Obshchaya Reanimatologiya最新文献

{"title":"Responsiveness to Infusion Load under Regional Anesthesia after Off-Pump Coronary Artery Bypass Graft Surgery","authors":"K. V. Paromov, D. A. Volkov, M. Y. Kirov","doi":"10.15360/1813-9779-2023-5-2352","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2352","url":null,"abstract":"Objective. To evaluate the effect of erector spinae plane block (ESPB) and epidural anesthesia on responsiveness to infusion load after coronary bypass surgery on a beating heart. Materials and methods . A prospective randomized single-center study included 45 patients who were grouped into 3 equal arms based on anesthesia techniques: general anesthesia in combination with ESPB (GA+ESPB), general anesthesia and epidural anesthesia (GA+EA) and general anesthesia without regional techniques (GA). Patient’s response to volume loading was assessed using dynamic and orthostatic tests after transfer from the operating room and at the end of the first postoperative day. Passive leg raise (PLR) and standard bolus injection tests were done at the first stage; changes in hemodynamic parameters during verticalization were additionally evaluated at the second stage. Patients with >10% cardiac index (CI) increase after PLR test and >15% increase after bolus injection test were categorized as responders. Results . The concordance of obtained results in PLR and bolus injection tests for the GA+ESPB, GA+ EA and GA groups at the first stage was 0.53 (95% CI 0.12-0.94), 0.68 (95% CI 0.30-1.00) and 0.61 (CI 0.24-0.99), at the second stage - 0.70 (0.32-1.00), 0.84 (95% CI 0.55-1.00) and 0.82 (95% CI 0.47-1.00), respectively. There were no differences in distribution of responders between the groups. CI dynamics did not differ between the groups during verticalization, and there were no associations of CI changes during verticalization with the preceding PLR test results. The dynamics of troponin T and NT-proBNP did not differ between the groups. Conclusion . Methods of regional anesthesia (SPB or EA) do not significantly affect the responsiveness to infusion therapy in the postoperative period after coronary bypass surgery on a beating heart.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135968697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sepsis Course and Outcome Depends on the Genetic Variant in the 3`-Region of Aquaporin 4 Gene AQP4 and Comorbidities","authors":"Anastasia G. Chumachenko, Evgeniy K. Grigoriev, Rostislav A. Cherpakov, Igor N. Tyurin, Vladimir M. Pisarev","doi":"10.15360/1813-9779-2023-5-2291","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2291","url":null,"abstract":"Aquaporins 4 and 5 are proteins that form water channels in the cell membrane, participate in the transfer and migration of immune cells, being expressed on many cell types including CNS astrocytes, kidney cells, lungs, and the immune system. We have previously shown that AQP5 genetic polymorphism is associated with different outcomes of abdominal sepsis. Since another common aquaporin protein, AQP4, is also expressed on the surface of immunocompetent cells, determining cell motility, it was suggested that AQP4 may also be important in the pathogenesis of sepsis, and that AQP4 polymorphism may predetermine sepsis severity and outcome. AQP4 rs1058427 genetic polymorphism has not been studied earlier. The aim of the study was to determine the effects of region 3` polymorphism in the AQP4 gene on the clinical course and outcome of sepsis. Materials and methods. The prospective study included 290 ICU patients from three clinical hospitals in Moscow aged 18-75 years with clinical signs of sepsis (SEPSIS-3, 2016). Results. It was found that the minor T allele of the AQP4 rs1058427 gene provides strong protection against septic shock, as among GG genotype carriers septic shock developed in 66%, but in presence of the minor T allele this number dropped two-fold ( p =0.009, Fisher’s exact test, OR=1.99, 95% CI: 1.12-3.55, n=290). There was a significant association between AQP4 rs1058427 genetic polymorphism and 30-day hospital mortality in a subgroup of patients with more severe organ dysfunction and higher comorbidity