[Heart surgery interventions in risk patients. New possibilities for improving therapeutic results].
Perioperative therapy in conjunction with cardiac surgery had so far been guided by functional, paraclinical, and clinical parameters which only conditionally enabled objective appraisal of the present condition of the myocardium. Perioperative recording of the arterio-coronary-venous concentration difference of lactate (acDL) has now enabled the use of an objectivated parameter for accurate description of the metabolic-energetic situation of the myocardium. This will be helpful in metabolic-energetic condition monitoring (MESM) to optimise perioperative cardiotonic therapy. Stabilisation of the metabolic-energetic situation of the myocardium, objectivated by MESM, has proved to be superior to premature cardiac support, using catecholamines. It has been associated with improved restitution with high significance (p less than 0.005).
Wollert
H G
HG
Klinik und Poliklinik für Chirurgie, Martin-Luther-Universität Halle-Wittenberg, DDR.
Müller
W
W
Fischer
D
D
Wollert
U
U
Schubert
F
F
Krause
E G
EG
Panzner
R
R
D000328:Adult; D002302:Cardiac Output / Q000187:drug effects; D002316:Cardiotonic Agents / Q000008:administration & dosage; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006331:Heart Diseases / Q000601:surgery*; D006333:Heart Failure / Q000517:prevention & control*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors
D002316:Cardiotonic Agents; D007773:Lactates; D019344:Lactic Acid
Herzchirurgische Eingriffe bei Risikopatienten. Neue Möglichkeiten zur Verbesserung der Therapieergebnisse.