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Latent dysfunction of the heart right ventricle and hypovolemia were assessed in 50 patients divided into 4 groups, operated on the heart, abdominal aorta and lungs. It was found that after revascularization of the myocardium the diastolic disorders prevailed. In patients operated for the heart valve (mitral and aortal) diseases prevailing were the systolic and pump dysfunction of the right ventricle. Insufficiency of the right ventricle in these groups was 13% and 22% respectively. After operations on the abdominal aorta a combination of the systolic and diastolic impairments of the right ventricle were observed. After extended resections of the lungs there was a characteristic combination of systolic, diastolic and pump dysfunctions. When the operation was followed by a decreased minute volume of circulation, its cause was hypovolemia in 29% of cases in the examined surgical patients. The investigation of the right ventricle functions with the help of pulmonary arterial volumetry can reveal their latent dysfunctions as well as hypovolemia in a considerable part of surgical patients.

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Sevoflurane, a new halogen inhalation anesthetic for mononarcosis, was used in 33 patients aged 22-57 years subjected to noncavitary general surgical and urological operations lasting for 50 +/- 9 min. Induction anesthesia consisted in sevoflurane inhalation in a semi-open contour. The anesthetic was delivered first in a dose of 0.2 vol% which was increased to 3-4 vol% by the end of induction (1.5-1.8 MAC). Laryngeal mask was used in 28 patients, in the rest tracheal intubation was carried out after succinyl choline. Maintenance dose of sevoflurane was 2-3 vol%. Electrocardiogram was recorded and arterial pressure monitored by indirect methods, pulse oxymetry and capnography were carried out. For evaluating the probable toxic effect, serum levels of total bilirubin, SGPT, creatinine, alkaline phosphatase, urea, albumin, potassium, and sodium were measured. Sevoflurane did not suppress the respiration and allowed assisted ventilation of the lungs, if necessary. No appreciable changes in the hemodynamics were observed, though heart rate was to be monitored. There were no biochemical shifts indicative of hepatic or renal involvement. Sevoflurane is recommended for total anesthesia in short non-cavitary interventions as mononarcosis, that is, such anesthesia requires virtually no extra narcotics, neuroleptics, or ataractics.

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Aggregation and rheological properties of blood were evaluated in 20 atherosclerotic patients after cryoplasmosorption. The change of the patients' plasma for extracorporeally modified autoplasma reduced coagulation potential, enhanced fibrinolysis and suppressed anticoagulation systems. Clinical efficacy manifested in decreased frequency and duration of anginal episodes, intensity of intermittent claudication. Biochemically, cholesterol levels and atherogenic index lowering was evident.

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It has been established that aortocoronary bypass surgery is characterized by imbalance in lipid peroxidation and antioxidant defense system. These changes are more pronounced in patients with the most severe forms of ischemic heart disease. During surgery the greatest intensity of lipid peroxidation is observed at the end of assisted circulation period. To prevent these disturbances it is necessary to minimize surgical trauma, reduce the duration of operation stages, refuse pronounced normobaric hyperoxia during cardiopulmonary bypass.

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The destructive process in the abdominal cavity leading to peritonitis is accompanied by the activation of free-radical lipid oxidation which promotes the disturbances of cellular membrane integrity and the development of endotoxemia. Hemodilution and plasmapheresis decreased the blood level of lipid peroxidation products and activated the system of antioxidant protection.

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The composition of blood was evaluated (parameters of blood clinical analysis, figures of lipid peroxidation processes and system of antioxidant protection, traditional biochemical blood parameters, total proteolytic activity and peptides of blood plasma, quantity and activity of some parameters of humoral immunity) in patients with late stages of peripheral atherosclerosis. It was showed that chronic endotoxicosis appeared in these patients. The processes of chronic endotoxicosis are compensated in patients with the 3-d stage of low extremities ischemia. The quantity of endogenic toxins and markers of endogenic intoxication increased in patients with the 4-th stage of ischemia and loading on the system of detoxication was enlarged; and as a result, compensation reserves of detoxication system of organism decreased.

