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56 patients with portal hypertension were examined who underwent decompressive shunt surgery. Cardiorhytmography and integral rheography body were performed in different stages. In the late postoperative period, there were positive changes in the autonomic regulation of functions: reduced tension index and sympathetic influence on heart rhythm, increases the value of other indicators of heart rate variability. Due to an increase in heart rate and peripheral vascular resistance normalizes blood pressure while reducing the values of cardiac output. There is a further normalization of the reactivity of blood circulation: arterial pressure and vascular resistance during the functional test remained at a constant level of magnitude of shock and cardiac index significantly increased and then decreased to the level of the original values, which corresponds to the reaction apparently healthy. Disorders of regulation, state and reactivity of blood flow in portal hypertension, manifested: 1. Reduction of heart rate variability with a significant increase in sympathetic activity of autonomic nervous system. 2. Reduction of cardiac output and vascular resistance, heart rate, changes in physiological determination of hemodynamic parameters: Blood pressure is determined only by the vessel resistance. 3. Reduction of blood pressure in response to breath holding test.

The work presents an experience with the diagnosing of synchronous tumors of double localization in 256 patients. Operations were performed on 146 of them. Single-stage operations were made in 55 cases. When performing single-stage operations, 20 patients were found to have cancer of the lung with distant metastases or cancer of other localization with a metastasis in the lung. In the other 35 patients the diagnosis of true polyneoplasia was made followed by radical operations. Advantages of single-stage operations are shown, performing the first stage of the operation on the lung being substantiated. The five year survival after surgical treatment of multiple primary cancer was 15%.

In 32% of patients operated on the lungs various changes in the tracheobronchial tree develop as early as during the surgical intervention. They are of determining significance in pathogenesis of postoperative disorders in the external breathing function. Bronchoscopy is the most effective method of diagnosis and of timely correction of these disorders during operation on the lungs.

The causes of lethal outcomes (n = 60) and postoperative complications which occurred in 26.1% of 610 patients operated on for lung cancer were investigated with due consideration for the regularities of thermodynamics of nonequilibrium processes and theory of disasters. A total systems pathological inflammatory reaction, which augments the injury by many times and develops as a result of inadequate anesthesiological protection, underlies the development of the most unfavorable variant of response to surgery leading to life-threatening complications, such as pneumonia, thromboembolism, or ulcerative hemorrhages.

An experience with 350 anesthesias in severely wounded patients is analyzed. Two main tasks had to be solved for successful treatment. The first one is the creation of compensation by the infusion-transfusion therapy. The second one is the defense of compensatory processes from the inhibition by pathological afferentation. The second task was being solved by combination of conductive anesthesia and rationalization of analgesia with phentanyl. This approach resulted in 13% less lethality of the patients.

The impact of different variants of neuroleptanalgesia (NLA) on respiration immediately after gastric resection and cholecystectomy has been studied in two homogeneous groups of patients (30 persons each) after operations on the upper abdominal organs. In patients of group I NLA was performed using fentanyl (initial dose--7.5 micrograms/kg, maintenance dose--100 micrograms) supplemented with epidural blockade and isovolemic hemodilution. In patients of group II NLA was performed with graded administration of 100-200 micrograms fentanyl. In patients of group I right after surgery gas exchange during room air inhalation was unimpaired, while in patients of group II hypoxemia due to inadequate ventilation and metabolic acidosis were registered. It is concluded that the type of anesthesia management suggested has a protective effect on respiration in the earliest postoperative period.

It is not advisable to prescribe any types of the diet to patients with acute surgical diseases of the abdominal cavity in the early postoperative period because of membranous digestion disturbances and intestinal motility dysfunction. The fasting of the patients with the normal nutritional status may be based physiologically in such cases till the recovery of digestive function, since it favours significant desensitization, namely a decrease of the number of postoperative complications and creation of functional rest for the intestine.

