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Biomedical subjects

E V Roĭtman

Publications and source records attributed to E V Roĭtman.

At least 19 recordsLinked to original sources
PubMed2005

[Changes in hemostasis at aortic surgery under conditions of extracorporeal circulation].

This paper describes hemostatic changes in patients who had undergone aortic surgery under conditions of extracorporeal circulation. The changes in the hemostatic system are marked by the thrombophilic condition made up for activation ox blood fibrinolytic activity in the preoperative period. The basic amount of blood loss falls within the first 6 hours after operation. Prolonged hypothermic extracorporeal circulation and the high intraoperative blood loss (over 35 ml/kg bw) lead to an appreciable decrease in antithrombin III and protein C activity which results in activation of disseminated intravascular blood coagulation in the early postoperative period and ineffectiveness of heparin therapy. Secondary hyperfibrinolysis together with combined thrombocytopenia and platelet dysfunction are the basic causes of higher than usual bleeding in patients after aortic surgery under conditions of extracorporeal circulation.

Antithrombin III↗
PubMed2004

[Hemorheological changes during mammary coronary bypass grafting].

Hemorheological studies were performed in 44 patients subjected to mammary coronary bypass surgery during induction of anesthesia, at initiation of cardiopulmonary bypass, at the end of operation, on the 1(st) and 2(nd) or 3(rd) postoperative day. Methods included determination of whole blood and plasma viscosity with estimation of suspension stability and calculation of Caisson viscosity and fluidity limit. Rigidometry was used for assessment times of linear (T(1)) and three dimensional (T(2)) aggregates formation, final aggregates dimensions, total hydrodynamic strength of aggregates (beta), index of strength of especially large aggregates. Indexes of aggregation and deformation of erythrocytes were also calculated. Cardiopulmonary bypass was associated with lengthening of T(1) and shortening of T(2), increase of aggregates dimension and their hydrodynamic strength beta and lowering deformability of erythrocytes. By the end of operation increase of difference between Caisson and asymptotic viscosity was noted. Postoperative period was characterized by improvement of deformability of erythrocytes, prolongation of T(2), increases of aggregates dimension, their hydrodynamic strength beta, and fluidity limit. Thus measures of intensive therapy should be directed at correction of disturbances of rheological properties of blood with consideration of their changes specific for cardiosurgical patients.

Blood Viscosity↗
PubMed2003

[Prophylaxis of thrombotic complications in microsurgical auto-transplantation of tissue complexes].

Problems of prophylaxis of intra- and postoperative thrombotic complications are discussed basing on the experience of treatment of more than 1500 patients who underwent microsurgical autotransplantation of tissues. Influence of non-fractionated heparin, acelysin and low-molecular heparin on hemostasis in combination with standard hemodilution after microsurgical autotransplantation was analyzed. Scheme of treatment before, during and after surgery are developed for prophylaxis of thrombotic complications.

Adolescent↗
PubMed2003

[Hemorheological changes at reconstructive operations on the aorta].

Fifteen patients who had undergone aortic reconstructions were examined. Hemorheologic studies were performed at the following stagest initial anesthesia, the end of operation, the early postoperative period, and the 2nd-3rd days after operation. A study was made of blood viscosity at a shift rate 5-300 s(-1), of suspension stability, caisson viscosity (CV), and the yield stress (YS). The back light diffusion intensity was recorded on the erythroaggregometer ADE=5 (Russia) to evaluate the time of linear aggregate formation (T(1)), the time of three-dimensional aggregate formation (T(2)), characteristics of the end size of the aggregates (Ampl), total hydrodynamic strength of the aggregates (Beta), strength index of especially large aggregates (Ia((2,5))). The index of erythrocyte aggregation (IEA) and the index of erythrocyte deformation (IED) were also computed. Initially, the normal blood viscosity values were marked. However, in the early postoperative period, their values returned to the preoperative level. In patients with complications, blood viscosity appreciably rose, exceeding the preoperative parameters. At the end of operation there was a decrease in erythrocyte aggregation, especially due to the TT(1) and Ampl rise, while beta dropped. In the postoperative period, patients without complications demonstrated the growth of erythrocyte aggregation but Ampl of cell aggregation diminished. In the postoperative period, patients with complications showed a considerable intensification of erythrocyte aggregation due to the rise of Ampl, Beta and Ia((2,5)). Toward the end of operation a decrease of plasma viscosity was revealed in the presence of GV rise. In the postoperative period, patients with complications demonstrated the growth of plasma viscosity concurrently with CV lowering. Toward the end of operation the YS increased. However, in patients with the uncomplicated postoperative period, the magnitude of this parameter dropped and reached permissible values in the given patient group whereas in patients with complications, the YS remained significantly high.

