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Laboratory studies of the influence of the staphylococcal endotoxin on functional properties of thrombocytes and clinical observations of patients with a pronounced syndrome of endotoxicosis have shown an important role of endotoxinemia in pathogenesis of the arising thrombocytopathies. Possibilities of the medicamentous protection of blood plates from the damaging action of endotoxinemia are considered.

The study of arteriovenous ratio of medium-molecular oligopeptides level in 32 patients with acute infectious lung destructions has established an important detoxicating role of the lungs in endotoxemia syndrome during pulmonary-pleural suppurations. It has been found that, with the pronounced endotoxemia syndrome, during catabolic phase of the disease the lungs turn from toxin filter into their source. Detoxicating capacity of the lung parenchyma was shown to be more dependent on the severity of general metabolic disturbances than on the dissemination of suppurative lung destruction.

Positive hemorheological effect was found in using therapeutical plasmapheresis in combination with extracorporeal blood oxygenation. Indications and contraindications for therapeutical plasmapheresis are discussed in the paper.

It was shown that plasmapheresis included in the complex program of intensive therapy of patients with acute pyo-septic lesions of the lungs and pleura allowed to effectively arrest manifestations of endotoxicosis and to improve results of treatment of this category of patients. Extracorporeal hemoxygenation of small volumes added to plasmapheresis at the expense of inclusion of dialyzer DIP-02-02 in the extracorporeal contour considerably reinforced the detoxicating effect of plasmapheresis at the expense of nonspecific biotransformation of toxins.

An examination of 110 patients with septic injuries of the lungs (acute pneumonia without purulent destruction, acute abscessing pneumonia, gangrene and lung abscess) has established that lung parenchyma plays an important role in the regulation of functional properties of thrombocytes. Growth of unfavourable thrombocytic lesions were shown to accompany an increase of sizes of purulent-destructive lesions of the lungs. The suppression of coagulolytic and barrier function of the lungs was found to be associated with the appearance of thrombotic complications.

The results of the clinico-laboratory analysis conducted in 69 patients with varying forms of acute purulent surgical infections have shown that the therapeutic plasmapheresis is attended by the improvement of the disease clinical picture, and attenuation of endotoxicosis by day 3 after the perfusion. Indications and contraindications for plasmapheresis in critical patients are considered, the causes of unsuccessful plasmapheresis procedures are analyzed, the ways for the improvement of this operation are outlined.

Partial megakaryocytograms were studied in patients with acute infectious destructions of the lungs. Acid phosphatase and glycogen megakaryocytic levels, overall number of megakaryocytes elucidated the role of the central link of the system megakaryocyte--platelet in the onset of thromboembolism and hemorrhagic complications arising in the above patients. Inefficiency of megakaryocytopoiesis in pulmonary and pleural acute pyo-destructions is under discussion.

Leukotransfusion from ordinary donors and those immunized by staphylococcal anatoxin were used in complex treatment of 55 patients in a catabolic phase of different forms of sepsis. It was found that transfusion of leukosuspensions, immune ones in particular, had pronounced immunostimulating, detoxicating, antibacterial and anti-inflammatory effects. A short course of transfusions of allogenic leukocytes can be fulfilled without a selection by the HLA system.

The antiviral cellular resistance was studied in 22 patients with acute sepsis of different etiology. The acute sepsis was found to develop as a rule against the background of substantially decreased antiviral cellular resistance. So, treatment of this category of patients should include not only antibacterial and antimycotic, but also antiviral methods of therapy.

In 163 patients with acute suppurations of lungs and pleura a substantial reduction of deformability of erythrocytes was established. The maximum increased rigidity of blood red cells was noted at the peak of the pyo-destructive process and postoperative period as well as in the complicated course of the postoperative period. The curative plasmapheresis, general hyperbaric oxygenation exert positive influence upon plastic properties of erythrocytes.

The authors studied the effect of transfusions of a leukocyte suspension on the main clinico-immunological values of homeostasis in 56 patients with acute pyodestructive diseases of the lungs. They found that inclusion of leukocyte transfusions in the complex of therapeutic measures produced a marked clinical effect, reduced the term of treatment, and allowed successful control of endotoxicosis and immunodeficiency in patients with pulmonary suppuration. Immune leukocytes obtained according to a specially developed method had a more marked immunocorrective effect.

Antiviral cellular resistance was studied in 32 patients with acute purulent-destructive pulmonary diseases and in 46 normal subjects by determination of monocytes and lymphocytes containing viral inclusions and the coefficient of their viral affection. Parameters of humoral activity and functional monocyte activity were also studied. It has been established that these diseases are attended by the affection of immunocompetent cells which leads to the suppression of their functional activity to reduce anti-infectious cellular defence. Development of an abscess and gangrene in the lung is being investigated taking into consideration not only changes in the quantity of the immunocompetent cells but also the dependence on the degree of their functional activity.

The osmolar status was studied in 63 patients with acute abscesses of lungs and empyema of pleura at different stages of the conservative and operative treatment. The hypoosmolarity syndrome was revealed at the acute stage of the disease against the background of a pronounced purulent intoxication. An increased excretion of nonidentified osmotically active metabolites with urine was registered at the height of pyodestructive process and postoperative disease.

An examination of 96 patients has established that the development of a pyo-destructive process in the lungs and pleura is accompanied by an increase of concentration of circulating thrombocytes as well as their adhesive-aggregating activity and degenerative-dystrophic alterations. These parameters were most pronounced in patients 1-3 days before their sudden death from thromboembolism of the pulmonary artery without a clinically detected source. Persantine, aspirin, pyrazolones and heparin in generally accepted therapeutic doses were shown not to possess evident anti-aggregative properties.

The investigation of aggregation properties of erythrocytes in 218 patients with acute pyo-destructive diseases of lungs and pleura at different stages of the conservative and operative treatment has revealed a pronounced hyperaggregation of erythrocytes. The aggregation mechanisms are to be studied and new methods of correction of the aggregation properties of blood red cells are to be searched for.