The author considers that the most important prerequisite of the effective anesthesiology is high qualification of the anesthesiologist. The main components of the anesthesia are believed to be strong analgesia of the NLA-II type by high doses of phentanyl supplemented with local anesthesia at the expense of peridural blockade and infiltration of trimecain of reflexogenous zones. The motor reaction should be cupped off not by a relaxant but by the increased analgesia. Such analgesia against the background of prophylactic hemodilution, restriction of blood transfusions can reliably maintain homeostasis providing the recovery of clear consciousness and adequate spontaneous respiration as early as the end of injurious operations on the organs of abdomen and chest including those with the artificial blood circulation.

An analysis of clinico-laboratory examinations of 60 patients with a suspected contusion of the heart in an isolated and associated trauma of the chest and experimental investigations on 46 dogs have shown that the closed trauma of the chest with a contusion of the heart is accompanied by disorders of the contractive function of the myocardium and hemodynamics which contributes to the development of cardiogenic shock.

The investigation of indices of the humoral and cell immunity in 48 patients with severe cranio-cerebral injuries and results of high prolonged peridural blockade in 21 patients has shown the efficacy of this curative measure for preventing "shock lung". The blockade has been found however to inhibit indices of immunity and should not be longer than 48 hours.

The relationship between the arterial resistance and pumping function of the heart was studied in 203 patients by the method of integral rheography. An inverse relationship between the pumping capacity of the heart and vascular resistance was confirmed at different stages of examination and treatment of the patients. The maximal levels of increase of the minute blood flow volume were established as well as the conditions under which the increase of the cardiac output discontinued despite the decrease of the postexercise.

Surgical diseases are not infrequently responsible for severe operations when the choice between its endurability and poor effects of the conservative treatment speaks in the favour of surgery. The method of integral body rheography when allows the main hemodynamic indices to be reliably assessed as frequently as it is necessary and under any conditions, gives differentiated and quantitative characteristics of the degree and dynamics of heart failure and circulatory insufficiency. It makes the method valuable as an instrument of surgical control good for a wide clinical application.

Techniques of open field, instrumental food conditioning and acute hypoxic hypoxia were used in experiments on white rats which had been divided into three groups: low--(I), middle--(II) and high-entropy (III). The III group rats were characterized by high motor activity, various postures and states which seemed to account for fast instrumental conditioning of these rats. Rats of the II and III groups (67% of all the rats) proved most resistant against hypoxia and therefore more adaptable to extreme factors.

The method of integral rheography of the body allows to make quantitative and qualitative assessments of the cardiac activity, blood circulation level, systemic arterial tone, the degree of strain of the ventilatory function, volume of the extracellular fluid and some other parameters characteristic of the patient's state as a whole on the basis of a one-channel registration. The method of integral rheography of the body may be taken as a basis for the development of effective systems of the operative medical control of the state of critical patients and those operated upon as well as systems of mass examinations of the population.

Under study was the clinico-roentgenological dynamic of the lung state in 79 patients with severe cranio-cerebral trauma. High continuous peridural blocade performed from the moment of admission to the hospital was shown to prevent the development of hard reactive alterations in the lungs. This method however fails to control acute severe aspiration pneumonia.

Prevention of pulmonary complications according to the generally accepted principles was conducted in 47 patients with severe craniocerebral trauma (control group). At the same time, 32 patients were subjected to a high long-term peridural block at the Th2-6 level (main group). Pneumonia developed in 59.6% of patients in the control group, 71.4% of them died. In the main group pneumonia occurred in 40.7% of patients, 84.6% of them died. A complex of changes corresponding to the "shock-lung" syndrome was detected macroscopically and histologically in the dead patients of the control group. Histological examination in the main group showed that high long-term peridural block led to a 2-3-fold reduction in the frequency of such characteristic signs of "shock lung" as congestive hyperemia, hemorrhage into the alveoli and intraalveolar edema, desquamation of alveolocytes and atelectasis. The authors warn against the danger of the development of immunodepression in the T-system of immunity due to the effect of the block on the intensity of sympathetic efferentation to the thymus.