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Biomedical subjects

G G Khubulava

Publications and source records attributed to G G Khubulava.

At least 19 recordsLinked to original sources
PubMed2006

[Effectiveness of combined treatment of infective endocarditis].

The purpose of the study was to develop and perfect complex therapy of modern infective endocarditis (IE). Ten-year experience in clinical diagnostics of 240 patients with acute, subacute, and lingering IE was summarized; the effectiveness of their treatment was evaluated. The features of modern IE were acute and subacute course of the disease with the involvement of aortal (37.8% of cases), tricuspid (16.8%), mitral (15.2%) valve, and septicemia, caused by highly virulent microflora (staphylococci--51% of cases; gram-negative bacteria--13%; fungi--5%). The clinical manifestations of modern IE included toxic infectious syndrome (24% of cases), heart failure (21%), symptoms of complications (16%), central hemodynamics disturbances (12%), and splenomegaly (8%). The treatment included antibacterial, pathogenetic, and symptomatic therapy, as well as extracorporal hemocorrection and cardiosurgery. Analysis of the results of surgical treatment of 140 IE patients allowed development of indications for valve prosthesis.

Adult↗
PubMed2004

[Survival of patients with infectious endocarditis in various treatment methods].

The aim of the study was to compare survival of patients with infectious endocarditis (IE) by abuse of intravenous narcotic substances in conservative and combined treatment in acute IE phase. A total of 195 IE patients were examined. 121 of them was treated conservatively, 74 patients received a combined treatment including surgical one. A long-term prognosis was studied by the Kaplan-Meier method. Among drug addicts with IE, the number of survivors in the observation period in early operation in the active IE phase was significantly higher than in the conservative therapy. Long-term survival of drug addicts with IE in combined treatment was also higher: 1-2- and 3-year survival was 85.8, 76.3 and 61.0% against 64.8, 49.0 and 34.2% in conservative treatment, respectively. In non-addicts the differences were weaker: long-term survival in combined treatment was higher than in conservative one only in 5-year survival (74.1 and 41.6%, respectively).

Adult↗
PubMed2003

[Infectious endocarditis as a surgical problem in Russia].

Infectious endocarditis (IE) is mainly a surgical problem and requires an integration of efforts of specialists of different fields for its treatment. Successful treatment of this severe disease is to be based on the early diagnosis and early operation. So IE should be estimated as a surgical pathology and this nosological form must be included in all manuals on general surgery and studying infectious endocarditis must be included in the programs of training doctors at surgical series of lectures. Such interpretation of this question will change doctors' mentality and will lead to the earliest admission of the patient with this pathology to specialized cardiosurgical hospital and will allow to avoid severe disabling complications of IE, to increase the number of valve-saving operations and to improve prognosis in the treatment of this disease.

Early Diagnosis↗
PubMed2003

[Intraoperative reservation of auto-blood in surgical treatment of ischemic heart disease].

The article presents results of using the method of intraoperative autotransfusion in surgical treatment of IHD. It was shown that in patients with IHD intraoperative reservation of 400 ml of autoblood at the stage of surgical access (prior to infusion of heparin) during coronary shunting did not lead to disturbances of hemodynamics, gas exchange and oxygen-transporting function of blood. The following transfusion of predonated autoblood at the final stage of operation promotes the early reestablishment of the circulating erythron and allows to reduce the requirement of transfusion of the donor erythrocyte concentrate by 26.1%, and chilled plasma--by more than 1.5 times.

Blood Loss, Surgical↗
PubMed2003

[Surgical treatment of aneurysms of the abdominal aorta in patients with generalized atherosclerosis].

The authors made operations on 131 patients with aneurysms of the abdominal aorta (AAA). Most severe patients were operated on using a modified resection or "exclusion" of the AAA and aorto-iliac bifurcation prosthesis with reverse formation of anastomoses. It was found that the proposed method increases safety of the operative treatment of AAA and is preferable for patients with a severe coexisting pathology.

Aged↗
PubMed2003

[The first experience with using a preparation of lung surfactant for prevention and treatment of the acute lung injury syndrome after operations on the heart and aorta].

The authors made an analysis of their experience with using the preparation in 29 patients (22 for treatment and 7 for prophylactics) with acute injury of the lungs. When used for treatment, it gave good results in 16 patients. The prophylactic application of the preparation allowed to avoid acute respiratory insufficiency.

Cardiovascular Surgical Procedures↗
PubMed2002

[Intravascular photohemotherapy in the complex prophylaxis of purulent-septic complications after coronary shunting].

