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MATERIALS AND METHODS: We studied 66 patients (males aged 39.5 +/- 5.3) with hemorrhagic shock II. Gas composition of arterial and venous blood and a detailed analysis of the blood were studied twice (before and after hemotransfusion). RESULTS: We found that a low-volume (up to 2 doses) transfusion of erythrocyte mass with terms of storage up to 3 days, held after bleeding stop and hypovolemia correction, is the most effective treatment for hemorrhagic shock II. CONCLUSIONS: Substitution therapy in operating room does not contribute oxygen transfering in tissues and inhibits stimulation of the bone marrow due to hypoxia. Thus the substitution therapy is an aggravating factor when the bleeding stopped, but hypovolemia not eliminated.

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It was studied 66 males aged 39.5±5.3 years with hemorrhagic shock II degree. Gas composition of arterial and venous blood was studied twice (before and after transfusion). It was revealed that succinct transfusion of packed red blood cells (to 2 doses) with storage life to 3 days after bleeding stop and hypovolemia filling is the most effective correction of hemorrhagic shock II degree. Replacement therapy in operating room in condition of stopped bleeding and unrepaired hypovolemia is burdening factor because it does not conducive to transfer of oxygen at the tissue level and inhibits stimulation of bone marrow in response to hypoxia.

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The article reviews recent studies of iron exchange and its role in a traumatic disease and traumatic shock. The review stresses a relationship of iron metabolism disturbance with free radical oxidation, lipid peroxidation and multiple organ dysfunctions. The article deals with data of unbound iron collect mechanisms, ways of endotoxemia activation, haemostasis and haemodynamics disturbance proving the role of iron in a multiple organ dysfunctions during traumatic disease.

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MATERIALS AND METHODS: We conducted an open prospective study in 60 patients (30 men and 30 women) with acetic acid poisoning. A randomization was performed on the groups, taking into account the tactics of infusion therapy: group I--15 patients who did not receive an infusion therapy at a pre-admission stage; group II--15 patients who received the infiusion therapy with solution of sodium chloride 0.9%; group III--15 patients who received the infusion therapy with modified gelatin (Gelofusinwn), group IV-15 patients who received the infusion therapy with reamberinum. RESULTS: We found that the most favorable results were noted in patients of group IV in the early posttraumatic period.

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The review deals with a modern view of iron exchange in general and during pregnancy, in particular Different views on the mechanisms of the development of anemia in pregnancy are reflected. The protective role of anemia is noted, and also the opinion of the review authors to the negative role of prophylactic supplementation of iron is reflected. Are numerous and compelling scientific evidence pointing to the large number of negative prevention of iron. That questioned the usefulness of routine appointments for pregnant women with iron. According to a large number of studies assigning pregnant iron on the one hand, contributes to excessive activation of free radical oxidation, the accumulation of lipid peroxidation products and demonstrations of eclampsia, and from the other potentiates the bacterial aggression and development of purulent-septic diseases that generally leads to the development of complications in pregnancy.

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An analysis of efficacy of 1.5% reamberin solution usage was made in 80 patients for correction of blood rheological properties disorder in the case of peritonitis and bowel obstruction. It was established, that reamberin, which was administered in the dose of 500 ml after 12 hours of the beginning of intensive care during 48 hours, efficiently corrected the rheological disorders. It was because the erythron and reticulocyte production were activated, the hyposmolarity was removed, the intensity of free radical oxidation and peroxide oxidation of lipids was decreased and the antioxidant status was restored. This facilitated the hydrophily and erythrocyte volume decrease, the haemolysis reduction and qualitative gas exchange at the level of tissues.

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A group of 66 patients with purulent-septic surgical pathology on the background of type 2 diabetes mellitus (in the compensation phase) and atherosclerosis of vessels in lower extremities (in the decompensation phase) have been studied. The status of all patients has been determined by the syndrome of systemic inflammation reaction (rated 12.4 +/- 2.2 on the APACHE II scale). Group I (n = 30) included 19 men aged 53.7 +/-7.7 and 11 women aged 54.4 +/- 9.1, which were administered reamberin (single daily dose of 500 ml for three days after operation). Group II (n = 36) included 24 men aged 56.1 +/- 9.2 and 12 women aged 51.9 +/- 8.8 with analogous pathology and general status, which received infusion therapy without reamberin. It is established that the administration of reamberin in patients with purulent-septic surgical pathology on the background of type 2 diabetes mellitus and atherosclerosis of vessels in lower extremities is patho-. genetically justified and allows the reperfusion syndrome upon various operations to be prevented and the critical state in post-operation regime to be eliminated.

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It is revealed that in all models of critical conditions will activate the free-radical oxidation, decreasing the total antioxidant activity, the concentration of transferrin decreases in the serum of the blood, increase of the concentration of ferritin, the theological properties of the blood are violated and the signs of endothelial dysfunction are identified. Pre-entered deferoxamine in the dose of 80 mg/kg reduced the intensity of free-radical oxidation processes, restoring the antioxidant potential, concentration of the transferrin, and a lower level of ferritin, contributed to the normalization of blood theological properties and a reduction of the extent endothelium destruction as a result of the reduction Fe2+ concentration in blood serum.

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A case of severe paracetamol poisoning is described. The beneficial outcome of potentially fatal poisoning (a single intake of 20 g paracetamol) is believed to depend on intensive therapy with remaxol to maintain reparative processes in hepatocytes.

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Modern concepts concerning iron metabolisms in the body, its circulation, involvement into free radical processes and lipid peroxidation (LP) are reviewed. Spetial attention is paid to cytotoxic effects, Fe2+ influence on lipid peroxidation, its role in multiple organ failure development in critical states. Iron ion can be bound by desferal, which may be effectively used for intensive care of critical states.

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The experience of management of 426 children with chemical burns of the esophagus and the stomach has been analyzed. The necessity of earlier (up to 3 hours) lavage not only of the stomach, but also of the esophagus, is substantiated. It is considered advisable to carry out diagnostic fibrogastroesophagoscopy not later than 1 day after the trauma and to give up early prophylactic bouginage of the esophagus. The latfer rather stimulates sear formation than prevents it. The developed scheme of treatment was used in 256 patients with resultant decrease of postburn stenoses of the esophagus 3 times is the results of conventional methods of treatment.

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