[The pathogenetic correction of disorders of blood oxygen transport in the postshock period of traumatic disease].

The state of the gas exchange system was analyzed in 79 patients with a severe combined trauma (SCT) at the postshock period. It allowed detection of specific features of disturbances of the oxygen transport by blood in different kinds of injuries. The SCT with a critical injury of the brain is more often accompanied by hyperdynamia of circulation within the first two days after trauma, while the 3rd-4th days are characterized by a sharp drop of the heart index to (2,17 +/- 0,21) l/min.m2, oxygen transport to (261,9 +/- 37,2) ml/min.m2, oxygen consumption to (99,9 +/- 8,3) ml/min.m2. If the SCT was accompanied by a contusion of the heart the changes of central hemodynamics were especially pronounced and prolonged having a hypocirculatory character with a decreased cardiac and stroke index from the first hours of stay at the hospital (20,4 +/- 1,5) ml/m2 and (2,10 +/- 0,14) ml/min.m2 correspondingly. It led to a substantial decrease of indicators of the transport and consumption of oxygen correspondingly: (266,5 +/- 25,1) ml/min.m2 and (112,6 +/- 8,2) ml/min.m2. For the pathogenetically substantiated therapy of disturbances of the oxygen transport by blood the following measures are considered: isovolemic hemodilution, moderate sympathetic blockade, the use of membrane stabilizers, glucocorticoids, adrenolytics, solcoseryl. The state of the organism system of respiration and subsystem of the oxygen transport must be taken into consideration when choosing the optimum time for performing the postponed operative interventions at the postshock period.