Научно-практический журнал
«Клиническая физиология кровообращения»

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

 

Главный редактор

Лео Антонович Бокерия, доктор медицинских наук, профессор, академик РАН и РАМН, президент ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» МЗ РФ


Каталог статей ➤ КФК. 2021; 18 (3): 181-256 ➤ Центральная гемодинамика при операциях реваскуляризации коронарных артерий без искусственного кровообращения

Центральная гемодинамика при операциях реваскуляризации коронарных артерий без искусственного кровообращения

Авторы: Хинчагов Д.Я., Рыбка М.М.

Организация:
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» (президент – академик РАН и РАМН Л.А. Бокерия) Минздрава России, Рублевское ш., 135, Москва, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2021-18-3-201-211

УДК: 616.127-089.168:616.12-005.4-052

Библиографическая ссылка: Клиническая физиология кровообращения. 2021; 3 (18): 201-211

Цитировать как: Хинчагов Д.Я., Рыбка М.М. . Центральная гемодинамика при операциях реваскуляризации коронарных артерий без искусственного кровообращения. Клиническая физиология кровообращения. 2021; 3 (18): 201-211. DOI: 10.24022/1814-6910-2021-18-3-201-211

Ключевые слова: аортокоронарное шунтирование без искусственного кровообращения, анестезиологическое обеспечение, гемодинамика

Поступила / Принята к печати:  03.09.2021 / 21.09.2021

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Аннотация

При осуществлении полной реваскуляризации пораженных коронарных артерий в ходе операций аортокоронарного шунтирования (АКШ), выполняемых без подключения искусственного кровообращения (ИК), повышается анестезиологический риск и возрастает степень сложности обеспечения анестезиологическим пособием. Новые требования, предъявляемые при АКШ без ИК к анестезиологическому обеспечению, связаны с нарушениями функции миокарда и гемодинамическими расстройствами вследствие позиционирования сердца и пережатия коронарной артерии, это определяет необходимость тщательного мониторинга, адекватной кардиотонической поддержки и инфузионной терапии. В статье освещены современные представления о центральной гемодинамике при проведении шунтирования коронарных артерий и рекомендации, позволяющие выполнить полную реваскуляризацию миокарда, снизив риск конверсии на ИК. Представлен обзор основных научных работ в области анестезиологического обеспечения и обеспечения стабильной гемодинамики при операциях АКШ без ИК.

Литература

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****
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  25. Patel N.C., Patel N.U., Loulmet D.F., McCabe J.C., Subramanian V.A. Emergency conversion to cardiopulmonary bypass during attempted off-pump revascularization results in increased morbidity and mortality. J. Thorac. Cardiovasc. Surg. 2004; 128: 655–61. DOI: 10.1016/j.jtcvs.2004.04.043
  26. Vassiliades T.A. Jr, Nielsen J.L., Lonquist J.L. Hemodynamic collapse during off-pump coronary artery bypass grafting. Ann. Thorac. Surg. 2002; 73: 1874–9. DOI: 10.1016/s0003-4975(02)03592-0
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Об авторах

  • Хинчагов Джумбер Яковлевич, канд. мед. наук, врач – анестезиолог-реаниматолог; ORCID
  • Рыбка Михаил Михайлович, д-р мед. наук, заведующий отделением анестезиологии-реанимации; ORCID

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