The purpose of the study was to analyze the Russian legislation to identify the medicolegal aspects of cardiopulmonary resuscitation, which are most significant for an intensive care anesthesiologist. Statutory acts concerning human health care, including those pertinent to cardiopulmonary resuscitation and those providing for the responsibility of medical workers in some cases were analyzed. A number of discrepancies in various legal acts concerning human death verification and resuscitative measures were identified. The analysis has revealed the aspects of cardiopulmonary resuscitation, which are, from the point of view of legislation, most important for the physician.

The investigation was undertaken to study early postresuscitative sexual differences in cerebral structural and functional changes 12 min after cardiac arrest in albino rats. There were great sexual differences in orientative-investigating behavior and anxiety before, as well as neurological recovering processes after clinical death, without distinctions in cardiopul-monary resuscitative processes and postresuscitative mortality. Common changes in the content of peptide substances having a molecular weight of as high as 5 kDa in the brain tissue and gender-associated features were revealed in the early postoperative period. The baseline increased behavioral activity and a rapid postresuscitative recovery of females, unlike males, are associated with the early postresuscitative development of neurodystrophic and degenerative changes in the neuronal populations of the hippocampus and cerebellum.

Inhaled nitrous oxide (iNO) therapy aimed at improving pulmonary oxygenizing function and at decreasing artificial ventilation (AV) load has been used in foreign clinical practice in the past decade. The study was undertaken to evaluate the hemodynamic and gas exchange effects of iNO in acute respiratory distress syndrome (ARDS) that developed after car-diosurgical operations. Fifty-eight (43 males and 15 females) patients aged 21 to 76 (55.2±2.4) years were examined. The study has demonstrated that in 48.3% of cases, the early stage of ARDS is attended by the increased tone pulmonary vessels due to impaired NO-dependent vasodilatation. In these patients, iNO therapy is an effective therapeutic method for correcting hemodynamic disorders and lung oxygenizing function.

The results of the multicentric study on «The safety of the spinal anesthesia during the caesarean section» describing the analysis of the hemodynamic changes due to neuroaxial block in parturients were presented. Thirteen clinics participated in the study. The volume of the sampling includes 2228 spinal anesthesia protocols. The study results confirm the consistency of some well-known regulations and standards of the safe performance of spinal anesthesia. Moreover, the following facts were revealed: the preinfusion during the spinal anesthesia does not have a preventive effect on arterial hypotension; the increase of the infusion volume results in elevating of the arterial hypotension frequency during spinal anesthesia; the bandaging of the lower extremities is a serious measure to prevent the hemodynamic complications; the application of 6% pentastarch solution for the postin-fusion is an effective method to prevent the arterial hypotension during spinal anesthesia for the cesarean section.

Acute rat experiments have studied the impact of acute blood loss on the distribution of water fractions (total, free, and bound) in myocardial and hepatic tissues and whether detected impairments can be corrected by laser irradiation. They have provided an insight into the new pathogenetic mechanisms responsible for homeostatic disorders in blood loss and some aspects of the mechanism of action of laser emission on the body’s adaptive processes. The functioning of biopolymers and molecular structures in tissues is largely determined by their content of water. The redistribution of water towards to a blood loss-associated increase in bound water is a compensatory reaction aimed at preserving the biological structure of biopoly-mers. The decrease in hydrant-bound water suggests that there are severe derangements of their structure. The changes in the tissue free/bound water ratio reflect the degree of the body’s dysadaptation to blood loss. Laser irradiation has an adap-togenic effect on the structure of water in compensated hemorrhagic shock and a damaging action in decompensated one.

 

Trauma of foot and an ankle have high prevalence among the population. Anesthesiological maintenance of operative treatment of such traumas represents a separate problem because of high durations of operation, expressiveness of a postoperative painful syndrome. The important feature of a heavy trauma of the foot is infringement regional haemocirculation of development of a vascular spasm. We offer a technique complex of perioperative analgesia, based on a combination of spinal anesthesia and parenteral introductions of synthetic analogue L-encephaline (Dalargin). Intraoperative dalargin was entered intravenously, in postoperative period — intramuscularly in a combination with ketorol. It is surveyed 42 patients. In comparison with the control, got prolongation of effective spinal anesthesia, decrease of intensity of a postoperative painful syndrome that marked according to a visual analog scale, increase of thresholds of painful sensitivity by the data of electrosensometriya, improvement regional haemocirculation and microcirculation be the date of ultrasonic dopplero-graphia and electrothermometry of a stops skin. Stress — limiting action of a preparation was showed including reduction in comparison with the control leucocitosis and neutrophil shift of leucocitar formulas in the postoperative period, absence of episodes hiperglicemiya. Offered method permits raise of duration of the analgetick effect of spinal anaesthesia, evade appointment in postoperative period opioid analgeticks, improve results of surgical treatment at the expense of normalization of the regional haemodinamicks and avert isemiya of local tissue.

