Currently, there is no uniform respiratory support strategy during cardiopulmonary bypass (CPB) in cardiac anesthesiology.The aim of the study was to examine possible variants of respiratory support during CPB and determine the most effective technique capable to reduce the incidence of postoperative pulmonary complications.Material and methods. Ninety cardiac surgery patients were enrolled in the pilot study and divided into groups (CPAP, VC, and apnea). In the CPAP group, positive airway pressure of + 5 cm H2O was maintained during CPB. The VC group patients underwent mechanical ventilation during CPB with a reduced tidal volume of 3 mL/kg, respiratory rate of 6/min, and REER of + 5 cm H2O. In the apnea group, patients received no respiratory support (non-rebreathing system).Results. In both the apnea and CPAP (constant positive airway pressure) group, there was a decrease in oxygenation index (OI) at the end of the CPB compared with baseline values. In the apnea group, the OI dropped from 316.31±81.76 to 230.10±102.48, while in the CPAP group it decreased from 319.37±80.01 to 223.17±152.36 (P<0.001). No significant changes in this parameter were observed in the VC group. The frequency of recruitment maneuvers after CPB to correct the impaired respiratory oxygenation was maximal in patients from apnea group (22 cases (73%) versus 13 cases (43%) in the CPAP group and 5 cases (16%) in the VC group) (P<0.001). Frequency of pulmonary atelectasis on chest radiology in postoperative period was 47, 37, 10% in apnea, CPAP, and VC groups, respectively, and the difference was also significant (P=0.006).Conclusion. Low-volume ventilation is the preferable method of respiratory support in cardiac surgery patients during CPB.

Первый Московский государственный медицинский университет им. И. М. Сеченова МЗ РФ (Сеченовский университет), Москва, РФ В кардиохирургии частота развития различных послеоперационных осложнений, в том числе и легочных, остается на достаточно высоком уровне� Цель: оценка эффективности применения высокочастотной искусственной вентиляции легких (ВЧ ИВЛ) во время искусственного кровообращения (ИК) как меры профилактики послеоперационных легочных осложнений в сравнении с малообъемной вентиляцией� Материалы и методы. В исследование включено 60 кардиохирургических пациентов� Группа HF (ВЧ ИВЛ с контролем давления в дыхательных путях с частотой 300/мин, соотношением длительности вдоха и выдоха 1:2, средним давлением в дыхательных путях 8 мбар) и группа VC (вентиляция легких во время ИК с параметрами: дыхательный объем 3 мл/кг, частота дыхания 6/мин, положительное давление конца выдоха +5 см Н 2 О)� Результаты. Статистически значимой разницы между группами в отношении индекса оксигенации на всех этапах ведения пациентов не выявлено� Общее количество пациентов с выявленными ателектазами в послеоперационном периоде в группе VC составило 3 (9%), а в группе HF -4 (12%) (p = 0,71)� Частота применения рекрутмент-маневров после окончания ИК в группе VС -5 (16%), HF -6 (18%) (p = 0,75)� Продолжительность послеоперационной ИВЛ не различалась между группами исследования� Вывод. Проведение ВЧ ИВЛ в период ИК не имеет существенного преимущества перед малообъемной ИВЛ� Применение обоих режимов вентиляции сопровождается одинаковыми эффектами в отношении послеоперационной оксигенирующей функции легких�

As the body ages, free radical processes intensify and the risk of various age-related diseases increases, including memory impairment, as exchange processes in nerve cells deteriorate. The internal antioxidant system, capable of neutralizing free radicals, is not always able to cope with the growing load, and then the supply of antioxidants from outside is necessary. A source of biologically active substances possessing antioxidant activity are plant extracts possessing a pronounced therapeutic effect combined with a minimum of side effects. The purpose of our study was to study the learning and memory of the offspring of rats that received aqueous plant extracts as an additional load. The study of the learning and memory of the offspring of rats that received aqueous plant extracts of Ginkgo biloba, Centella asiatica, Eleutherococcus and a mixture of aqueous extracts of Ginkgo biloba and Centella asiatica was performed on 4-month-old animals, obtained in an experiment from 15 males and 50 females, which in the course of 30 days water extracts were obtained in a dose of 30 mg/100 g of body weight in a volume of 1 ml. The study was carried out with the help of the test "Passive escape with negative (painful) reinforcement". Conclusions: the offspring of rats that received as an additional load intragastric mixture of aqueous extracts of Ginkgo biloba and Centella asiatica are characterized by the best indicators of learning and memory, compared to the offspring of animals of the control group, and rats that received aqueous extracts of Ginkgo biloba, Centella asiatica and Eleutherococcus separately.