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Anesteziol Reanimatol ; 60(5): 11-7, 2015.
Artigo em Russo | MEDLINE | ID: mdl-27019881

RESUMO

UNLABELLED: The purpose of the study is to examine the perioperative dynamics of strategic blood oxygen transport indicators: delivery (DO2), consumption (VO2), the coefficient of oxygen uptake (CUO2) and their composition, as well as the dynamics of blood lactate indicators in patients with ischaemic heart disease (IHD) who underwent surgery under cardiopulmonary bypass with high thoracic epidural anaesthesia (HTEA) as the main component of anesthesia. MATERIALS AND METHODS: Research was conducted in 30 patients with a critical degree of operational risk, during the correction of post-infarction heart aneurysmn using the V. Dor method in combination with coronary artery bypass grafting. RESULTS: The strategic blood oxygen transport indicators (delivery, consumption and the oxygen uptake coefficient) showed a statistically significant decrease compared to the physiological norm and to the initial data at two points of the research: the intubation of the trachea and during cardiopulmonary bypass. The system components of oxygen were influenced at problematic stages by the dynamics of SvO2 (increase), AVD (decrease), hemodilution withe fall of the HIb- in the process of JR in the persence of superficial hypothermia. The maintenance of optimal CA in the context of HTEA, combined with a balanced volemic load and a minimized cardiotonic support ensured the stabilisation of strategic blood oxygen transport indicators aithe postperfusion stage and during the immediate postoperative period CONCLUSION: The article is dedicated to the study of strategic blood oxygen transport indicators and their components during the operation of geometric reconstruc-tion of the left ventricle combined with coronary artery-bypass using cardiopulmonary bypass and with high thoracic epidural anesthesia as the main component of general anaesthesia. The analysis has covered the stagewise delivery dynamics, consumption and the oxygen uptake coefficient at II stages of the operation and of the immediate postoperative period. The study has ident (fled the causes qf reduced oxygen transport during the preperfu- sion and postperfusion periods, under IR and during the immediate postoperative period. Values of CA, SvO2, AVD, Hb, hemnodilution, T qf the body in oxygen transport indicator dynamics have been proven. A way of maintaining oxygen transport indicators close to the physiological norm in the immediate postoperative period has been justified.


Assuntos
Anestesia Epidural/métodos , Anestesia Geral/métodos , Ponte de Artéria Coronária/métodos , Ventrículos do Coração/cirurgia , Oxigênio/sangue , Procedimentos de Cirurgia Plástica/métodos , Aneurisma Cardíaco/etiologia , Aneurisma Cardíaco/metabolismo , Aneurisma Cardíaco/cirurgia , Testes de Função Cardíaca , Ventrículos do Coração/metabolismo , Humanos , Pessoa de Meia-Idade , Monitorização Intraoperatória , Infarto do Miocárdio/complicações , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/cirurgia , Consumo de Oxigênio/fisiologia
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