[Pulmonary complications of severe craniocerebral injuries and their prevention (clinico-morphologic aspects)].

Prevention of pulmonary complications according to the generally accepted principles was conducted in 47 patients with severe craniocerebral trauma (control group). At the same time, 32 patients were subjected to a high long-term peridural block at the Th2-6 level (main group). Pneumonia developed in 59.6% of patients in the control group, 71.4% of them died. In the main group pneumonia occurred in 40.7% of patients, 84.6% of them died. A complex of changes corresponding to the "shock-lung" syndrome was detected macroscopically and histologically in the dead patients of the control group. Histological examination in the main group showed that high long-term peridural block led to a 2-3-fold reduction in the frequency of such characteristic signs of "shock lung" as congestive hyperemia, hemorrhage into the alveoli and intraalveolar edema, desquamation of alveolocytes and atelectasis. The authors warn against the danger of the development of immunodepression in the T-system of immunity due to the effect of the block on the intensity of sympathetic efferentation to the thymus.