[Target-oriented infusion therapy in patients during myocardial revascularization].
The paper analyzes goal-oriented infusion therapy used during myocardial revascularization on the working heart. Forty-seven patients with coronary heart disease were examined. Group 1 (control) (n = 20) received standard infusion therapy (a combination of colloids and crystalloids (1:1) at a rate of 6-7 ml/kg/h, by being oriented to indices, such as heart rate, blood pressure, central venous pressure, and diuresis rate. In group 2, an anesthetist was oriented to central hemodynamic parameters during infusion therapy. In addition, the patients of this group underwent the 45 degrees passive leg raising test. In this group, a volume load was done at the beginning of an operation until the maximum possible SV resulted from increased preload (global end-diastolic volume index). The goal of infusion therapy throughout the operation was to maintain these values of the latter index. Goal-oriented infusion therapy, the purpose of which was to determine and maintain the individual optimal values of preload, was found to minimize hemodynamic disorders at surgery and to reduce the frequency of use of cardiotonic agents and the duration of artificial ventilation.
Tolstova
I A
IA
Aksel'rod
B A
BA
Shmyrin
M M
MM
Iavorovskiĭ
A G
AG
D000368:Aged; D005440:Fluid Therapy / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D007262:Infusions, Intravenous; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery*; D009204:Myocardial Revascularization / Q000379:methods*; D011446:Prospective Studies; D013815:Thermodilution; D016896:Treatment Outcome