[Aprotinin in the correction of the hemodynamic syndrome of systemic inflammatory response in surgeries with extracorporeal circulation].
Seventy-three patients with ischemic heart disease (IHD), who underwent coronary artery bypass grafting with artificial circulation (AC), were examined within a prospective randomized study. The patients were randomized between three groups. The group-1 patients were administered trasilol (T) according to the below scheme: 1 mln KIU from patient's admission to the surgery room to the time the skin incision is made plus 2 mln KIU from the moment the surgical approach is preformed to the beginning of AC. KIU was added to the artificial circulation apparatus (ACA) when it was initially filled (total T dose of 6 min KIU). T was administered in the group-2 patients similarly to the scheme used in group 1; however, it was not added to the ACA (total T dose of 3 mln KIU). And T was not used at all in the group-3 patients. The dose of mezatone administered at the AC stage was reliably higher in groups 3 and 4 versus group 1 (p < 0.05 and p < 0.1, respectively). Doses of mezatone that were used for the vasopressin management did not differ significantly between the groups after surgery. A statistically more significant increase of stroke index (deltaSI) and a decrease of general peripheral vascular resistance (GPVR--deltaGPVR) were registered in 12 hours after surgery in group 3 versus group 1, p < 0.05 and p < 0.01, respectively. The negative deltaGPRV was also more pronounced versus the parameters observed in group 1 and 2 (p < 0.01 and p < 0.02, respectively). Therefore, T, when used at 6 mln KIU in AC, provides for a smaller-scope vasopressin management in AC. And, when it is used before AC at 3 mln KIU, T dose not diminish the dose of vasopressin management in AC. The intraoperative use of T (6 or 3 mln KIU) arrests a pronounced decreased postoperative deltaGPRVR and an increased postoperative CI irrespective of a dose.
Naumenko
S E
SE
Naumenko
K S
KS
Pokrovskiĭ
M G
MG
Kim
S F
SF
D007611:Aprotinin / Q000494:pharmacology / Q000627:therapeutic use*; D001775:Blood Circulation; D001026:Coronary Artery Bypass; D005112:Extracorporeal Circulation; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000601:surgery*; D010656:Phenylephrine / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D014655:Vascular Resistance / Q000187:drug effects; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D006490:Hemostatics; D014662:Vasoconstrictor Agents; D010656:Phenylephrine; D007611:Aprotinin