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The effects of fractional apparatus plasmapheresis in a volume of 25% of circulating blood plasma on the processes of lipid peroxidation and on the antioxidant defence system parameters were studied in 31 patients with ischemia of the lower limbs, stage III-IV. It has been shown that plasmapheresis induces elevation of ceruloplasmin activity and superoxide dismutase activity of blood plasma, lowers the ratio of lipid oxidation to lipid peroxidation products simultaneously with intensification of lipid peroxidation that leads to regeneration of biological membranes of the body.

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Depletion of antioxidant system which accompanies excessive formation of oxygen radicals and increased activity of lipid peroxidation in destructive diseases of the abdominal organs leads to the generalization of the pathological process and severe endogenous intoxication. Hemosorption as part of intensive therapy in patients with peritonitis ensures a decrease in endotoxemia degree due to elimination of toxic LPO metabolites from the blood flow and stabilizes in the post-hemosorption period the activity of free radical reactions due to an increase in antioxidant activity.

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Reconstructive surgery on the vessels of the lower extremities accompanied by ischemia and the following tissue oxygenation leads to the activation of lipid peroxidation causing the destruction of cellular membranes and formation of toxic products, namely medium mass oligopeptides. The accumulation of lipid peroxidation metabolites in the blood correlates with the onset of renal-hepatic failure complicating the postoperative period.

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To ensure controlled lung ventilation in endolaryngeal surgical interventions, using a high-energy laser, use was made of normal frequency jet ventilation (NFJV) and high frequency jet ventilation (HFJV) through a non-inflammable fluoroplast catheter supplied at a distal end with a device fixing it in a central position. HFJV seems preferable, as endolaryngeal manipulations become more convenient. The study was performed in 118 patients. Venturi effect was observed only during ventilation through a tracheostomic canule. It has been established that, unlike NFJV, in HFJV gas exchange parameters are much better, though oxygenation in NFJV is satisfactory in all the patients.

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Investigation was carried out for studying the role of lipid peroxidation (LP) in the genesis of destructive process in the abdominal cavity. The model of experimental peritonitis was made on the dogs. According to the concentration of fat acids conjugates with double couplings (diene conjugates--DC), malondialdehyde (MDA) the LP activity was discovered. Simultaneously the activity of ceruloplasmin (CP), superoxide dismutase activity of plasma, total proteolytic blood activity, summary indicators of antioxidants plasma status and the level of medium-mass molecules was indicated. It was established that LP activation began in the first hours of peritonitis development yet, concentration of LP metabolites (MDA and DC) in plasma increased during disease progressing. CP and superoxide dismutase activity of plasma decreased. Total proteolytic blood activity and level of medium-mass molecules increased after the growth of LP intensity.

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The effect of Staphylococcus albus and the contact time on hydrolytic adsorption of ions on activated charcoal SKN-2K in the physiological solution (0.9% NaCl) was investigated. Experiments were performed without polarization or with cathodic and anodic polarization of the adsorbent. The adsorbed microorganisms decreased the rate of electrolyte ion adsorption, especially in case of cathodic polarization. When activate charcoal was at negative potential (-0.2 V), up to 95% of active microorganisms was adsorbed at the initial concentration of 5.75.10(6) microorganisms per ml, while in case of anodic polarization only 43-44% of microorganisms was adsorbed.

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The investigation of parameters of the artificial pulmonary ventilation and hemodynamics of the greater and lesser circulation circles during operation on the lungs has shown these parameters to be most greatly changed at the stages of separation of the pulmonary root and dissection of the vessels and bronchi. Changes in the ventilatory regimen were not followed by changes in the pulmonary hemodynamics and gas composition of the blood.

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Parameters of hemodynamics and gas exchange were studied in experiments in 25 dogs having experimental microembolism of the lungs. Microembolism was found to result in an abrupt increase of the pulmonary arterial pressure and resistance of lungs, stable hypoxemia with phenomena of metabolic acidosis, incrsed intrapulmonary shunting and the ventilation/perfusion ratio. The mechanisms of hemodynamic and respiratory rearrangement are discussed.

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