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A total of 68 patients suffering from chronic obliterating diseases of the lower-limb arteries (CODLLA) under-went treatment with rhythmic pneumocompression (RPC) in the descending <> mode with a simultaneous relief of pressure in the sections of the cuffs. The values of the pneumatic action exceeded the APS determined on the shoulder by 10-20 mm Hg. The therapeutic course consisted of 10-15 sessions. Clinical improvement commenced to be observed as soon as after the first session of RPC: the patients were found to have decreased pain, and increased distance of pain-free walking. Based upon the parameters of the dynamics of the cutaneous temperature on the feet, transcutaneous determination of pO2, dynamic pulse oximetry, acid-base balance, and the indices of the blood gaseous composition, the authors have hereby arrived at the conclusion that the therapeutic impact of the RPC in the mode of the descending <> with the values of the pneumatic impact exceeding the APS was related to the opening of the capillary bed and stimulation of the metabolic processes. The method may therefore be safely recommended to be used in patients presenting with CODLLA, especially in the presence of distal lesions to the arteries of the lower extremities, as a preoperative preparation of the vascular bed.

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It is well known from experiments that the circulation is going on under physiological parameters, only if the rigidity of the aortic wall is sufficiently small. We show that the result can be confirmed by the one-dimensional mathematical model describing the dynamics of the aortic reservoir (AR) by means of a hyperbolic system of PDE.

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About 2 percent of the population of the world suffers from atherosclerotic lesion of the lower extremity arteries. However, the treatment of this pathology is an unsolved problem so far. The authors used a method of rhythmic pneumocompression for medical treatment of patients with chronic arterial insufficiency due to lower extremity vascular atherosclerosis obliterans. A total of 56 patients with stages II-III atherosclerotic lesion were examined. The findings indicated that the method noticeably reduced the intensity of the pain syndrome and tissue ischemia. The procedure exerted a reflex action on the cardiovascular system: the patients had slower heart rate and lowered blood pressure.

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The role of "arterial reservoir" (AR) has been assessed experimentally in 20 mongrel dogs during the onset of acute heart failure (AHF) and in left ventricular bypass (LVB). The criteria evaluating AR function were as follows: diameter and volume of aorta filling (dA; VA), aortic wall distensibility (D). Va in the range of BPm 30.4 to 171 mm Hg changed from 12.62 to 49.32 ml, i.e. two-three-fold. D at maximum and minimum BRm values decreased by 10 and more times. A direct correlation between relative Va and da changes with a coefficient 2 has been observed in any aortic section. BPm (but not BPsy st or BPdia st which characterizes a degree of "tense" AR filling can serve as an adequate index of LVB efficacy.

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Hemodynamics was studied experimentally in 36 mongrel dogs during ventricular fibrillation (VF) in conditions of controlled lung ventilation with tidal volumes (TV) 7, 14 and 21 ml/kg and minute ventilation (MV) 140 ml/(min.kg). Cardiac output determined in ascending aorta varied from 4.1 to 7.3 ml/(min.kg) depending on TV and evaluation period with initial values prior to VF 101-110 ml/(min.kg). In 12 experiments using TV of 14 ml/kg acid-base balance and blood gas composition in central and peripheral circulation compartments have been determined. High HbO2 and pO2 levels in peripheral vessels have been noted; HbO2 difference between aortic blood and caudal vein blood was 37% on minute 30 and 28% between aortic and peripheral venous (femoral vein) blood.

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The experience of the use of noninvasive assisted circulation in patients with cardiac pathology is summarized. It has been demonstrated that rhythmic pneumo-compression of the lower extremities, abdominal compression, muscular electrical stimulation of the lower extremities and the abdomen have a pronounced effect on circulation compartments with low pressure. All the above pre-determines the role of these techniques in the management of cardiac failure and in intensive care.

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The experimental study of 20 mongrel dogs has defined the values of threshold defibrillation (TDF) in 4 positions of voltage electrodes. Analysis of the findings by using the equivalent electric circuit has led to the conclusion that the increase of TDF values, even up to the absence of an effect produced by defibrillation, is due to the shunting of electromagnetic field lines, bypassing the myocardial component of the external circuit of an electrical pulse generator.

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Experiments were conducted on 26 mongrel dogs and 10 calves to evaluate the effect of uni- and biventricular bypass created by means of artificial heart ventricle on hemodynamics in acute cardiovascular insufficiency (ACVI) and heart arrest (HA). The use of unilateral right-ventricular (RVB) and left-ventricular bypass (LVB) was shown to be equivocal: in sufficient functional reserve of the left-ventricular myocardium the volume blood flow in the aorta was increased to a greater degree by RVB (to 2.1 +/- 0.3 l/min) than by LVB (to 2.0 +/- 0.5 l/min). Experiments during HA allowed the authors to evaluate selectively the bypasses in maintenance of the systemic blood flow. It was found that in univentricular bypass the other half of the heart had an effect on hemodynamics, which depended on the initial hemodynamic parameters of the divisions of circulation with high and low pressure, the filling of the heart cavities with blood, and the effect produced through the interventricular septum. The increase of the volume blood flow in the aorta in RVB to 0.6 +/- 0.1 l/min is linked to a great measure by the authors with the conducted artificial ventilation of the lungs. It was noted that the greatest difficulties in maintaining the systemic blood flow in ACVI were associated with the development of disproportion of the contractile function of the right and left parts of the heart. With consideration for this circumstance, the indications for univentricular bypass are determined. A clinical case with prolonged use of LVB (8 days) is discussed.

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Experiments were performed on 15 mongrel dogs to evaluate the influence of electrostimulated contractions of the hind limb and abdominal skeletal muscles on the efficacy of assisted circulation (AC). The influence of massage of the abdomen on AC efficacy was studied in 10 experiments. In electrostimulation of the hind limb muscles the drainage along the femoral vein, measured by the direct method, increased threefold: from 58 +/- 9 to 162 +/- 7 ml/min under conditions of an intact heart and from 5.8 +/- 0.8 to 15 +/- 1.2 ml/min in cardiac insufficiency. The efficacy of AC by the method of left-ventricular bypass by means of the Module artificial heart ventricle (AHV) increased through the flow of blood to the heart, which was manifested by greater AHV performance with rise of systolic and diastolic pressure to 7-8 mm Hg. In cardiovascular insufficiency the influence of electrostimulation on AC efficacy was weaker, the systolic and diastolic pressure increased only by 2-4 mm Hg, in massage of the abdomen both indices increased by 8-10 mm Hg.

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The efficiency of electric defibrillation of the heart was assessed in 17 experiments where the position of action electrodes varied. It is suggested that intravascular application of one electrode plus extravascular application of the other gives the optimum effect. The duration of unassisted reversible fibrillation averaged 3 minutes.

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In the course of the assisted circulation combined with the electrocardiostimulation the comparative study has been carried out to estimate the following conditions of the cardiosynchronization for an assisted circulation device: a) at the R-wave on the patient's electrocardiogram, b) at the R-wave on the ECG when an artefact from the electrocardiostimulation is previously "cut", c) when the electrocardiostimulation pulse is used as that of the cardiosynchronization. A system for the assisted circulation is proposed where the cardiosynchronization is realized by a separator of the R-waves for the ECS, thus providing consistent cardiosynchronization under conditions of both electrocardiostimulation and restoration of the cardiac rhythm.

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The possibility of revascularization of the myocardium in acute ischemia by means of cardiosynchronized retrograde perfusion of the coronary sinus with arterial blood was studied. Signs of a decrease of the ischemic zone and improvement in the metabolism of the intact myocardium were noted.

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