burden (cardiovascular diseases, type II diabetes mellitus) requiring extracorporeal treatment modalities and ventilator support for 5 or more days (n=66). Carriers of the minor T allele showed better survival rates as compared AQP4 rs1058427 GG genotype carriers (5 deaths out of 10 and 47 deaths out of 56, respectively, p =0.003, Fisher’s exact test, n=66, OR=5.22, 95% CI: 1.25-21.82, P =0.009, log-rank criterion). Conclusion. The minor AQP4 rs1058427 T allele is associated with protection against septic shock and better survival in sepsis in a group of ICU patients with high comorbidity burden requiring extracorporeal life support interventions.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135141834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of ACE Inhibitors/ARBs Withdrawal on the Risk of Postoperative Complications in Abdominal Surgery","authors":"Nikita V. Trembach, Marat A. Magomedov, Vladislav G. Krasnov, Larisa Yu. Chernienko, Sergey N. Shevyrev, Alexander S. Popov, Elena V. Tyutyunova, Sergey N. Vatutin, Alexey A. Dmitriev, Vasily V. Fisher, Evgeniy V. Volkov, Ivan V. Yatsuk, Victoria E. Khoronenko, Maria M. Shemetova, Alexey I. Gritsan, Sergey V. Sorsunov, Pavel V. Dunts, Ainagul Zh. Bayalieva, Alexey M. Ovezov, Alina A. Pivovarova, Dmitry V. Martynov, Olesya A. Batigyan, Konstantin M. Lebedinsky, Artem N. Kuzovlev, Dmitry E. Fedunets, Tatiana S. Musaeva, Roman V. Veiler, Igor B. Zabolotskikh","doi":"10.15360/1813-9779-2023-5-2328","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2328","url":null,"abstract":"A significant proportion of patients undergoing non-cardiac surgery receive therapy with angiotensin converting enzyme (ACE) inhibitors/angiotensin II receptor blockers (ARBs), which are usually prescribed for treatment of arterial hypertension and CHF. Current guidelines fail to provide clear consensus on whether it is worth discontinuing ACEi/ARBs before non-cardiac surgery. The aim of this research was to assess the contribution of pre-op ACEi/ARBs withdrawal to the development of postoperative complications in patients after abdominal surgery using data from STOPRISK database. Materials and methods. Data of 1945 patients from of the STOPRISK database was used for the analysis. Patients were retrospectively divided into two groups: first group (n=471, 24.2%) included patients subjected to ACEi/ARBs withdrawal 24 hours before surgery, second group (n=1474, 75.8%) included patients continuing on ACEi/ARBs therapy. The 30-day outcomes were analyzed – postoperative complications (acute kidney injury, acute respiratory distress syndrome, anastomosis failure, arrhythmias, circulatory arrest, cardiogenic pulmonary edema, postoperative delirium, myocardial infarction, pneumonia, ileus, postoperative bleeding, pulmonary embolism, acute cerebrovascular accident, wound infection) and mortality. We were not evaluating intraoperative and postoperative arterial hypotension and hypertension, we analyzed the use of vasopressors as a surrogate marker. ACEi/ARBs re-initiation after surgery was not evaluated. Results. One or more post-operative complications were documented in 113 patients (5.8%). Only postoperative delirium was more common in patients (1.06% vs. 0.27%, p =0.027) after ACEi/ARBs withdrawal 24 hours before surgery, the difference reached statistical significance. Sub-analysis in the group of patients with arterial hypertension as the only comorbidity showed no statistically significant differences in the outcomes. Sub-analysis in the group of patients with CFH showed higher incidence of postoperative delirium after ACEi/ARBs withdrawal (2.68% vs. 0.6%, p =0.023). The logistic regression analysis showed that the risk of developing postoperative delirium is influenced by age, vasopressor support, and ACEi/ARBs withdrawal (the area under the curve for the model was 0.92 (0.90-0.93). Conclusion. Rates of pre-op ACEi/ARBs withdrawal (24.2%) are consistent with published data. In the entire cohort, ACEi/ARBs withdrawal resulted in higher incidence of postoperative delirium, as well as in the subgroup of patients with CHF, while ACEi/ARBs withdrawal in the subgroup of patients with arterial hypertension had no influence on postop complications. ACEi/ARBs withdrawal, along with hemodynamic instability and older age, contributes to the development of postoperative delirium, which is the subject of future research.