[Oxygen transport and consumption in patients in critical states].
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Biological Transport↗
Biomedical subjects
D A Ostapchenko
Publications and source records attributed to D A Ostapchenko.
[Effect of perftoran on morphology and rheologic properties of erythrocytes in patients with severe trauma and blood loss].
Erythrocyte morphology and function, plasma viscosity, central hemodynamics and oxygen status were studied in patients with severe injury and blood loss. The percentage of morphologically changed erythrocytes (mainly stomatocytes) increased, their filterability changed negligibly. Changes in these parameters were studied during intravenous infusion of perfluorane. Perfluorane therapy during the acute period of severe injury decreased total peripheral and pulmonary vascular resistance and reduced the entry of an extra amount of structurally changed erythrocytes from peripheral tissues into the blood stream.
Erythrocytes↗
[Acute hemorrhage. View on the problem].
Acute hemorrhage is a main cause of reduction of blood oxygen capacity. The main aim of correction of sequels of acute hemorrhage is to maintain effective gas exchange by restoring central circulation and microcirculation, the rate of diuresis, by normalizing water-salt exchange, to eliminate anemia, hypoproteinemia, and acute blood coagulability disorders. The values of oxygen budget with calculated oxygen delivery and consumption and those of hemoglobin and hematocrit which are of great value only after recovery of circulating blood volume are considered to be major indications for hemotransfusion. A relationship is established between the extraction and uptake of oxygen and its delivery. The concept of the critical level of oxygen delivery is considered, ways of correcting oxygen indebtedness are presented. Alternatives to the use of hemotransfusions by employing the solutions of modified hemoglobulin and perfluorocarbon-containing emulsions are under consideration. A possible algorithm of aid rendering in acute hemorrhage is given.
Acute Disease↗
[Late potentials of the heart ventricles and a method of spectral mapping for evaluating the action of dalargin in intensive therapy].
The data of 114 examinations of 38 patients with respiratory failure of different genesis have been presented. The method used was that of averaging the ECG signal with analysis of late ventricular potentials and parameters of spectral mapping, as well as analysis of the R-R intervals. The patients were examined initially, 30-45 min after intravenous injection of 1 mg dalargin and 16-20 hours later. The results have shown that there were differences in the changes of a number of basic characteristics of the QRS complex spectrum. In 18 cases (21%) signs of late potentials have been recorded, 14 of them (78%) in the group with decreased total spectral density. A shift of extremums by the beginning of QRS was observed. Statistical and spectral characteristics of the R-R intervals changed in one direction. It has been shown that dalargin has a complex effect on electrophysiological myocardial properties. The use of the method of ECG signal averaging and its different modifications broadens considerably the quality of evaluation of the drug effect in the heart. The technique of spectral-time mapping simplifies the diagnosis of late potentials and elucidates their inner structure.
Adult↗
[Effect of perftoran on the oxidant-antioxidant system in patients with severe trauma and blood loss].
Diminution of reperfusion and re-oxygenation lesions is an important task in the treatment of patients with severe injury and blood loss. From this standpoint the influence of perforan on the condition of the oxidant-antioxidant system was studied in patients with severe combined trauma. The application of perftoran in the early post-trauma period was found to intensify the processes of lipid peroxidation and, simultaneously, to normalize the parameters of the antioxidant-protection system.
APACHE↗
[Use of orthostasis during artificial pulmonary ventilation in patients with acute parenchymal pulmonary lesion].
The paper contains the results of a study involving an inclined body positioning (45 degrees orthostasis) under the conditions of artificial pulmonary ventilation applied to patients with acute parenchymatous pulmonary lesion of different etiologies. The impact of the method produced on pulmonary gas exchange, hemodynamics, transport and consumption of oxygen as well as its efficiency and disadvantages, indications and contraindications are in the focus of attention.
Adolescent↗
[Dynamics of prekallikrein and kallikrein inhibitors in development of acute pulmonary lesion (experimental study)].
The reaction of the kallikrein-kinin blood system was studied in an experimental acute pulmonary lesion caused by a prolonged intravenous infusion of thrombin solution. It was established that the progressing of the acute pulmonary lesion brings about an increasing activation of the kallikrein-kinin blood system with a limited check by the lungs. It is displayed by lower levels of prekallikrein and its inhibitors observed first in the venous and later in the arterial blood. Bradykinin was shown to exhaust and impair the metabolic pulmonary activity. The conclusion is that the indices of the kallikrein-kinin blood system reflect the integrity of the pulmonary metabolic activity and can be biochemical markers of an acute pulmonary lesion.
Acute Disease↗
[Choice of the parameters of artificial ventilation in patients with acute respiratory distress syndrome].
The paper presents the results of use of two modes of controlled artificial ventilation (ALV) in adult patients with acute respiratory distress syndrome of various genesis: 1) ALV with its controlled volume, the descending pattern of inspiratory flow, the limitation of respiratory volume in the airways (RV, 6-8 ml/kg; Ptr.peak < 30 cm H2O), 2) ALV with its controlled volume, the orthogonal pattern of inspiratory flow (RV, 12-15 ml/kg, Ptr.peak > 35 cm H2O). It also shows the advantages and disadvantages of these respiratory procedures in this group of patients.
Adult↗
[Hemodynamics and function of the myocardium during xenon anesthesia].
Hemodynamics and phase structure of the cardiac cycle have been studied, using a technical complex "KO phi OOC", on 12 anesthesiologists volunteers during various stages of Xe anesthesia (70:30). During 30 min anesthesia Xe formed conditions for normalization of hemodynamic changes caused by emotional stress, had no depressive effect on the myocardium, failed to affect considerably vascular tone and myocardial phase structure. Due to its narcotic effect Xe changed variability of the cardiac rhythm.
Adult↗
[Effect of xenon anesthesia on morphology and the blood coagulation system].
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Adult↗
[Clinical stages and subjective sensations in xenon anesthesia].
Clinical pattern of monoanesthesia with Xe:O2 (70:30) has been studied in 12 anesthesiologists volunteers in comparison with their subjective sensations. Four clinical stages of anesthesia have been identified: paresthesia and hypoalgesia, euphoria and psychomotor activity, analgesia and partial amnesia, anesthesia (analgesia and amnesia). Induction anesthesia took 5 to 6 min, anesthesia discontinuation was easy and prompt without any adverse events. In healthy men it was impossible to achieve complete amnesia with Xe:O2 (60:40). Subjective sensations from the anesthesia were pleasant. Xenone is the best alternative to N2O2.
Adult↗