[Evaluation of the cardiac pump function and the adequacy of infusion therapy in heart surgery patients in the early postoperative period].
149 patients after open-heart surgery (correction of heart valve defects and aortocoronary bypass surgery) have been examined. Volume expansion was performed by rapid intravenous infusion of 200-800 ml of fluid. Hemodynamic parameters were studied by direct methods. Patients with initially high heart chamber filling pressure were subject to forced diuresis (bolus intravenous injection of 1-2 mg lasix), the changes in hemodynamic parameters were registered with gradual fluid excretion. Left ventricular function curves were plotted in the coordinates: stroke heart work or stroke index--left ventricular end diastolic pressure. A down slope of the Starling curve was registered in 34% of patients, which was indicative of heart failure, volume overload of the myocardium or was prognostically unfavourable as to the onset of heart failure. The values of left ventricular diastolic pressure, when a down slope was registered, varied from 3-5 to greater than or equal to 20 mm Hg, depending on myocardial contractility and diastolic function. Peripheral vasodilation was the earliest sign of the myocardial volume overload. Volume load test proved to be ineffective in 27% of patients and insufficiently effective in 13.7% of patients.
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D000328:Adult; D003327:Coronary Disease / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012214:Rheumatic Heart Disease / Q000503:physiopathology / Q000601:surgery*; D013318:Stroke Volume / Q000502:physiology*
Otsenka nasosnoĭ funktsii serdtsa i adekvatnosti infuzionnoĭ terapii u kardiokhirurgicheskikh bol'nykh v rannem posleoperatsionnom periode.