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135142236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for the Development and Severe Course of Ventilator-Associated Tracheobronchitis in Patients with Prolonged Mechanical Ventilation","authors":"Ravshan A. Ibadov, Djurabay M. Sabirov, Otabek D. Eshonkhodjaev, Sardor Kh. Ibragimov, Gavkhar M. Azizova, Tatyana B. Ugarova","doi":"10.15360/1813-9779-2023-5-2320","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2320","url":null,"abstract":"Objective. Identification of risk factors for the development and severe course of ventilator-associated tracheobronchitis (VAT) in patients on prolonged mechanical ventilation (PMV). Methods. VAT incidence rate in the intensive care unit of Academician V. Vakhidov Republican Scientific and Practical Medical Center for Surgery for the period 2018-2022 was evaluated retrospectively in 724 patients who were on PMV (more than 48 hours). Patients’ clinical and demographic characteristics were subjected to factor analysis. Mean age was 52.4±3.3 (18-81) years. VAT was diagnosed based on clinical signs (fever >38°C, leukocytosis > 12 000 ctlls/ml, or leukopenia <4 000 cells/ml, purulent endotracheal secretions, or conversion to purulent), radiological (no progression of existing or emergence of new pulmonary infiltrates) and microbiological (polymorphonuclear lymphocytes with or without bacteria, moderate-to active growth of colonies of potentially pathogenic microorganisms) criteria. VAT prophylaxis was based on the use of bacterial filters and humidification of the respiratory gas; selective decontamination of the digestive tract; regulation of pressure in the tracheal cuff; sanitation of the oral cavity. Treatment of VAT included antimicrobial drugs administered i/v and/or inhalational, bronchodilators, expectorants and mucolytics. Results. VAT incidence rate decreased over time from 24.7% to 10.1% (χ2=9.52; p =0.003) with invariable practice of ventilator support. The incidence of the most severe VAT (hemorrhagic catarrhal purulent) also gradually decreased from 44.7% to 14.3% (χ2=4.53; p =0.034).The duration of PMV and ICU stay in patients with VAT gradually decreased from 202.1±6.15 hours to 125.3±7.81 hours (t=7.73; p <0.0001), and from 9.7±0.25 days to 6.6±0.3 days (t=7.94; p <0.0001), respectively. In patients with VAT (n=122), in contrast to patients without VAT (n=602), the incidence of concomitant COPD was higher – 22.9% vs 10.6%, respectively ( p <0.001). Gram-negative flora was the leading cause for development of severe tracheobronchitis, including Acinetobacter spp . - in 24% of cases, Klebsiella pneumoniae – in 11.6%, Pseudomonas aeruginosa – in 13.0%, Esherichia coli – 10.6%. Less frequently were isolated Staphylococcus aureus – in 5.3%, Enterococcus spp . – in 2.2% and Candida fungi– in 17.0%. The following predictors of severe VAT were identified: age over 60 years (OR=2.28; 95% CI 1.0-4.9), SAPS II > 40 scores (OR=5.9; 95% CI 2.6-13.8), duration of mechanical ventilation > 144 hours (OR=5.4; 95% CI 1.8-16.7) and the presence of malignant neoplasms (OR=2.83; 95% CI 1.2-6.9). Conclusion. Decrease in VAT incidence rates, reduced duration of mechanical ventilation and ICU stay are indicative of adequate VAT prevention and treatment strategies within the analyzed period. Factors associated with VAT development and predictors of severe VAT can be used for identification of high risk patients.