The use of autoblood components — autoplasma or autoerythrocyte concentrate is more effective. As studies have shown, harvesting autoplasma in a volume of up to 1.5 liters by the method of single or multiple plasma exchange is possible even in patients with concomitant diseases and anemia and does not cause clinically significant manifestations of protein deficiency. The creation of such a reserve of autoplasma allows one to achieve stable stabilization of the BCC and provides for the completion of moderate blood loss without any signs of protein mismatch, while the total need for donor blood components is reduced by 2.4 times.

If the estimated blood loss may exceed 25—% bcc, the method of choice is to reserve an auto-erythrocyte concentrate harvested 5— days before the operation using the method of a single hardware erythrocyte apheresis. The volume of erythrocyte concentrate obtained in this way with 0.75– Ht, 85 l / l is 0.4–6 l (20–% of the volume of circulating red blood cells). The safety of the method is ensured by the fact that only autoerythrocyte is harvested to the patient, whose quantitative pool in the body has a triple reserve. In addition, the total amount of exposure does not exceed 10% of the BCC, that is, a safe level. As shown by our studies, transfusion of reserved erythrocytes, conducted according to indications during surgery and in the postoperative period,provides replenishment and stabilization of globular blood volume without using homologous media even if blood loss is 30—% bcc. The main disadvantage of this method is an increased risk of infection of the transfusion medium prepared by the hardware, which requires additional bacteriological control. The results obtained allow us to consider the autocomponent,

controlled by indicators of the oxygen transport system and the degree of hemodilution, blood circulation as the basis for infusion-transfusion therapy, the main purpose of which is to preserve the macro-microcirculation effective, corresponding to increased information, metabolic and oxygen needs of organs and tissues.

Of course, hemodynamic disturbances during pulmonary operations are determined not only by quantitative or qualitative changes in circulating blood. Pain and hypoxia, which naturally lead to disorganization of regulation centers, energy deficit, hypodynamic state of blood circulation, are of no less importance for their development. That is why the infusion-transfusion program can be effective only if the entire intensive care system is effective, the elements of which are interconnected and united by a single task. Such a dialectical approach assumes the probability

significant individual changes of the infusion-transfusion program, if it is necessary to achieve the final beneficial result. In particular, inadequate anesthesia (for example, as a result of intolerance to drugs for local anesthesia or in the case of individual refractoriness to fentanyl, etc.) or acute hypovolemia (with sudden massive blood loss) lead to pathological deposition of up to 20% of the circulating blood, often exceeding volume of the “external” blood loss. In such a situation, the volume of infusions is forcedly increased, reaching 200% or more of the weighted blood loss, and it is possible to stabilize the globular volume and ensure the hyperdynamic circulation regime only with excessive “preventive” blood transfusions. Of course, this increases the intensity of activitieswarning violations of pulmonary gas exchange.

On the other hand, effective analgesia, prevention or timely elimination of hypovolemia and anemia provide an earlier restoration of the patient’s independent breathing, which allows him to extubate immediately after the end of the surgical intervention (that is, during the period when the structural integrity of vital systems is restored, including there is no excess supply of blood and air through the drains from the pleural cavity), of course, always with full consciousness and undoubted performance of the Gale tetrad. Before removal of the endotracheal tube, rehabilitation bronchoscopy is obligatory. If it is impossible to fulfill any of these conditions, it is shown prolonged until the general condition of the patient is stabilized. artificial or assisted ventilation of the lungs with an appropriate complex of intensive therapy in the immediate postoperative period.