Aortic Aneurysm, Abdominal↗
PubMed2002

[Hemorheology and morphofunctional characteristics of blood cells in children with congenital heart defects].

Patients with congenital heart diseases (CHD) aged 4 months to 12 years, hospitalized for surgical treatment, were examined. Complex viscosity of the blood and the constituents of this parameter (dynamic viscosity and elastic component) were evaluated in the range of shift strain corresponding to the range of shift velocities 0.37-500 s-1 at a frequency of 2 Hz. The threshold blood fluidity was estimated for evaluating the conditions under which erythrocyte disaggregation begins. The relationship between blood rheology and morphofunctional characteristics of blood cells was evaluated. In accordance with the findings, the patients were divided into 3 groups with different suspension stability of the blood. In group 1 the threshold fluidity approximated the norm. In group 2 with normal blood rheology the shifts were compensated and regulation of rheology was in general intact. In group 3 the hematocrit values, mean erythrocyte volume, mean concentration of hemoglobin in erythrocyte, leukocyte counts, and complex viscosity of the blood were the highest, while the suspension stability was the lowest, which indicates depletion of the adaptive potential of the organism. Hence, blood rheology in patients with CHD differs by the type of regulation, mechanisms and compensation of changes, and depend largely on the mean erythrocyte volume, mean hemoglobin concentration in erythrocytes, and leukocyte counts.

Blood Cell Count↗
PubMed2001

[Changes in blood rheological properties and erythrocyte osmotic resistance in activation of free radical processes].

Relationship between serum oxidation of different degree and micro- and macrorheology of the blood and modification of this relationship in the presence of antioxidant alpha-tocopherol were studied. Lipid peroxidation affects blood rheology and erythrocyte osmotic resistance. Erythrocytes are the first to react to increased activity of free radical oxidation and to exhaust their compensatory potential. Plasma viscosity remains stable in serum oxidation of different degree, and therefore erythrocytes are responsible for changes in blood rheology during intensification of free radical oxidation. Moreover, erythrocytes are functionally resistant to oxidative stress in malonic dialdehyde concentrations under 3.62 +/- 0.41 nM/ml. alpha-Tocopherol increases functional resistance of erythrocytes and maybe of protein components of the plasma to damaging action of free radicals.

Antioxidants↗
PubMed1999

[Novel method for calculation of hemostatic potential and its clinical applications. 2].

A formula for calculating the hemostatic potential is proposed: HV = -{Ig[(APTT + PTTIS)/(WBCT.Hct)] + IgPF/PT}, where APTT is activated partial thromboplastin time, sec; PTT prothrombin time, sec; IS index of sensitivity of thromboplastin reagent used; WBCT whole blood clotting time after Lee-White, sec; Het hematocrit; PF probability of liquid blood preservation: and PT probability of thrombotic complications. The aim of the study was to evaluate the probability of practical use of the method and its practical potentialities. Statistical analysis (1014 specimens from 402 patients) confirmed the correctness (plausibility) of our concept and of the model of hemostatic potential. Despite the difficulties of calculation, the resultant hemostatic potential value represents the actual conditions of hemostasis in vivo. The physiological norm is represented as small-positive values of hemostatic potential, reflecting the constant "readiness" of blood to coagulation. Time course of hemostatic potential demonstrates the hemostasis status and its stability during various exposures. The homeostatic potential is a value highly sensitive to hemostatic status and outer exposures. Its changes can be used as a criterion of therapy efficacy.

Adult↗
PubMed1997

[Use of software "Aggregate state of the blood" in staged diagnosis and correction of disorders of blood coagulation and rheology].

