[A risk of myocardial ischemia and the nature of infusion-transfusion therapy in scheduled surgical treatment of infrarenal aneurisms of the aorta].
The authors analyzed effects produced by different variations of the infusion-transfusion therapy on the risk of cardiovascular complications that can develop in the scheduled surgical treatment of the aorta abdominal part. The patients were randomized in 2 groups. Intraoperative hemodilution was made in group-1 patients (n = 50) before aorta clipping. Hemodynamics was stabilized by colloids and crystacolloids during clip removal; donor packed red blood cells were used at the hemoglobin level below 80 g/l. Group 2 comprised 66 patients for whom autoblood was prepared preoperatively. The infusion volume was limited before aorta clipping; blood losses were compensated for by autoblood and autoerythrocytes collected from surgical blood by "Cell Saver". The below results were obtained on the basis of conducted research: preventive infusion load aggravates, before aorta clipping, the risk of cardiac complications. Maintenance of Hb below the level of 90 g/l is accompanied by an impaired transport of oxygen to tissues; it speeds up the heart beat and provokes an increased cardiac need in oxygen, which enhances the risk of myocardium ischemia. Preparation of autoblood and hardware-based reinfusion of autoerythrocytes provide for an adequate compensation of blood losses and diminish the risk of cardiac complications in the scheduled surgical treatment of infrarenal aneurisms of the aorta.
Merkulov
I V
IV
Neĭmark
M I
MI
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000601:surgery*; D001775:Blood Circulation / Q000502:physiology; D016063:Blood Loss, Surgical; D017707:Erythrocyte Transfusion; D005260:Female; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis / Q000378:metabolism; D006801:Humans; D007668:Kidney / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D010101:Oxygen Consumption; D012306:Risk
D006454:Hemoglobins