The aim of investigation was opthimizaition an analgesia in patients with the acute forms of an ischemic heart, based on a combination of phentanyl, tramadol and droperidol. It proceeds from a comparative analysis of the investigating vales that a use of the phentanile-tramadole neuroleptanalgesia permits to more adequately conduct an analgesia, normalized the hemodynamics values, has better prognosis. Key words: acute forms of an ischemic heart disease, anginal pains, neurolep-tanalgesia, phentanyl, tramadol, droperidol.

To process a material and to prepare it to be published is a most topical problem in the context of evidence-based medicine. The paper lays down basic requirements for paper in this context. It considers all the constituents: abstract, introduction, materials and methods, results and their discussion, references. Particular emphasis is laid on the description of methods of biomedical studies.

The lungs from persons whose death cause had been idiopathic fibrosing alveolitis (IFA) were histologically studied. Different histological types of IFA were identified. Individual clinical, X-ray, and histological approaches are required to diagnose IFA, by obligatorily performing open lung biopsy, bacteriological and virological studies.

The authors have developed a method for predicting a probable outcome in patients with acute poisoning by mushrooms, by examining the data of routine laboratory studies and dynamic interphase tensiometry and rheometry of sera from patients. Sixty-eight patients with acute mushroom intoxication were followed up. According to the outcome of the disease, they were divided into two groups: A) survivors and B) (deceased). In the sera of the deceased, the time of T monolayer relaxation and the angle of L1 tensiogram slope were 2.5 greater and PN3-PN4 and L2/L1 were 6 and 3.7 times less, respectively, than those in the survivors. Based on these data, by using the discriminant analysis, the authors have derived a classification rule that permits prediction of the outcome of the disease with a high degree of probability, by examining the results of dynamic interphase tensiometry and the data of routine laboratory studies of blood samples from patients with acute poisoning by mushrooms. The derived rule is of high significance (p<0.05).

The purpose of the present study was to examine the pattern of acute intoxications and to analyze the causes of acute chemical injury in Omsk in the past 5 years. The patients referred for and admitted to the Acute Intoxication Center for acute chemical intoxication were qualitatively and quantitatively analyzed. The study has established that there was an increase in the number of patients referred for and admitted to the Acute Intoxication Center in the period of 2000 to 2004; the main causes of acute chemical injury being unintentional intoxications associated with alcoholization and ingestion of poisonous substances for suicidal purpose and a rise in the incidence of poisonings with narcotics. The study shows it expedient to elaborate a regional programme for the prevention of acute exogenous intoxications in the context of the region’s chemical safety jointly with drug addiction and psychiatric services.

The paper presents a concept of formation and development of interregional, regional, and equated centers, interregional specialized units set up on the basis of therapeutic-and-prophylactic institutions on the basis of a multileveled multistage health care system. Large multidisciplinary clinical hospital One (Novokuznetsk) was used as an example to consider the mechanism of integration of innovation technology of organizing a specialized medical aid. Analysis of the needs of the region’s population for dialysis care for patients with acute and chronic renal failure has revealed the barest necessity of setting up a regional hemodyalisis center under a multidisciplinary clinical hospital. The setting up of a hemodialysis center substantially has quantitatively and qualitatively improved health care delivered to patients with acute and chronic renal failure.

The Editorial Board of the journal «Obshchaya Reanimatologiya» intends to publish a series of papers dedicated to the history of the science «Anesthesiology and Reanimatology». In the first paper, the authors attempted to gather historical facts concerning the development of anesthesia. This makes it possible to analyze the course of development of the thought of scientists and physicians, the time of striking discoveries in our specialty, to reflect the most important points that impulses the expansion and optimization of methods of anesthesia and resuscitation. The authors understand clearly that they have no sufficient number of factors associated with the history of anesthesiology and reanimatology and they will be grateful in receiving any comments and additional information on historical aspects, specialized sections of the science, bibliographic data of Russian and foreign sciences dealing with this specialty. The to offer apologies for possible inaccuracies since controversial questions occasionally arise as to authorship and priority of ideas and usage of any methods in practice. There are not sometimes coincidences in the dates of the same events in different references used by us. The authors believe that the proposed historical analysis will generally provide a keen insight into the overall picture of development of world anesthesiology and reanimatology.