[Changes in the blood coagulation system at the early stage of trauma].
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Biomedical subjects
Publications and source records attributed to G Ia Bazarevich.
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From the observations on 18 patients and the experiments on 77 dogs with experimental pancreatitis neuro-humoral interrelations and hydrocortisone effect upon the respiratory function have been studied. Both in the clinic and in the experiment the authors have found the intermediate metabolism disturbed: adrenaline-like substances blood level rises, while the cholinergic complex blood level drops dramatically. The conclusion on a vital importance of a consecutive neuro-humoral correction with the use of cholinomimetics and corticosteroids in pancreatitis is drawn.
A relationship between the state of adrenergic, cholinergic, and serotoninergic systems, on the one hand, and the acid-alkaline balance of the organism, on the other hand, was revealed in sharp and chronic experiments on dogs. A surplus of each of the mediators was accompanied by respiratory alkalosis, and its deficiency--by combined respiratory and metabolic acidosis.
Clinico-physiological data on 52 patients after spleno-pancreatogastrectomy are analysed. The mortality was 25%, the late results were as follows: a 3-year survival--in 28%, a 5-year survival--in 14.7%, a 10-year survival--in 9%. This group of patients was examined for the functional state of the cholinergic system, carbohydrate metabolism, external respiration and basic metabolism. Carbohydrate metabolism is found to change but insignificantly and requires no corrective measures. The cholinergic system activity was reduced, that adversely affects the respiratory function and contributes to the decreased basic metabolism. The latter would necessitate including of cholinomimetics and lipocain in the scheme of the postoperative management.
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The influence of the serotin biological activity on forming the "shock" lung syndrome was revealed in experiments on rats. Tachyhyperpnea with predominance of functional emphysema and a small number of atelectic tissue areas were observed in the animals with traumatic "shock" during the serotonin hypersecretion. Tachyhypopnea with a significant predominance of atelectiv areas was seen during the serotonin hypoproduction.
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During observations of 26 patients and in acute and chronic experiments on 31 dogs under conditions of peritonitis the author studied neurohumoral relations and the effect of hydrocortisone on the respiratory function. A conclusion is made on the vital importance of the consistent associated corrective neurohumoral therapy with cholinomimetics and corticosteroids in peritonitis.
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Experimental studies on dogs and clinical examinations of patients with brain injuries permitted to state that the activity of the sympathicoadrenal system in the posttraumatic period is increased. The cholinergic processes in such conditions are inhibited, the concentration of blood serotonin is decreased. Depending upon the character of changed neurohumoral blood factors the parameters of external respiration (hypotachypnoe with respiratory acidosis) are also changed. In such condition hydrocortison fulfills the normalizing effect on the respiratory function only in a stimulation of the inhibited cholinergic system by cholinomimetics.
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In experiments on 30 animals and in observations over the course of acute closed craniocerebral trauma in 24 patients is was found that the course and prognosis of a posttraumatic period were dependent on the functional activity of the sympathoadrenal system and cholin- and serotoninergic processes. Based on the data obtained, it is concluded that the character of neurohumoral interrelations can serve as the prognostic criterion in craniocerebral traumas, whereas the information about these processes--in selecting the appropriate therapy.
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