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Biomedical subjects

V V Abbakumov

Publications and source records attributed to V V Abbakumov.

At least 19 recordsLinked to original sources
PubMed1994

[Immunological indices of "drainage" blood used for compensation of blood loss].

The authors discuss experience in compensation for blood loss in patients with ischemic heart disease after aortocoronary shunting using drainage blood without or with donor blood (80 persons) and donor blood alone (60 persons). Mild changes of immunity cell factors were revealed and no differences in the concentration of class A, M, and G immunoglobulins and phagocytosis as compared to the indices recorded before the operation and 24 hours after it. Analysis of postoperative infectious-inflammatory complications showed their incidence to be less in patients who received drainage blood without or donor blood (23%) than in those given transfusion of only donor blood (55%). The results of the study allow drainage blood to be recommended for reinfusion.

Adult↗
PubMed1993

[Current approaches to the prevention of infectious complications in heart surgery].

Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation. Extracorporeal circulation increases the cefotaxime half-life period which is in direct proportional dependence of the period of time between the beginning of the administration of the agent and the beginning of extracorporeal circulation. Immunocorrection by means of myelopid in the early postoperative period accelerates restoration of cellular and humoral immunity, and reduces the frequency of pneumonia occurrence and suppuration of the postoperative wound. Therefore, the prevention of infectious complications after operations on an open heart should be complex and should include broad-spectrum antibiotics and immunocorrective therapy.

Activins↗
PubMed1990

[Various aspects of the status of humoral immunity in patients after surgical correction of rheumatic heart defects under artificial circulation].

The serum concentrations of immunoglobulins A, M, and G were studied in 70 patients with rheumatic heart diseases and in 72 patients with spontaneous and pokeweed mitogen-induced production of these immunoglobulins and mononuclear peripheral blood cells. The investigations were done before and 1-2 and 7-8 days after surgery. Some patients received myelopid in the early postoperative period in addition to the conventional methods of therapy. With high serum IgA, IgM, and IgG levels, reduced humoral immunity was noted. Within the first two days after the operation, the capability of cells to produce IgA and IgG in response to pokeweed mitogen stimulation was lost, the induced IgM production was reduced considerably, and the serum IgA and IgM levels fell significantly. Eight days after surgery, the immune response was partially recovered. Myelopid facilitates complete restoration of humoral immunity and reduces the incidence of postoperative pneumonia more than threefold.

Activins↗
PubMed1986

[Use of sympathomimetic agents in the treatment of acute circulatory insufficiency in the immediate postoperative period of heart surgery patients].

Sympathomimetic agents: isoproterenol (novodrin), dopamine, noradrenalin, adrenalin were used in 137 patients with acute circulatory insufficiency. Their hemodynamic effects were assessed, using catheterization of heart chambers and radiocardiography, and studies of circulating blood oxygen transport, acid-base state and metabolic product levels. A differential approach to sympathomimetic treatment has been developed. Isoproterenol is primarily indicated in those cases where myocardial failure is combined with decreased heart rate, conductivity disorders and markedly increased total peripheral resistance. Dopamine is more justified in cases where increasing the heart rate is more desirable, and there are signs of renal failure and heart rhythm disorders. The possibility of dopamine-induced pulmonary hypertension and pO2 fall should not be dismissed. Correct choice of an agent or a combination of agents makes it possible to control the patient's condition through action on various hemodynamic mechanisms that determine the magnitude of cardiac output.

Acute Disease↗
PubMed1986

[Pathophysiologic aspects of homeostatic disorders in patients after open-heart surgery].

Systemic and intracardiac hemodynamic parameters and laboratory characteristics of oxygen, acid-base and water-salt balance and tissue metabolism were examined in 172 patients operated on for acquired and congenital heart defects and coronary disease. Early postoperative acid-base (SB and BE) parameters in the presence of intensive care cannot be used for the diagnosis of metabolic shifts, while blood lactate monitoring helps to assess the severity of circulatory hypoxia and the adequacy of treatment, and make outcome prognosis.

Acid-Base Imbalance↗
PubMed1984

[Low cardiac output syndrome in heart surgery patients].

Using cardiac chamber catheterization and isotope methods, the systemic and intracardiac hemodynamics was studied in 232 patients who had undergone heart surgery under conditions of extracorporeal circulation. The syndrome of a low cardiac output was detected in 46.9% of the patients and was caused by various forms of heart failure, by hypovolemia, a postoperative shock and pericardiac tamponade. The functional state of the right and the left ventricles of the heart in various types of circulatory insufficiency was shown to vary in different directions. The volume of the circulating blood in the postoperative period was determined by the adequacy of the blood loss compensation, by blood deposition, the redistribution of fluid between the vascular, interstitial and cellular spaces of the body and also by the functional condition of the myocardium. The syndrome of a low cardiac output associated with cardiac tamponade is due largely to the diastolic insufficiency of the myocardium. The shock noted in the open heart surgery patients is a polyetiological syndrome in which the impaired circulation is secondary to myocardial failure, deficit of the circulation blood volume, and microcirculatory disorders.

