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. 2021; 18 (1): 1-92 ➤ Центральная гемодинамика, потребление кислорода и оксигенирующая функция легких при рестриктивной и либеральной периоперационной инфузии у больных с приобретенными пороками сердца

Central hemodynamics, oxygen consumption and oxygenating function of the lungs during restrictive and lebaraly perioperative infusion in patients with heart valves defects

Authors: Yudin G.V., Aydashev Yu.Yu., Rybka M.M., Khinchagov D.Ya., Meshchanov B.V., Goncharov A.A.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2021-18-1-60-72

UDC: 10.24022/1814-6910-2021-18-1-60-72

Link: Clinical Physiology of Blood Circulaiton. 2021; 1 (18): 60-72

Quote as: Yudin G.V., Aydashev Yu.Yu., Rybka M.M., Khinchagov D.Ya., Meshchanov B.V., Goncharov A.A. Central hemodynamics, oxygen consumption and oxygenating function of the lungs during restrictive and lebaraly perioperative infusion in patients with heart valves defects. Clinical Physiology of Circulation. 2021; 18 (1): 60–72 (in Russ.). DOI: 10.24022/1814-6910-2021-18-1-60-72

Keywords:  fluid therapy central hemodynamic oxygenating function of the lungs

Received / Accepted:  11.01.2021 / 26.01.2021

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Abstract

Objective: To compare of the central hemodynamic, oxygen transport and consumption and oxygenating function of the lungs in the conditions of restrictive and liberal perioperative fluid therapy in patients operated on heart valves.

Material and methods. A prospective randomized study involving two groups of patients with heart valves deffects: the restrictive strategy group (RS) – 32 patients with limited infusion in pre-bypass period – 3 ml/kg/h, and the liberal strategy group (LS) – 31 patients with volume of infusion in pre-bypass period 20 ml/kg/h. We compared the condition of central hemodynamic, oxygen transport and its consumption, oxygenating function of the lungs in the pre- and post-bypass periods and after the operation, and the total hydrobalance for the operation.

Results. In the post-bypass period and after the operation, oxygen consumption (IVO2) and extraction were comparatively lower in the LS group, 72 ± 26 ml/min/m2 and 17 ± 7% vs. 93 ± 53 ml/min/m2 (p = 0.01) and 24 ± 10% (p = 0.001) in the RS group in the post-bypass period and 83 ± 38 ml/min/m2 and 17 ± 10% vs. 116 ± 60 ml/min/m2 (p = 0.02) and 24 ± 10% (p = 0.001) in the RS group after the operation with the same parameters of central hemodynamic and oxygen delivery. The PaO2/FiO2 index was reduced in the LS group in the post-bypass period of 308 ± 92 against 369 ± 87 in the RS group (p = 0.04) and after the operation 319 ± 78 against 379 ± 73 in the RS group (p = 0.02). The final hydrobalance for the operation was 25.9 (16.9; 33.3) ml/kg in the LS group and 10.9 (4.5; 16.9) ml/kg in the RS group (p < 0.0001).

Conclusion. In comparison with the liberal approach, limiting the volume of infusion provides increased tissue oxygen utilization and improved oxygenating function of the lungs with relatively identical parameters of central hemodynamic and a lower hydrobalance in patients operated on heart valves.

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About Authors

  • Gennadiy V. Yudin, Cand. Med. Sc., Anesthesiologist-Intensivist; ORCID
  • Yuris Yu. Aydashev, Anesthesiologist-Intensivist; ORCID
  • Mikhail M. Rybka, Dr. Med. Sc., Professor, Head of Department of Anesthesiology; ORCID
  • Dzhumber Ya. Khinchagov, Cand. Med. Sc., Anesthesiologist-Intensivist; ORCID
  • Bair V. Meshchanov, Anesthesiologist-Intensivist; ORCID
  • Andrey A. Goncharov, Anesthesiologist-Intensivist; ORCID

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