Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Specifics of early post-operational management of patients with ischemic heartdisease over 70 years old

Authors: G.V. Lobacheva

Company:
Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2017-14-2-84-90

UDC: 616.12-004.5-053.89-089.168.1

Link: Clinical Physiology of Blood Circulaiton. 2017; 14 (2): 84-90

Quote as: Lobacheva G.V. Specifics of early post-operational management of patients with ischemic heart disease over 70 years old. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2017; 14 (2): 84–90 (in Russ.). DOI: 10.24022/1814-6910-2017-14-2-84-90

Received / Accepted:  16.05.2017/19.05.2017

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Abstract

As the result of analysis of the literature data performed we found out that the category of patients over 70 years old with ischemic heart disease post coronary artery bypass surgery require further research in order to better understand the specifics of management in the early post-operational period, to decrease the risk of complications and the risk of unfavorable outcomes. The use of preventive drug therapy is justified, especially for the purposes of preventing rhythm disorders. We also noted the efficiency of non-drug-based methods for decreasing the number of post-operational complications, among which the most important is the early activation of patients in post-operational period, ensuring lesser need for critical care support, low risk of thrombosis and embolisms, and accelerated physical and psychological recovery. We also justified the use of post-operation limitation of liquid infusion in order to achieve positive effect in form of organ protections, decreased need for artificial lungs ventilation and blood transfusion. We discovered the advantage in use of epidural anesthesia compared to inhalation anesthesia in form of significantly decreased the degree of post-operative respiratory distress, improved arterial blood gas parameters, as well as provided faster recovery. We detected the decrease of hospital mortality rate and strokes rate in patients over 70 years old when abstaining from use of artificial circulation or at least decreasing its duration.

About Authors

Lobacheva Galina Vasil’evna, MD, PhD, DSc, Professor, Chief of Department of Intensive Care

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