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135094230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overtime Histological Changes in the Lungs after Intoxication with Baclofen Alone or in Combination with Ethanol (Experimental Study)","authors":"Olga L. Romanova, Mikhail L. Blagonravov, Pavel G. Dzhuvalyakov, Vladimir I. Torshin, Anton V. Ershov, Evgeniy Kh. Barinov","doi":"10.15360/1813-9779-2023-5-2337","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2337","url":null,"abstract":"The aim of the study was to evaluate the overtime histological changes in the lungs after intoxication with baclofen alone or in combination with ethanol. Materials and methods. The experiment was carried out on 35 male Wistar rats weighing 290-350 g and aged 20 weeks. The animals were split into 7 equal groups (n=5); test drugs were administered via nasogastric tube: rats from Groups 1, 3 and 5 were treated with baclofen at 85 mg/kg; rats from Groups 2, 4 and 6 received similar dose of baclofen and 40% alcohol by volume at a dose of 7 ml/kg; control group rats were not administered with any drugs. Animals of all groups were removed from the experiment by cervical dislocation under anesthesia (chlorolase) after 3 hours (Groups 1, 2), 4.5 hours (Groups 3, 4) and after 24 hours (Groups 5, 6, and the controls). Lung tissue samples were examined by light microscopy. The nonparametric Kraskel-Wallis test was used for multiple comparisons between the groups, and nonparametric Mann–Whitney test with Bonferroni correction was used for pairwise comparison. Results. Light microscopy showed no pathological changes in the lungs of the Control group animals. Baclofen alone, or in combination with ethanol caused significant circulatory disorders (venular and capillary fullness, hemorrhages in the interalveolar septa (IAS) and alveoli, sludge phenomenon), emphysema, atelectasis and distelectasis, and pulmonary edema. IAS thickness in rats from all experimental groups was different from that in animals from the Control group, all differences confirmed by the Kruskel-Wallis test: H=748, p =0.00001. In Group 1 animals IAS was 44.2% thinner ( p =0.00052) vs the control Group, while in all remaining experimental groups it was, on the contrary, thicker: in Group 2 – 57.6% increase in thickness ( p =0.000038), in Group 3 – 99 % ( p =0.00001), in Group 4 – 2.2-fold increase ( p = 0.00001), in Group 5 – 2.1-fold ( p = 0.00001), in Group 6 – 2.5-fold increase ( p = 0.00001). Most significant increase in IAS thickness (6-fold, p =0.00001) occurred within the period from 3 to 4.5 hours after administration of baclofen, while within the period from 4.5 to 24 hours no statistically significant increase occurred ( p =0.99). Co-administration of baclofen and ethanol caused 2.8-fold ( p =0.00001) increase in IAS thickness after 3 hours as compared to the effects of baclofen only. IAS thickness at 4.5 hours after baclofen and ethanol co-administration increased by additional 41.8% as compared to thickness at 3 hours ( p =0.00001). IAS became 11.8% thicker at 24 hours vs 4.5 hours ( p =0.87). At 24 hours IAS was 21.7% ( p = 0.0011) thicker after baclofen and ethanol co-administration vs baclofen alone. The alveoli size increased by 69.4% ( p =0.00001) in Group 1 animals vs the Control group, by 14.3% ( p =0.43) - in Group 2, by 55% ( p =0.00004) - in Group 3, by 26.3% ( p =0.002) - in Group 4, by 45% ( p =0.0003) - in Group 5 (baclofen, 24 h), by 43.3% ( p =0.0004) – in Group 6 (","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135481188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morphological and Functional Alterations of Respiratory Muscle Performance and Spirometry Parameters in Patients with Congestive Heart Failure","authors":"Vitaliy S. Shabaev, Indira V. Orazmagomedova, Vadim A. Mazurok, Aelita V. Berezina, Andrei E. Bautin, Lyudmila G. Vasilyeva, Daria A. Aleksandrova","doi":"10.15360/1813-9779-2023-5-2344","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2344","url":null,"abstract":"The purpose of the study. To identify structural changes and functional modifications in respiratory muscle performance in patients with congestive heart failure. Materials and methods. We conducted prospective observational study at the V.A. Almazov National Medical Research Center involving 118 subjects: 49 patients with congestive heart failure (CHF-group) and 69 healthy people (control group). NYHA functional classes of II to IV were taken as inclusion criteria in the CHF group, and respiratory diseases, abdominal pathology, morbid obesity, and anemia – as exclusion criteria. Ultrasound imaging was used to assess the structural (thickness) and functional (thickening and excursion indices) diaphragmatic impairments during quiet (resting) and deep breathing. Facemask spirometry was used to assess pulmonary function. Results. Patients with CHF were on average older than 59.0 years (53.0;70.0) vs. 25.0 years (24.0;26.0) in the control group, p=0.000001, had excessive body weight - 82.0 (73.0;95.0) vs. 68.5 (55.0;84.0) kg, p=0.000005 and higher body mass index - 28.4 (24.3;31.3) vs 21.8 (19.9;24.0) kg/m2, p =0.000001, but did not differ in height 173.0 (166.0;179.0) vs. 170.0 (165.0;183.0) cm, 0.97. Lower maximum inspiratory volume (MIV): 3000,0 (2300,0;4000,0) vs. 3684,1 (3392,5;4310,8) ml, p =0.0006, and negative inspiratory force (NIF) measured as max negative pressure generated by the respiratory muscles: 43,1 (-56,7; -33,0) vs. 53,5 (-58,8; - 50,9) mBar, p=0.000082, respectively were found in patients with CHF. The diaphragm was significantly thicker (mm) in patients with CHF during quiet (eupnea) and deep breathing compared to healthy subjects. The thickness at the end of quiet inspiration was 3,0 (2,2;3,6)/1,9 (1,5;2,2) in the right hemi-diaphragm, p <0.001; and 3,0 (2,4;3,5)/1,7 (1,4;2,0) – in the left, p =0.000001; thickness at the end of quite expiration - 2,2 (1,8;2,9)/1,5 (1,2;1,7) in the right dome, p =0.000001; and 2,0 (1,7;2,5)/1,4 (1,2;1,5) – in the left, p =0.000001. Thickness at the end of deep in spiration was 5.1 (4.4;6.1)/4.4 (3.6;5.1) in the right dome, p =0.0005, and 4,9 (4,2;6,2)/ 3,7 (3,1;4,8) – in the left, p =0,000007.The diaphragm thickening index during deep breathing was lower in the CHF group than in the control group: 131.1 (82.5;181.8) vs. 190.9 (150.0;240.0) in the right dome, p =0.000004; and 148.8 (112.5;190.3) vs. 175.2 (130.7;227.7) – in the left, p =0.03, respectively. Diaphragmatic excursions during quiet breathing were larger in patients with CHF than in healthy controls : 2,3 (1,6;2,8)/1,7 (1,5;1,9), p =0,0001 and 1,8 (1,5;2,2)/1,5 (1,3;1,9), p=0,03 of the right and left domes, respectively. Conclusion. Congestive heart failure contributes to the development of structural and functional impairments of the diaphragm.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135592067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Endothelinergic and Nitroxidergic Reactions in Predicting the Functional Outcome in Patients with Ischemic Stroke of Different Severity","authors":"A. M. Tynterova, E. M. Moiseeva, A. M. Golubev, N. M. Shusharina","doi":"10.15360/1813-9779-2023-5-2354","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2354","url":null,"abstract":"The aim of this study was to assess the value of nitric oxide (NO) and endothelin-1 (ET-1) serum concentrations as potential biomarkers for predicting the functional outcome in patients with acute ischemic stroke. Material and methods. A total of 37 patients diagnosed with ischemic stroke and admitted to a multidisciplinary vascular center were included in the study. The patients were divided into two groups based on the severity of neurological deficits as determined by the National Institutes of Health Stroke Scale (NIHSS): Group 1 consisted of 20 patients with NIHSS scores < 15, and Group 2 consisted of 17 patients with NIHSS scores ≥15. The functional outcome was assessed using the NIHSS absolute values and the degree of disability measured by the Modified Rankin Scale (mRS) by comparing the values before and after baseline treatment. Lab evaluation included quantitative assessment of stable NO and ET-1 metabolites in patient’s serum at admission and on day 10 of hospital stay. The SPSS Statistics V23.0 for Windows software package, Python programming language, and Pandas and SciPy libraries were used for statistical data processing. Results. Group 1 patients demonstrated a statistically significant decrease in NIHSS ( p =0.0013) and mRS ( p <0.0001) scores, which was indicative of a favorable functional outcome. Group 2 patients showed some recovery of only neurological deficit measured by NIHSS scale ( p =0.0012), changes in degree of disability by mRS were statistically insignificant. On Day10 of hospital stay, both groups showed a clinically significant increase in