Biomedical subjects
Publications and source records attributed to S A Shalaev.
A new method of bronchial sanitation consisting in conducting a polyurethane tube through the pulmonary tissue and thoracic wall outward under the bronchoscopy control is suggested. The method has been used successfully in 22 patients.
The experience of 800 bronchoscopies with the help of fibrobronchoscopes under anesthesia in the outpatient clinic is generalized. An original method of the artificial ventilation of the lungs with the aid of a specially elaborated by the authors attachment-injector to an ordinary endotracheal tube is described. According to the authors' data, fibrobronchoscopy under anesthesia with the injectional artificial ventilation of the lungs is a little-traumatic measure which permits obtaining a complete information on the character of changes in the tracheobroncheal tree of the patients.
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The results of the clinico-laboratory analysis conducted in 69 patients with varying forms of acute purulent surgical infections have shown that the therapeutic plasmapheresis is attended by the improvement of the disease clinical picture, and attenuation of endotoxicosis by day 3 after the perfusion. Indications and contraindications for plasmapheresis in critical patients are considered, the causes of unsuccessful plasmapheresis procedures are analyzed, the ways for the improvement of this operation are outlined.
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It was shown that plasmapheresis included in the complex program of intensive therapy of patients with acute pyo-septic lesions of the lungs and pleura allowed to effectively arrest manifestations of endotoxicosis and to improve results of treatment of this category of patients. Extracorporeal hemoxygenation of small volumes added to plasmapheresis at the expense of inclusion of dialyzer DIP-02-02 in the extracorporeal contour considerably reinforced the detoxicating effect of plasmapheresis at the expense of nonspecific biotransformation of toxins.
Extensive combined resections were made on 190 of 705 patients operated upon for lung cancer. The results have shown a prognostic value of the factor of variability of resections for immediate results. Long-term results were better in patients with highly differentiated cancers and without a metastatic involvement of the regional lymphatic system. Favourable results with 5-year survival (20.2%) point to the expedience of the extensive combined resections in patients with the long-neglected stages of lung cancer.
Laboratory studies of the influence of the staphylococcal endotoxin on functional properties of thrombocytes and clinical observations of patients with a pronounced syndrome of endotoxicosis have shown an important role of endotoxinemia in pathogenesis of the arising thrombocytopathies. Possibilities of the medicamentous protection of blood plates from the damaging action of endotoxinemia are considered.
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An examination of 110 patients with septic injuries of the lungs (acute pneumonia without purulent destruction, acute abscessing pneumonia, gangrene and lung abscess) has established that lung parenchyma plays an important role in the regulation of functional properties of thrombocytes. Growth of unfavourable thrombocytic lesions were shown to accompany an increase of sizes of purulent-destructive lesions of the lungs. The suppression of coagulolytic and barrier function of the lungs was found to be associated with the appearance of thrombotic complications.