal hippocampus of rats immunized with a dopamine-BSA conjugate was studied during immobilization stress by mean of the microdialysis technique. Immunization with dopamine conjugate was accompanied by intensive production of antibodies against dopamine in rat blood and a tendency toward an increase in dopamine content in the dorsal hippocampus even in the basal state (before stress exposure). Under stress conditions, dopamine content in the dorsal hippocampus of immunized rats significantly increased.

[Intraoperative myocardial protection with extracellular cardioplegic solutions in patients with cardiac valve diseases].

A hundred patients operated on under extracorporeal circulation (EC) with bicaval cannulation in the moderate general hypothermia mode were intraoperatively examined. According to the used cardioplegic solution, all the patients were divided into three groups: 1) Konsol; 2) Konsol MF; 3) St. Thomas (a control group).