Clinical Physiology of Circulation

ISSN 1814-6910 (Print)
ISSN 2410-9134 (Online)

 

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


Issue's catalogue ➤ КФК. 2018; 15 (1): 5-64 ➤ Хроническая гипоксемия как фактор риска при хирургических вмешательствах у больных с врожденными пороками сердца цианотического типа

Chronic hypoxemia as a risk factor for complications in patientswith cyanotic congenital heart diseases

Authors: A.P. Chislova, D.V. Kovalev, T.O. Astrakhantseva

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2018-15-1-5-11

UDC: 612.273.1-036.12:616.12-007-053.1-089.166-06

Link: Clinical Physiology of Blood Circulaiton. 2017; 15 (1): 5-11

Quote as: Chislova A.P., Kovalev D.V., Astrakhantseva T.O. Chronic hypoxemia as a risk factor for complications in patients with cyanotic congenital heart diseases. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2018; 15 (1): 5–11 (in Russ.). DOI: 10.24022/1814-6910-2018-15-1-5-11

Keywords:  polycythemia hemodilution coagulopathy reperfusion damage

Received / Accepted:  09.11.2017/10.11.2017

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Abstract

In patients with cyanotic congenital heart disease, chronic hypoxemia leads to a number of adaptive changes (polycythemia) and damage to organ systems. These pathophysiological changes can develop complications in patients following cardiac surgery with cardiopulmonary bypass. Secondary erythrocytosis is associated with increased blood viscosity and increased risk of thrombosis and embolism. High hematocrit and decrease in plasma volume lead to a deficiency of multiple coagulation factors and increase the risks of intraoperative bleeding. In this review, polycythemia and changes in rheology of blood, coagulopathy, diastolic myocardial dysfunction and proteinuria are considered. The pathogenesis of myocardial reoxygenation injury and the concept of “controlled reoxygenation” are presented. Risk factors and some methods of preventing the development of complications due to chronic hypoxemia during cardiosurgery operations are considered.

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About Authors

  • Chislova Anna Pavlovna, Anesthesiologist-Intensivist; orcid.org/0000-0003-0928-9392
  • Kovalev Dmitriy Viktorovich, Dr. Med. Sc., Leading Researcher, Cardiovascular Surgeon; orcid.org/0000-0002-4586-9258
  • Astrakhantseva Tat’yana Olegovna, Dr. Med. Sc., Leading Researcher, Cardiologist; orcid.org/0000-0002-8393-0275

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