ET-1 content, and slight change in NO concentration. NIHSS score demonstrated a significant negative correlation with baseline ET-1 concentrations: r = - 0,82, p =0,00023— in Group 1; r = - 0,55, p =0,00075 — in Group 2. Modified RS scores showed negative correlation with NO (r = - 0,50, p = 0,00044) and ET-1 (r = - 1,0, p= 0,0074) concentrations in Group 1, and positive correlation with NO (r = 0,55, p = 0,0023) and ET-1 (r = 0,33, p = 0,04) concentrations in Group 2. Conclusion. Monitoring of NO and ET-1 serum concentrations provides valuable insights for personalized assessment of the anticipated functional outcome in patients with cerebral ischemia. Further research and the development of prognostic mathematical models are needed to validate the use of endothelial function markers as predictive indicators of patients' recovery potential during the acute phase of ischemic stroke.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135966587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Destabilization of the Organized Structure of Ventricular Fibrillation During Reperfusion","authors":"Marat I. Gurianov, Peter K. Yablonsky","doi":"10.15360/1813-9779-2023-5-2338","DOIUrl":"https://doi.org/10.15360/1813-9779-2023-5-2338","url":null,"abstract":"Aim: to study the effect of reperfusion on the organized frequency-amplitude structure of ventricular fibrillation (VF) in the dog heart. Materials and methods. We conducted 4 experiments on 8 dogs. In each experiment, the isolated heart of one dog was perfused with the blood of the second (supporting) dog. In 4 experiments on an isolated artificially perfused heart, 6 episodes of 3-minute ischemia and 10-minute reperfusion of the heart were performed in VF (1-2 episodes of ischemia-reperfusion in one experiment). Each episode of 3-minute ischemia in VF was preceded by a 10-minute perfusion of the heart in VF. Ventricular electrogram was recorded during VF episodes. A frequency-amplitude (spectral) analysis of one-second segments of the electrogram was performed, and the proportion (in %) of 0.5-15 Hz frequency oscillations in 10-second segments of the electrogram was determined in 6 episodes of perfusion, ischemia and reperfusion in VF (M±m, n=60). The VF frequency-amplitude structures during ischemia and reperfusion were compared with the stable VF frequency-amplitude structure during perfusion taken as the control. The nonparametric Welch criterion in the “The R Project for Statistical Computing” software environment was used to compare the VF parameters during perfusion, ischemia and reperfusion. Results. 9-10 Hz frequency oscillations dominated in the VF frequency-amplitude structure during heart perfusion, taken as the control. In the first 30 seconds of ischemia, the frequency and amplitude of the dominant oscillations did not significantly change vs VF control obtained during cardiac perfusion. A decrease of dominant oscillations frequency up to 6.5-7.5 Hz, and of the proportion of oscillations - up to 26% was documented at the 3rd minute of ischemia. At the 1st minute of reperfusion, the frequency of dominant oscillations increased to 13.5-14.5 Hz, but the proportion of oscillations remained reduced to 26%, as at the 3rd minute of ischemia. At the 2nd minute of reperfusion, the frequency of dominant oscillations decreased to 9.5-10.5 Hz, and the proportion of dominant oscillations increased to 33%. The frequency and amplitude of the dominant oscillations stabilized at 3-10 minutes of reperfusion: oscillations at 9-10 Hz frequency accounted for 32-33% of the spectral power. Conclusion. Reperfusion in VF is characterized by transient destabilization of VF organized structure at the 1st minute of the procedure. VF organized structure regains stabilization within 2-10 minutes of reperfusion. Cardiac perfusion in intentionally induced VF can be used instead of cardioplegia during major cardiac surgery to boost cardiac resistance to ischemia and prevent or reduce reperfusion complications.","PeriodicalId":53475,"journal":{"name":"Obshchaya Reanimatologiya","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136312752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}