Biomedical subjects
Publications and source records attributed to A L Kostiuchenko.
The authors analyze results of using the intraoperative hemodilution with the help of the mannite plasma in 20 patients with obliterating lesions of the lower extremity vessels. Its influence on the central hemodynamics, water-electrolyte homeostasis, functions of the kidneys, liver, coagulating blood system were studied. The advantages of such method of autohemotransfusion are shown.
The osmolar status was studied in 63 patients with acute abscesses of lungs and empyema of pleura at different stages of the conservative and operative treatment. The hypoosmolarity syndrome was revealed at the acute stage of the disease against the background of a pronounced purulent intoxication. An increased excretion of nonidentified osmotically active metabolites with urine was registered at the height of pyodestructive process and postoperative disease.
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On the basis of experimental and laboratory investigations high fibrinolytic effect of the home proteolytic enzyme terrilythin and the absence of general toxic reactions after intrapleural administration of the drug have been proved. The article describes results of clinical results of clinical tests of the effectiveness of terrilythin in coagulated hemothorax after traumas of the chest and operations on the lungs and in 55 patients with acute pro-fibrinous pleurisy. The successful preventive sanitation was performed in 43 of 50 patients with coagulated hemothorax and initial symptoms of the infectious process as well at the development of pleural empyema were averted.
About 300 samples of the autogenous blood prepared by different methods were examined in order to study peculiarities of the accumulation and structure of microclots of autogenous hemotransfusion media. The morphological and coagulation properties of the blood of patients before exfusion were found to be related to the velocity of accumulation of microaggregates after it. The role of methods of stabilization, conservation and terms of storage is shown in the dynamics of the aggregation state and the role of fibrin in the microaggregate structure. The filtration "in the depth" is shown to be efficient for the prevention of posthemotransfusional microembolism of the pulmonary vascular bed.
Functional and morphological investigations have shown that the transfusion of preserved blood used to fill up the operation blood loss results in pulmonary microembolism by microaggregates. The authors believe functional manifestations of microembolism include disturbances of respiratory function, central hemodynamics, water-electrolyte and protein metabolism, the hemotransfusion pulmonary mciroembolism being an additional stress factor of genesis of the postoperative disease.
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A table of compatibility of proteases and antibacterial drugs was developed on the basis of investigation of fibrinolytic effect of proteolytic enzymes (fibrinolysine, chimotrypsin, streptokinase, terrilitin) and their combinations with most popular antibiotics and antiseptic solutions. According to the data of the authors, terrilitin and streptokinase are most efficient of the proteolytic enzymes studied and less dependent upon antibiotics and antiseptic solutions when used in combinations.
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