The article presents results of treatment of 78 patients with the history of coronary bypass operations for ischemic heart disease. There were 48 patients with high risk factors of the development of pyo-septic complications. Among them there were 27 patients treated by complex postoperative therapy including intravascular photomodification of blood. The intravascular irradiation of blood was shown to have a positive influence upon the development of the early postoperative period in this category of patients. The immunomodulating effect was noted due to a greater amount of activated lymphocytes and T-helpers in blood. The positive dynamics of immunological indices were in correspondence with the data of the clinical state, pyo-inflammatory complications were not registered in this group of patients. Early (on the 3rd-5th days) inclusion of the intravascular irradiation of blood in the complex postoperative therapy is thought to be expedient for the patients with high risk of pyo-inflammatory complications.

Adult↗
PubMed2001

[Critical state medicine. Surfactant therapy of adult respiratory distress syndrome (results of multicenter studies)].

The paper provides evidence for the pathogenetic approach to treating acute lung lesion (ALL) and adult respiratory distress syndrome (ARDS). An algorithm of the use of Russian lung surfactant preparations: CT-HL and CT-BL has been developed. In involves earlier (the first days following the onset of respiratory failure) use of surfactant, its combined bolus intratracheal or intrabronchial administration in doses of 200-400 mg/m2, followed by continuous (5-day) aerosol inhalation in doses of 20-30 mg/h for children and 30-75 mg/h for adults until pronounced clinical and X-ray effects are shown. Fifty three patients were found to develop ALL and ARDS in the presence of severe pneumonia, postperfusion lung disorders, reperfusion syndrome, pulmonary embolism, long-term artificial ventilation, combined car accident injury and gunshot wounds of the chest, heroine intoxication, septic shock, sepsis, postoperative sequels in cancer patients, and after hepatic transplantation or massive aspiration of gastric contents. Fifty patients were overcome their critical status, 44 survived. The duration of artificial ventilation (AV) ranged from 1 to 6 days. Earlier use of the drugs made it possible to transfer patients to safe AV regimens and to eliminate ALL and ARDS rapidly and to significantly reduce mortality due to critical states.

Acute Disease↗
PubMed1999

[Diagnosis and treatment of early bleedings after open-heart surgery].

On the basis of practical experience of the clinic for Cardiovascular Surgery and up-to-date literature data the causes of early bleedings after open-heart surgery are summarized. The main clinical, roentgenological and laboratory features of the bleeding and the methods for the assessment of their origin are demonstrated. The authors consider pathophysiologic causes of hemocoagulation disturbances after surgery with artificial circulation. Characteristics of clinical and laboratory tests for coagulation and hemostasis disturbances and the algorhythms for their interpretation are described. Both nonspecific and pathogenetic methods for management of coagulopathy bleedings in early postoperative period have been described and discussed.

Blood Coagulation Tests↗
PubMed1999

[Prevention of prosthetic heart valve infection].

Fourty patients with primary and secondary infective endocarditis of the native heart valves as well as patients with rheumatic heart diseases not complicated by infective endocarditis were operated upon in the clinic from 1996 till 1998. The prosthetic heart valves in which the tissue cuff was sutures by blanket suture along the perimeter with a silver thread were implanted to 25 patients. In the other 15 patients (a control group) prosthetics were made using unchanged construction of the prosthesis (without the silver thread). Patients with valve prostheses sutured with the silver thread had smooth postoperative period. They had no prosthetic endocarditis either at the early or at late postoperative periods. In 3 patients of the control group infective endocarditis of the valve prosthesis developed at different periods after operation. All of them were reoperated. The authors consider that defense of the tissue cuff of the prosthetic valve with the silver thread allows risk of the development of prosthetic endocarditis to be substantially reduced. In the cases described it was completely avoided.

Adolescent↗
PubMed1999

[Continuous inhalation administration of surfactant-BL for control of adult respiratory distress syndrome after reconstruction of the abdominal aorta].

A 62-year-old patient with Leriche's syndrome and critical ischemia of the low extremities has undergone the surgery of aortofemoral grafting. A patient has developed the severe ARDS on the second day of reperfusion (bilateral diffuse infiltrates, PO2/FiO2 < 100, lung injury score was 3). Different ways of administration of bovine surfactant (SURFACTANT BL, Russia) were used during the treatment. Total application time was 84 hours, total dose was 4000 mg (50 mg/kg). Considerable improvement of lung function occurred after start of the continuous inhalation of surfactant with a constant rate of 63 mg/h. Two hours after this step PO2/FiO2 reached 400 mm Hg and remained stable 12 hours more, up to the end of surfactant administration. The patient was soon successfully extubated and discharged on the 25th day after surgery. It is supposed that in spite of a small total dose of bovine surfactant the success was achieved due to an early start of the surfactant replacement, continuous inhalation and its definite rate.

Administration, Inhalation↗