Blood Transfusion↗
PubMed1982

[Use of intra-aortic balloon counterpulsation in treating acute heart failure in heart surgery patients].

Intra-aortal balloon contrapulsation (IABC) was used as part of combined treatment for acute cardiac failure following cardiac surgery in 17 patients. The monitoring of cardiac output and pressure inside the heart's cavities (using the thermodilution method) showed IABC to produce an obvious hemodynamic effect. Six patients survived. Acute myocardial infarction as a cause of cardiac failure considerably aggravated the outcome. The final result of treatment was not satisfactory in such patients. It is stressed that IABC should be started as early as possible (not later than 2-3 hours after signs of acute heart failure first appear).

Acute Disease↗
PubMed1978

[Radioisotope studies in the practice of an intensive therapy department].

The article discusses the 10-year experience in the use of radioisotop diagnosis in the practice of an intensive therapy department. The results of the examination of over 300 patients who had been operated on under conditions of extracorporeal circulation are analyzed. With the use of radioactive indicators some new aspects of the pathophysiology of acute circulatory disorders were revealed, among others those related to the problem of blood deposition, the correlation between the functioning of the right and left parts of the heart; the diagnostic possibilities in appraising the causes of the disorders of circulation, functioning of the parenchymatous organs, and tissue blood flow were widened; the therapeutic tactics in the development of hypovolemia, acute cardiac failure, and disturbances in tissue perfusion could be elaborated.

Blood Flow Velocity↗
PubMed1978

[Prolonged catheterization of the left atrium in assessing the circulatory state following the surgical correction of a mitral heart defect].

Left-atrial pressure was measured in 36 patients 24 hours to 6 days after surgical correction of the mitral valve under conditions of extracorporeal circulation. The interrelation of the average pressure in the left atrium and the pressure in the right atrium, the end-diastolic pressure in the pulmonary trunk, the cardiac index, and the circulation volume was studied. Normal relation between the average pressure in the left atrium and that in the right atrium was observed in only 1/3 of the patients. The end-diastolic pressure in the pulmonary trunk was close to the pressure in the left atrium in value only in patients with pulmonary-arterial resistance below 220 dyn.s.cm--5. Normal values of the cardiac index were in most patients encountered when the average pressure in the left atrium ranged from 12 to 15 mm Hg. On the basis of the measurement of average pressure in the left atrium, the value of the cardiac index, and the average arterial pressure the tactics in the management of patients after surgical correction of mitral heart disease have been developed.

Blood Circulation↗
PubMed1978

[Cardiac insufficiency and mortality after correction of the mitral valve defect, depending on the degree of cardiac output before the operation].

The course of the postoperative period was studied in 107 patients subjected to adequate correction of mitral valvular disease; 88 of them underwent open heart surgery. The cardiac output was measured by radiocardiography. Total postoperative mortality was 13%, cardiac insufficiency mortality 8.4%. Cardiac insufficiency was encountered in 42% of patients who had been operated on. Significant increase in the rate of cardiac insufficiency with the diminution of the cardiac index with "critical" value of 21/min/m2 was established: cardiac insufficiency was found in 76.3% of patients subjected to operation with cardiac index below 21/min/m2 and in 23.2% among those with cardiac index equal to or more than 21/min/m2. A similar regularity was revealed in analysis of cardiac insufficiency mortality:with cardiac index below 21/min/m2 it was 18.4%, with cardiac index of 21/min/m2 or more, it was 2.9%. No interrelationship was revealed between cardiac insufficiency incidence and mortality and the type of mitral valve lesion, extent of surgical intervention, and duration of extracorporeal circulation.

Adolescent↗
PubMed1977

[Evaluation of the indicators of acid-base equilibrium, oxygen and electrolyte blood levels for early diagnosis of hemodynamic disorders after heart surgery].

In 30 patients operated on under extracorporeal circulation the acid-base, oxygen and electrolytes balance parameters were studied in order to evaluate their potentials as additional diagnostic tests for various clinical forms of acute circulatory disorders in the early post-operative period. Cardiac insufficiency is predominantly characterized by a reduced oxygen saturation of mixed venous blood, an increased oxygen arterio-venous gradient and "lactate excess", hypokalemia and hypernatremia in plasma and erythrocytes. Metabolic and gas parameters of acid-base balance cannot be used for the diagnosis of postoperative cardiac insufficiency. In cases of hypovolemia the changes of the laboratory tests data are determined by the compensatory capacities of the human body in response to circulating blood volume deficit.

Acid-Base Equilibrium↗
PubMed1975

[Postoperative period and principles of intensive therapy after surgery of ischemic heart disease].

The early postoperative course (within 10 days after surgery) is analysed in 218 patients operated upon for the ischaemic heart disease. Resection and plastic repair of the postinfarction aneurysm was undertaken in 132 of them, aortocoronary bypass procedures--in 86. The peculiarities of an uneventful postoperative course are presented, the diagnosis and therapy of the complications are discussed, and the mortality is analysed.

Alanine Transaminase↗