The aim was to assess the efficacy of mitochondriatargeted antioxidant SkQ1 in prevention of structural and functional abnormalities of brain postresuscitation after cardiac arrest.

Materials and methods. Adult male Wistar rats (n=19) underwent cardiac arrest for 7 minutes followed by resuscitation. Nine rats were administered with 500 nmol/kg SkQ1 per os with water for 2 weeks (1 week before and 1 week after resuscitation). A control group consisted of shamoperated animals (n=10). At days 4—6 post operation locomotor activity and anxiety («elevated plus maze» test) and sensorimotor function of limbs («beam walking» test) were examined. Total numbers of neurons per 1 mm of their layer length in vulnerable neuronal populations (cerebellar Purkinje cells and piramidal neurons of hippocampus fields CA1 and CA4) were estimated by histological analysis of the specimens stained with cresyl violet on day 7 postresuscitation. To identify possible mechanisms of SkQ1 action, the immunohistochemical study of a glialderived neurotrophic factor (GDNF) expression in piramidal neurons of hippocampus was performed by indirect peroxidaseantiperoxidase method and antiGDNF primary polyclonal antibodies.

Results. Ischemiareperfusion resulted in neuronal loss in all studied brain areas followed by reduction in locomotor activity and development of sensorimotor deficit. SkQ1 prevented development of postresuscitative locomotor and sensorimotor irregularities, significantly reduced Purkinje cells loss, prevented death of piramidal neurons in hippocampal field CA4, but not in CA1. Data demonstrated, that iIn Purkinje cells from resuscitated rats treated with SkQ1 there was a significant increase in number of GDNFpositive neurons, which were more resistant to ischemia (transition of GDNFnegative cells toward the category of cells actively expressing this factor) that promoted their survival postresuscitation.

Conclusion. Data confirm the positive effects of SkQ1 on structural and functional status of the brain postre suscitation and suggest possible use of SkQ1 for the prevention or correction of posthypoxic encephalopathies.

Objective: to investigate the severity of the stress response of the organism during surgery on the colon because of a tumor by determining the level of stress hormones and glucose depending on various types of anesthesia.

Materials and methods. Patients who have undergone resection surgery because of the colon malignancy were divided into two groups: the study group (n=57) and comparison group (n=35). In the study group a multimodal anesthesia was performed that included a shallow sympathetic blockade in combination with surface inhalation anesthesia. In the comparison group inhalationintravenous anesthesia was performed on the basis of systemic administration of fentanyl when accompanied by myoplegia and sevoflurane insufflation. The levels of insulin, epinephrine, norepinephrine, dopamine, cortisol and glucose in serum were eavaluated during three periods of the study: prior to the induction of anesthesia, at the traumatic moment of operation and at the end of the surgery. Statistical hypothesis testing was performed using nonparametric methods and the data were processed with the aid of Statistica 6 software.

Results. A significant increase of the level of cortisol and serum catecholamines was observed in comparison group during the 2nd and 3rd stages. In the study group, these indicators did not exceed standard values. Insulin level was higher in the study group during the 1st and 2nd stages compared to the comparison group. Insulin level at the end of the surgery was lower in the study group. The glycemic profiles were almost identical with hyper glycemia trend in the comparison group.

Conclusion. Multimodal anesthesia provided most protective effect against stress during traumatic surgeries. The ratio of glucose and insulin values in groups demonstrate the capability of a multimodal anesthesia to prevent postoperative insulin resistance.

Aim of the research is to evaluate the structure changes of the capillaries, arterioles, venules and intra and extravascular alterations in myocardium of rats after traumatic brain injury (TBI).

Material and methods. Experiments were performed in 18 white male noninbred rats. Midline thoracotomy was performed, and the heart excised under intraperitoneal anesthesia (sodium thiopental) on 3, 7 and 12 days after TBI. Myocardial tissue of the left ventricle was examined under light and electron microscopy.

The results showed that following brain trauma there were changes of microvascular wall characterized by alterations of permeability, paracellular oedema, outgrowths of vessel endothelium, swelling, edema, and thinning of endothelial cells, intussusceptions, vacuolization of cytoplasm with fragmentation within the myocardium of the rats with TBI. Intravascular changes were manifested by the formation of hyaline thrombi, microaggregates and sludge of red blood cells in the lumen, altered vascular membrane structures, bubbles or even complete absence of circulation in capillaries (noreflow). Alterations outside of the vascular wall were manifested by the formation of diapedetic hemorrhage and development of a strongly pronounced perivascular edema. The injury of microvessels and the microrelief of the luminal surface of endothelial cells appeared to be important factors of activation of vascularplatelet mechanism of hemostasis.

Conclusion. Treatment of traumatic disease should consider the need in timely correction of nonspecific alter ations associated with TBI to optimize the restructuring of cytoskeleton of endothelial cells, abrogate endothelial dysfunction and prevent microcirculatory complications.