The "Aggregate State of the Blood" software was created at the National Research Center of Surgery in 1994. The software is intended for comprehensive assessment of the blood fluidity under different conditions of clotting, rheology, and acid-base balance and shows deviations of the detected values from the norm, predicting the risk of thrombotic and/or hemorrhagic complications. From 1994 to 1996, the program was used in more than 1000 patients subjected to cardiopulmonary bypass surgery with complicated and uneventful peri- and postoperative period. The operations were as follows: heart and liver transplantations (19 and 7 cases), intraaortic balloon counterpulsation (16), extracorporeal detoxication (10), acute myocardial infarction (9), etc. The results were compared with the data recorded in case histories of 255 patients who underwent similar operations in 1991-1994. The results of diagnosis and prediction were commented in the protocol for each case. The conclusions were used for therapy or prevention. The incidence of thrombotic and hemorrhagic complications and the DIC syndrome in 1995-1996, when the new software started to be used, was significantly lower than before. The best clinical results were attained in the patients examined before surgery (n = 92). In this group application of the program (and subsequent preventive treatment) helped improve the adaptive potential of the physiological systems maintaining the blood fluidity. This resulted in a lower postoperative blood loss and a lesser incidence of thrombotic and hemorrhagic complications and the DIC syndrome as against the reference group.

Blood Coagulation↗
PubMedDate not supplied

[The diagnostic value of blood rheology studies in cardiac surgical interventions].

The diagnostic value of routine studies of blood rheology in cardiosurgical patients was investigated. Blood rheology, hemostatic system, and acid-base balance were analyzed in 75 cardiosurgical patients during the early postoperative period. In 41 of these the postoperative period was uneventful and 34 patients developed complications. The blood fluidity conditions and estimation of the risk of thrombotic and hemorrhagic complications were assessed using the "Aggregate Status of the Blood" software. The data indicate a high diagnostic and prognostic significance of plasma viscosity, relative blood viscosity, erythrocyte aggregation and deformability indices in evaluation of the status of cardiosurgical patients in early periods after surgery. Application of hemorheological studies as routine methods for examination of patients improved the quality of treatment. Hence, rheological studies of the blood and plasma should become an obligatory component in the diagnosis of the hemostatic status in the early postoperative period after aortocoronary bypass surgery.

Arteries↗
PubMedDate not supplied

[The prevention of thrombus formation and the improvement of the blood rheological properties during operations with a microsurgical technic. I. The possibilities for using acelysin--an acetylsalicylic acid derivative].

Changes in the blood clotting system and rheology were studied in 39 patients during reconstructive operations making use of microsurgical methods. Effects of various doses of water soluble acelysine, an acetylsalicylic acid preparations (DL-lysine acetylsalicylate and glycine) have been evaluated during surgery and the immediate postoperative period. Clinical and laboratory changes in blood coagulation were determined at different doses (1000, 500, and 250 mg). Even in low doses (3.94 +/- 0.25 mg/kg) acelysine ensured chronometric and structural hypocoagulation as early as 1 h after dosed infusion and throughout the entire intervention, preventing thrombosis of microvascular anastomoses. Administration of acelysine in doses higher than 250 mg is not recommended, because higher doses involve the risk of hypocoagulation complications.

Adolescent↗
PubMedDate not supplied

[Urine viscosity in the evaluation of homeostasis in heart surgery patients in the early postoperative period].

A total of 100 dynamic measurements of the urinary viscosity were carried out in 38 patients subjected to open-heart surgery. Biochemical parameters and levels of electrolytes were measured in the cystic urine. The viscosity of the urine was found to be unchanged from 10 to 300 sec-1. A significant increase of its level was observed only in acute renal failure and led to the development of multiorgan abnormalities. The results indicate that urine viscosity in the early postoperative period was due to pH values (r = 0.47, p < 0.05) and free hemoglobin level (r = -0.52, p < 0.01) in coronary patients and due to concentrations of sodium (r = -0.57, p < 0.01) and chloride ions (r = 0.38, p < 0.01), osmolarity (r = -0.53, p < 0.1), and protein levels (e = -0.37, p < 0.1) in patients with acquired heart diseases. These causal relations were conditioned by the postoperative directions of regular reactions of homeostasis, because in coronary disease it is virtually the same as before surgery. Contrariwise, renal perfusion has a great impact on homeostasis stabilization in new bloodflow state in patients subjected to open-heart surgery for acquired heart diseases. As molecular and cellular disorders anticipate the clinical symptoms, we came to a conclusion that increase of urine viscosity may be an early sign predicting the development of multiorgan abnormalities.

Acute Kidney Injury↗
PubMedDate not supplied

[Polypharmacotherapy: the risk of developing postoperative hemorrhages].

The impact of polypragmasy on the causes of endogenic heparinemia in the early postoperative period was studied in patients operated on the heart under extracorporeal circulation. It has been found that polypragmasy does not break down the heparin-protamine sulfate complex, but impairs the process of its formation to a certain degree. Ascorbic acid lowers the activity of heparin and hence it may be used as a hemostatic stabilizer during endogenous heparinemia.

Adult↗