Circulatory failure

Insufficiency of blood circulation in the brain, previous strokes significantly increase the risk of surgery, however, we consider only hemiparesis with impaired respiratory muscle function as a contraindication to surgery, which has a significant negative effect on the respiratory apparatus, even with relatively little changed external respiration rates. In all other cases, an increase in blood circulation reserves due to preoperative preparation,the correct choice of anesthesia, postoperative therapy with the achievement of adequate oxygenation, prevention of hypocirculation and severe hypercoagulation, reduce the risk of recurring complications of hypertension and vascular sclerosis. Examination and preoperative preparation of patients with cerebral atherosclerosis should be carried out under the control and with the participation of a consultant-neuropathologist. Commonly used drugs that enhance the energy processes and respiratory activity of the brain (aminolone), antispasmodics, vitamins.

During the period of preparation for surgical treatment, oxygen therapy has a beneficial effect on the state of the cardiovascular system and the respiratory organs. In the first period of the clinic for this purpose, oxygen inhalation through anesthetic apparatus mask, nasopharyngeal catheters was used with the help of an oxygen tent. In the past two decades, in the preoperative preparation program for patients with lung cancer, hyperbaric oxygenation sessions in a therapeutic pressure chamber (OKA-MT) have been widely used.

Pathogenetic substantiation of the use of hyperbaric oxygenation in lung diseases, including cancer, is based on the elimination of oxygen deficiency (most often of hemodynamic type), restoration of immune homeostasis, potentiation of the effect of drug therapy (including antibacterial therapy, direct effect on the infectious agent (anaerobic flora) . Studies performed in the clinic. , convincingly proved that decompression does not cause barotrauma of the lungs affected by pneumonia, and even the presence of cavities of destruction is not a contraindication to this method of treatment. It was shown that sessions of hyperbaric oxygenation at oxygen pressure up to 2 at (203 kPa) and exposure 40–60 min. do not have a toxic effect on the lung parenchyma, do not lead to deterioration of the diffusion capacity and ventilation-perfusion ratios in the lungs. On the contrary, under the influence of oxygen barotherapy, the general condition of patients is normalized , respiratory mechanics improve, VC and CIO 2increase, respiration decreases, central hemodynamic parameters improve.

Under the influence of hyperbaric oxygenation, myocardial trophicity is restored. The normalization of its metabolism is the disappearance of cardiac arrhythmias, and the decrease in elevated IOC occurs due to a significant decrease in the heart rate, with an increase in UI, which indicates

improving myocardial contractility. In the presence of heart failure under the influence of oxygenbarotherapy, an increase in the tolerance of glycoside therapy is noted. Providing restoration, even if temporary, of the oxygen regime of the body, oxygenation changes the metabolic background on which lung disease develops, stabilizes vital functions, increases the possibility of natural detoxification mechanisms, improves reparative capabilities and immuno-tolerance.

As shown performed in the clinic and investigations , hyperbaric oxygenation has a beneficial effect on the rheological properties of blood, helps to normalize microcirculatory disorders and improve tissue respiration. Thus, in particular, oxygen barbar therapy has a pronounced positive effect on blood hemoaggregation properties in patients with lung cancer, which results in an increase in the rate of platelet aggregation and disaggregation, decrease in acid phosphatase and increase in glycogen, decrease in the erythrocyte aggregation activity and increase their suspension stability. The use of hemorheologically active agents in the complex therapy — antiaggregants (persantil, curantil, trental), antihypoxants (olifen, amtizol, trimin), direct anticoagulants (heparin) contribute to the effectiveness of the correction of hematoaggregatory disorders.

Hyperbaric oxygenation sessions are conducted in a single “Oka-MT” cell for 40– min. with an oxygen pressure of 165— kPa. The course of oxygen therapy in the preoperative period consists of four to five sessions.

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