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Abstract
Abstract. Introduction. Coronary heart disease, the complexity of the surgery conducted, inflammatory reaction to extracorporeal circulation and the need for perioperative anticoagulation influence perioperative state of hemodynamics during the surgical revascularization of a myocardium in patients with coronary heart disease.
The aim. To improve the results of treatment of cardiac surgery patients with heart failure who underwent surgery, namely, coronary artery bypass grafting using extracorporeal circulation by improving methods of diagnosing heart failure.
Materials and methods. 100 cardiac surgery patients with coronary heart disease were operated on at State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. In all the cases, coronary artery bypass grafting was performed using artificial circulation. In patients of group 1 (40 patients) in the postoperative period, the correction of hemodynamic disorders was performed according to the standard protocol. In group 2 (60 patients) - a differentiated approach to the correction of hemodynamic disorders was used.
Results. It was found that in group 2 for stabilization of hemodynamics, oxygen status, microcirculation, smaller doses of sympathomimetics and shorter duration of their use, P <0.05 than in 1 were applied.
Conclusions. The results of the studies indicate the possibility of using the method of phasography, in particular, the analysis of symmetry of the T wave, as a marker of ischemic changes in the myocardium in cardiac patients who underwent coronary artery bypass grafting using artificial circulation. The obtained data show that the developed algorithm of perioperative management of cardiac surgery patients with heart failure makes it possible to significantly accelerate the rehabilitation of cardiac surgery patients, increase patient comfort and reduce the length of their hospitalization. The possibility of using phasography for monitoring of myocardial condition in patients undergoing coronary artery bypass surgery has been investigated.
References
Pfortmueller, C. A., Faeh, L., Müller, M., Eberle, B., Jenni, H., Zante, B., Prazak, J., Englberger, L., Takala, J., & Jakob, S. M. (2019). Fluid management in patients undergoing cardiac surgery: effects of an acetate- versus lactate-buffered balanced infusion solution on hemodynamic stability (HEMACETAT). Critical care (London, England), 23(1), 159. https://doi.org/10.1186/s13054-019-2423-8
Babaev, M A, Eremenko, A A, Minbolatova, N M, Dzemeshkevich, S L. (2013). Sindrom poliorgannoj nedostatochnosti u bolnyh posle operacij v uslovajah iskusstvennogo krovoobraschenia [The multiple organ failure syndrome after cardiac surgery with artificial blood circulation]. Khirurgiya, 2,119-123. https://doi.org/10.15360/1813-9779-2010-3-76
Loskutov, O.A., Druzhyna, O.M., Dzyuba, D.O., Pashchenko, S.V. (2019). Comparison of cardioprotective properties of artificial electrical fibrillation
of the heart and Bretschneider solution during coronary artery
bypass grafting. Emergency Medicine, 2 (97), 105-110. https://doi.org/10.22141/2224-0586.2.97.2019.161648
Riedel, B. J., Gal, J., Ellis, G., Marangos, P. J., Fox, A. W., & Royston, D. (2004). Myocardial protection using fructose-1,6-diphosphate during coronary artery bypass graft surgery: a randomized, placebo-controlled clinical trial. Anesthesia and analgesia, 98(1), 20–29. https://doi.org/10.1213/01.ANE.0000094336.97693.90
Oleynikov, D.A., Yashin, A.V. (2015). Energeticheskij obmen miokarda v norme i pri patologii [Normal and pathological energy metabolism of the myocardium]. RVZh – MDZh, 5, 38–41. http://cyberleninka.ru/article/n/energeticheskiy-obmen-miokarda-v-norme-i-pri-patologii
Dyachuk, D.D., Kravchenko, A.N., Feinzilberg, L.S., Stanislavskaya, S.S., Korchinskaya, Z.A, Orikhovskaya, K.B., Pasko, V.S., Mikhalev, K.A. (2016). Skrining ishemii miokarda metodom ocenki fazy repolarizacii [Screening of myocardial ischemia by the method of estimating the repolarization phase]. Ukrainskij kardiologichnyj zhurnal, 6, 82-89. http://nbuv.gov.ua/UJRN/Ukzh_2016_6_11
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