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Biomedical subjects

V P Osipov

Publications and source records attributed to V P Osipov.

At least 19 recordsLinked to original sources
PubMed1992

[First experience in the treatment of bronchial asthma by resection of the superior laryngeal nerve].

Operations were conducted on 21 patients for bronchial asthma. Four of them suffered from the hormone-dependent form of the disease. The duration of the disease ranged from 12 months to 18 years. The operations were performed under local anesthesia through a left approach. The internal branch of the superior laryngeal nerve was exposed and identified and a segment of it was resected. The immediate results were positive in 16 cases, no effect was produced in 5 patients. The positive results were confirmed by clinical data and spirometry.

Adolescent↗
PubMed1991

[Heart transplantation conducted at the All-Union Research Center of Surgery (the first clinical experience)].

The authors analyse experience in the first eight operations for orthotopic transplantation of the heart. Six patients were discharged from the clinic with good immediate results. Comparison of their own data with summarized results gained in other countries allowed the authors to define some specific problems which are of practical interest for clinics embarking on the clinical realization of the problem of heart transplantation.

Adult↗
PubMed1990

[First clinical test of the use of artificial blood circulation with auto-oxygenation].

Thirteen operations for ischemic heart disease were performed in the All-Union Surgery Centre of the AMS USSR using the method of simultaneous left and right heart bypass with oxygenation of the blood in the patient's lungs. This method was found to provide for a better gas exchange in artificial lung ventilation (ALV) with 30 per cent oxygen in the inhaled mixture, and for the reduction in the perfusion blood damage. The biventricular bypass is more complicated technically than the conventional artificial circulation (AC), but it is believed to be more physiological and cost-effective, which allows for considering it an alternative in aortocoronary bypass surgery.

Adult↗
PubMed1990

[Experience in hemoconcentration by ultrafiltration in operations using artificial circulation at the All-Union Scientific Center of Surgery of the USSR Academy of Medical Sciences].

The article deals with the results of using ultrafiltration hemoconcentration in 649 operations conducted on the open heart with extracorporeal circulation at the All-Union Scientific Center of Surgery, USSR AMS during 1983-1989. The method allows control of hemodilution and colloid-osmotic pressure of plasma during the indicated interventions, lessens the loss of blood, and reduces the expenditure of donor blood.

Cardiac Surgical Procedures↗
PubMed1990

[Extracorporeal circulation with auto-oxygenation in cardiac surgery].

The authors describe briefly the historical development of the method of biventricular bypass without the use of and oxygenator and its technique. With regard to the favourable influence on physiological parameters of the organism, the reduced number of complications and the economic factor, the authors consider its wider use in contemporary coronary surgery justified.

Cardiac Surgical Procedures↗
PubMed1989

[Mortality in cardiac surgery].

The authors analyse the status of the title problem as compared with the experience in surgical activity of the cardiosurgical hospital designed for 75 beds, performing 500-600 heart operations a year with the use of extracorporeal circulation. The total hospital lethality was 0 after "closed" interventions and 5.7% after open correction. Analysis is made of the lethality after the most common operations: aortocoronary shunting (1.8%), prosthetic mitral valve (6.7%), prosthetic aortal valves (8%), and radical correction of Fallot's tetrad (6.2%), and so forth. The paper treats of the structure and causes of the lethality, among which attention is drawn to iatrogenesis. Intensification of surgical work on the basis of the standardization of the main stages of the patient's treatment is regarded as one of the approaches to the lethality reduction.

Cardiac Care Facilities↗
PubMed1987

[Middle molecule compounds of the plasma in heart surgery patients in operations with artificial circulation and blood ultrafiltration].

Venous plasma middle molecule compounds (MMC) were determined in 63 cardiosurgical patients, operated on for acquired heart diseases or coronary disease, with assisted circulation (AC) and with or without blood ultrafiltration (BUF). Intraoperative MMC level was superior to that of normal donors, and tended to decrease during AC, while BUF had basically no effect on MMC content, in spite of the latter's withdrawal with the ultrafiltrate.

Adolescent↗
PubMed1985

Hemoconcentration during open heart operations.

During surgical procedures with extracorporeal circulation the method of hemoconcentration by means of blood ultrafiltration was employed to control hemodilution in 84 patients. Disposable plate or hollow fiber dialyzers and a specially designed hemoconcentrator were used. The amount of ultrafiltrate received from one patient varied between 750 and 6250 cc, with a mean of 2588 +/- 221 cc, which was almost similar to the amount of cardioplegic solution given to the patients. Hemoconcentration by means of ultrafiltration is a relatively simple, safe and effective method of hemodilution control during extracorporeal circulation. In contrast to the centrifuging method (plasmapheresis) it preserves plasma proteins. The method is indicated for patients undergoing surgical procedures with heart-lung bypass and uncontrolled profound hemodilution, especially for patients with renal insufficiency. Hemoconcentration helps to reduce blood loss and bank blood usage. The employment of this method is not accompanied by any significant disturbances in humoral homeostasis. Hemoconcentration requires a larger volume of electrolyte solutions (sodium bicarbonate, potassium chloride) during heart-lung bypass. The method can be recommended for routine use in clinics operating on the open heart.

Blood↗
PubMed1982

Arterial pressure: its role in perfusion and as a criterion of extracorporeal circulation adequacy.

Thirty-five patients undergoing open-heart surgery are reported. Cardiac index, mean arterial pressure, oxygen consumption, lactate, pyruvate, and lactate excess in the blood were measured. An inverse correlation of arterial pressure with oxygen consumption and lactate excess was found during perfusion. Comparison of those parameters with hemodynamic and metabolic data before perfusion demonstrated that, even prior to extracorporeal circulation, lactate and lactate/pyruvate ratio affect cardiac index. These parameters determined the level of "hypoxic" lactate concentration as well as arterial pressure during perfusion. These data appear to suggest that during perfusion the severity of metabolic disturbances determines the level of arterial pressure rather than vice versa. Arterial pressure and oxygen consumption, thus, cannot be applied as general criteria of the adequacy of extracorporeal circulation.

Acidosis↗
PubMed1982

Experimental and clinical ventricular bypass during acute heart failure.

Mechanical support of the failing heart in the form of bypass of the left and right ventricles by roller pumps was used in 25 dogs with model cardiogenic shock. Early application of left ventricular bypass in acute heart failure normalizes the myocardial bioenergy state and promotes reversible changes in myocardial ultrastructure as demonstrated by an increased surface area of mitochondrial cristae. On the basis of hemodynamics and morphology, we conclude that pump-aided bypass of ventricles without synchronization is a simple and effective method of circulation assistance. Mechanical support duration from 1 to 138 hours has been used in 10 patients following corrective heart surgery.

Acute Disease↗
PubMed1982

A method for temporary complete substitution of gas exchange function of the lung.

Total substitution of lung gas exchange function can be achieved by oxygenating all blood in a heart-lung machine and requires thoracotomy. In accordance with calculations based on physical principles, if extracorporeal oxygenation is combined with barometric pressure raised to 3 atm, half of the cardiac output will suffice to maintain normal blood oxygenation. Excessive amounts of oxygen dissolved in blood passed through an oxygenator will suffice for the total oxygenation of the rest of the blood. This assumption was investigated in 15 experiments on dogs and one human patient in a hyperbaric chamber. The bubble oxygenator and pneumatic membrane pumps were used. The results suggest that this method of total substitution of lung gas exchange function is feasible. This technique does not require thoracotomy and can be carried out on a patient in any position on the operating table. This method can be used during bronchoscopy treatment, lung lavage, and trachea surgery.

Adult↗