RESUMO
We measured the level of cardiac markers (high-sensitivity troponin T and MB fraction of creatine kinase) in children of the first year of life with congenital heart disease in the perioperative period. After cardiac surgery, plasma levels of the above markers exceed the reference limits in the examined children. The diagnosis of myocardial ischemia using biochemical markers in the postoperative period is possible only by dynamic monitoring of the cardiac marker level. The preoperative concentration of high-sensitivity troponin T in children of the first year of life with congenital heart disease can be regarded as a predictor of postoperative complications.
Assuntos
Biomarcadores/sangue , Parada Cardíaca Induzida/efeitos adversos , Cardiopatias Congênitas/cirurgia , Hipóxia/patologia , Isquemia Miocárdica/diagnóstico , Área Sob a Curva , Creatina Quinase Forma MB/sangue , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/complicações , Humanos , Hipóxia/etiologia , Lactente , Isquemia Miocárdica/etiologia , Curva ROC , Troponina T/sangueRESUMO
A new cardioplegic solution based on three natural dipeptides was developed and introduced at the Laboratory of Cardioplegia, A. N. Bakulev Research Center of Cardiovascular Surgery. The electrolyte composition of the solution corresponded to the category of intracellular cardioplegic solutions. The results of 60 experiments on isolated rat hearts were analyzed for choosing the optimal concentration of sodium ions (35, 60, or 80 mmol/liter). The composition of the studied cardioplegic solutions was selected by ion concentrations in the intra- and extracellular fluid. Earlier and most effective recovery of cardiac function with minimum rhythm and conductivity disorders was observed in the group treated with cardioplegic solution with sodium ion concentration of 60 mmol/liter.
Assuntos
Isquemia/fisiopatologia , Miocárdio/metabolismo , Sódio/farmacologia , Animais , Relação Dose-Resposta a Droga , Líquido Extracelular/química , Parada Cardíaca Induzida , Masculino , Ratos , Ratos Wistar , Sódio/administração & dosagemAssuntos
Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Peptídeo Natriurético Encefálico/sangue , Complicações Pós-Operatórias/etiologia , Adulto , Biomarcadores/sangue , Procedimentos Cirúrgicos Cardíacos/mortalidade , Pré-Escolar , Medicina Baseada em Evidências , Mortalidade Hospitalar , Humanos , Lactente , Pessoa de Meia-Idade , Seleção de Pacientes , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/mortalidade , Complicações Pós-Operatórias/fisiopatologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento , Regulação para CimaRESUMO
We present the results of treatment of chronic ischemia of the lower extremities (distal form) with angiogenesis stimulators, autologous endothelioblast precursors (CD133+) and gene preparation of vascular endothelial growth factor VEGF165 (angiostimulin). Good clinical effect was attained in all patients, which was confirmed instrumentally 1, 3, and 6 months after administration of the stimulant: transcutaneous oxygen tension on the foot, index of malleolar pressure, and walking duration increased, parameters of microcirculation improved, the number of newly formed collateral arteries increased (angiography findings), quality of life improved (SF 36 questionnaire), and parameters of coagulogram also improved. The maximum positive dynamics was observed by month 3 of the study.
