[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.
I V
IV
Merkulov
M I
MI
Neĭmark
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