Objective. Evaluating the results of respiratory therapy in patients with complicated traumatic injury of the cervical spine.

Materials and methods. A retrospective comparative analysis of the clinical course was carried out in 52 patients with complicated traumatic injury of the cervical spine: group A: complete spinal cord injury (ASIA A), 37 patients and group B: incomplete injury (ASIA B), 15 patients. The severity of patients' status on integral scales, parameters of the respiratory pattern and thoracopulmonary compliance, gas composition, and acidbase status of the blood were assessed. Data on patients who required prolonged mechanical ventilation, duration of mechanical ventilation, incidence of nosocomial pneumonia, duration of stay in the ICU, time of hospital treatment, and mortality were included in the analysis.

Results. The average APACHE II and SOFA scores were higher in group A patients. The development of the acute respiratory failure required longterm mechanical ventilation (more than 48 hours) in 91.4% of group A patients and in 53.3% of group B patients. Ventilatorassociated pneumonia complicated the disease in 81.3% of group A patients and 62.5% of group B patients and was accompanied by sepsis in 25% and 12.5% of cases, respectively. Statistically significant deterioration of biomechanical properties and gas exchange function of the lungs was observed in patients complicated with septic pneumonia.

Conclusion. Patients with complicated ASIA A and ASIA B cervical spine injuries demonstrate the presence of respiratory failure of neurogenic origin. In addition, the infectious bronchopulmonary complications aggravated respiratory failure in patients with ASIA A injury in 70.3% versus 33.3% in patients with ASIA B. Development
of pulmonogenic sepsis led to deterioration of the biomechanical and gas exchange functions of the lungs and increased the likelihood of unfavorable outcome of the disease in 77.8% of cases. The high incidence of respiratory disorders in patients with complicated cervical spine injury requires timely decision on ventilatory support, especially in patients with complete spinal cord injury.

The aim of the study was to demonstrate the effectiveness of the method of selective polygraphy and resonance stimulation of gastrointestinal tract (GIT) in the complex intensive therapy in early postoperative period in a patient with acute intestinal obstruction complicated by peritonitis.

Materials and methods. The patient L., female, 52 years old, had numerous operations, because of small intestine obstruction complicated by serousfibrinous peritonitis in early postoperative period (7 days after the first surgery). Patient was performed with a longlasting diagnosis procedure followed by the GIT resonant stimulation to restore the motorevacuation function of GIT. An electrogastroenterography device was employed that was approved for clinical use by the Ministry of Healthcare Industry № 226819, 1998).

Results. The amplitude of the oscillations due to resonant effects on the excitable structures gradually increased from 8—22 mkV to 20—44 mkV that indicates the increase of the numbers of passive structures in smooth muscles of the stomach and the jejunum). At the end of three final sessions the amplitudes of the signals (specific reactions) demonstrated the following values: 93 mkV, 88 mkV, 90 mkV, 87 mkV (for the stomach, duodenum, jejunum and ileum, and large intestines, respectively).

Conclusion. These values and activity after the stimulation corresponded to the normal GIT motility.

The first part of the review highlights the data on the structural and functional organization of the microvas culature; regulation of vascular tone including local (metabolic and myogenic mechanisms, role of endothelium and red blood cells) and systemic (nervous, humoral) factors; general issues of microcirculatory alterations in blood loss and shock. Acute blood loss is considered as a phasic development of compensatory and adaptive processes involving the blood system, cardiovascular, nervous and endocrine systems. Changes in oxygen transport, the pathogenesis of hypoxia and metabolic abnormalities in blood loss and hemorrhagic shock are described. Examples of the vicious circles contributing to acute blood loss pathogenesis are considered as a base for developing decompensated hemorrhagic shock in which the role of hemostasis and blood rheology alterations are also considered.

The results of a clinical trial using different high — volume hemofiltration regimens in surgical patients with sepsis is presented.

Objective: improvement the clinical outcomes by inclusion the various regimens of a highvolume hemofiltration in the intensive therapy of patients with sepsis and septic shock.

Materials and methods: The study enrolled 46 patients. Twentyfour patients underwent intermittent very high volume hemofiltration (IHVH) with a replacement volume of 100 ml/kg/h for 4 hours and 22 patients were provided by continuous highvolume hemofiltration (CHVH) with an ultrafiltration dose of 50 ml/kg/h for 48 hours.

Results. In the IHVH group, 28day mortality was 29,2% that was significantly differed from that in the CHVH group (40,9%). The investigation revealed that a body mass index of more than 25 kg/m2 was a contraindications to IHVH.

Conclusion. There were positive changes in the patient's condition associated with the stabilization of the circulatory system and the normalization of the oxygentransport function. These changes persisted during and after the IHVH and were similarly observed in the CHVH group. Patients with high body weight (more than 25 kg/m2) required special blood flow velocity regimen (320—350 ml per minute). Maintaining fraction of filtration for less than 25% and preventing thrombosis hemofilter during IHVH was crucial for effective treatment.