THE “THIRD MODE” OF BLOOD FLOW AND PARAMETERS OF CENTRAL HEMODYNAMICS IN CHILDREN WITH APPENDICULAR PERITONITIS AND DESTRUCTIVE PNEUMONIA

Introduction. In modern world literature there are no data on changes in the central hemodynamics in children with purulent-septic pathologies. Purpose: to improve diagnostics of cardiovascular disorders in children with appendicular peritonitis and destructive pneumonia using device “Cardiocode”. Material and methods. The trial with “Cardiocode” was conducted in two regional medical centers in Voronezh and Belgorod. Hemodynamic parameters were studied in healthy children (n = 60), in children with destructive pneumonia (n = 83) and in children with appendicular peritonitis (n = 98). Parameters of the central hemodynamics were studied in pre- and postoperative period until recovery. Results. It has been found out that in children with appendicular peritonitis and destructive pneumonia the heart rate exceeds normal limits by 37-58%. The stroke volume in children with appendicular peritonitis did not differ of normal values, while in children with destructive pneumonia it declines by 10-15%. Early diastole was significantly reduced on admission, by 75-85% of normal limits. Reduction of parameters was recorded in the rapid expulsion of left ventricular systole from 80% to 70% of normal limits. In children with destructive pneumonia and appendicular peritonitis, tone of the ascending part of the aorta (Vt.a) was increased as well. conclusion. Apparatus "Cardiocode" is an effective non-invasive tool for early diagnostics and for controlling treatment of hemodynamic disorders in children with appendicular peritonitis and destructive pneumonia.

Left Atrial Appendage Closure Devices for Stroke Prevention in Patients with Non-Valvular AF

The left atrial appendage (LAA) may be involved in offloading atrial pressure during left ventricular systole. As ventricular rate increases, LAA emptying decreases during early diastole causing increased risk of thrombus formation particularly in patients with non-valvular AF (NVAF). The LAA is the site of thrombus formation in more than 90 % of patients with NVAF, so is an important target for thromboembolic prophylaxis in these patients. Anticoagulation therapy is used to treat NVAF, but it has long-term complications and may be contraindicated in some patients. Therefore, alternative strategies to reduce embolic risk in patients with AF have been developed. These include percutaneous, thoracoscopic, and open closure strategies. This study reviews the safety and efficacy of these strategies, comparing these approaches and devices with pharmacological strategies. There is little data to endorse one strategy over another. Given the minimal evidence available, recommendations in support of LAA occlusion remain weak and guidelines have called for more research and coding of endpoints for this emerging technology.

Detection of early signs of circulatory insufficiency in patients with chronic carbon disulfide intoxication

In 27 men who had undergone chronic intoxication with carbon disulfide, the shock ejection, heart rate, minute blood volume, phase analysis of left ventricular systole were examined; the amplitude-time parameters were determined: the rate of cardiac output, the rate of pressure rise and the rate of cardiac relaxation. The parameters of hemodynamics at rest and their change in response to increasing static strengthening of the right hand were studied. The most informative parameters for detecting heart failure in chronic carbon disulfide intoxication were amplitude-time parameters.