Anesteziologiia i reanimatologiia
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Anesteziol Reanimatol · Jan 1996
Comparative Study[The possible mechanisms of a fibrinolytic disorder in patients with severe craniocerebral trauma].
Fibrinolysis components were studied in 32 patients with slight and 38 ones with grave craniocerebral injuries on days 1, 3, 5, and 7 after the injury. No expressed disorders of blood fibrinolytic activity were revealed in patients with slight injuries. Grave craniocerebral injuries were associated with disorders of the plasmin system. Depression of the external and internal mechanisms of fibrinolysis were the most manifest starting from day 3 and caused by a number of factors characteristic of the developing disseminated intravascular blood coagulation syndrome and, possibly, by impaired regulation of the plasmin system by the central nervous system.
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Anesteziol Reanimatol · Jan 1996
Case Reports Comparative Study[The diagnosis and correction of hemostatic system disorders during surgical coagulopathic hemorrhages in cancer patients].
The hemostasis system was examined before surgery, during the principal stages of the operative intervention, and in the early postoperative period in 280 patients with various malignant tumors. The volume of intraoperative blood loss varied from 280 to 14,000 ml. The studies revealed that the main factor causing the most profound disorders in the hemostasis system which lead to the development of grave coagulopathic hemorrhages is blood loss due to surgical trauma. ⋯ Massive blood loss was found to involve primarily damage of the platelet component of the hemostasis system, thrombocytopenia being paralleled by a drastic reduction of the aggregability of these cells, this, in turn, increasing bleeding from small vessels. Laboratory signs of acute DIC diagnosed during surgery anticipate its clinical manifestation. Working classification of operative bleedings and rapid methods for their diagnosis have been developed.
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Anesteziol Reanimatol · Jan 1996
[The pathogenetic and treatment problems of multiple organ failure in patients with severe combined trauma and massive blood loss in the early postresuscitation period].
Analysis of the results of treatment of 583 patients with grave and terminal stages of shock resultant from severe combined injuries and blood loss, hospitalized in resuscitation wards, showed visceral involvement and development of pyoinflammatory complications in the early postresuscitation period (days 5-10 of treatment) in 43.6% cases. Prolonged mixed type hypoxia and persistence of impaired tissue perfusion, shown by rheovasography, play an important role in the mechanisms of development of complications. Early onset (6-8, 10-12 h after the beginning of treatment) and long standing of disseminated intravascular coagulation (DIC) contributes to the pathogenesis of polyorgan failure. A protocol of pathogenetically validated measures for the prevention and treatment of DIC is presented as one of approaches to the prevention and treatment of polyorgan failure.