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V A Maksimenko

Publications and source records attributed to V A Maksimenko.

12 recordsLinked to original sources

[Study of parameters of central hemodynamics in patients during hemodialysis].

The article discusses the results of study of the cardiac output (CO) and circulation blood volume (CBV) in patients at the beginning and end of hemodialysis. The dynamics of changes of these parameters during hemodialysis was studied in 31 patients (42 sessions). The CO and CBV reduced significantly. In a group of 10 patients who felt worse, the CO reduced by more than 30 per cent in 7, the CBV diminished by 25 and 30 per cent in 2, and CBV and CO reduced by more than 30 per cent in 1 patient in relation to the initial level. The CO and CBV were measured by means of the method of dilution of electroimpedance indicators.

Blood Volume

[The electrical impedance indicator dilution method in studying the basic hemodynamic parameters during dialysis].

The procedure for measuring cardiac output and circulating blood volume is based on blood ability to modify its electrical conductance due to the amount of introduced ions (0.9% sodium chloride solution) or undissociated molecules (5% glucose solution). The cardiac output and circulating blood volume were calculated after measuring an area under the electrical impedance indicator dilution curve using the given formulas. With the described and thermodilution methods, the cardiac output was compared (r = 0.95). The correlation factor with the radioisotopic method in measuring the circulating blood volume was 0.88. Clinical investigations carried out in 47 patients on a programmed hemodialysis showed a significant decrease in cardiac output approximately by 700 ml/mi (7.9%) and circulating blood volume by an average of 900 ml (15.2%) by the end of a hemodialysis session, the rate of the circulating blood volume to body weight being also decreased. There was a predominant fluid "release" from the vascular bed.

Blood Volume

[Criteria for the choice of the extracorporeal detoxication method in patients with postoperative renal failure].

Criteria for the choice of a method for extracorporeal detoxication (acetate hemodialysis, intermittent or continuous hemofiltration or hemodiafiltration, or plasmapheresis) were defined on the basis of a detailed examination of cardiorespiratory function (central hemodynamics, oxygen-transporting function of the blood) in 88 patients with acute postoperative renal failure (PRF). Multiple organ failure occurred in 90% of the patients examined in the postoperative period. The severity of visceral and metabolic disorders was the principal criterion in the choice of extracorporeal detoxication method. Hemofiltration is the method of choice for the treatment of PRF combined with multiple organ disorders, primarily with acute circulatory, respiratory, and metabolic disorders, due to its stabilizing effect on the hemodynamics and a wide spectrum of pathologic substances removed by it. Acetate hemodialysis is indicated for patients with PRF and slow recovery of renal function only after elimination of grave hemodynamic and respiratory disorders, provided there are no general cerebral symptoms, because of its negative effect on the circulation and oxygen balance of the organism and central nervous system. Plasmapheresis is a pathogenetically valid method for the treatment of the initial stages of PRF in cases with massive intravascular hemolysis and sepsis, which may be combined with other methods for extracorporeal detoxication, if necessary.

Acute Kidney Injury

[Hemodialysis with electrochemical regeneration of dialysis solution].

The method of electrochemical regeneration of dialysis solution is virtually as effective as the traditional hemoperfusion system in removing creatinine and potassium ions from the body, but inferior to it as regards urea and inorganic phosphorus and superior in removal of medium-weight toxins. A more smooth reduction of urea level in the blood provides relatively stable hemodynamics in patients liable to hypotension. Electrochemical regeneration permits a continuous purification of dialysis solution, the regeneration block may be used many times, and sodium hypochlorite produced during electrolysis operation maintains the sterility of the system. Electrochemical regeneration does not require water purification systems, water communication, and dialysis concentrate, this permitting the performance of detoxication in rooms without special equipment.

Creatinine

[Experimental and clinical studies of methods for regenerating the dialysis solution].

The efficacy of artificial kidney apparatuses was assessed by using 5 different methods of regenerating the dialysis solution. In the series of model experiments the authors have studied the quality of the solution purification from urea, creatinine, uric acid, nonorganic phosphorus and potassium ions. Clinical trial of the regeneration systems was performed in patients with chronic renal failure on preparation for renal transplantation. The efficacy of the regeneration systems by elimination from the blood of metabolic products was not inferior to the standard hemodialysis system working in the discharge mode. The most promising method was that of electrochemical regeneration of the dialysis solution.

Hemodialysis Solutions