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. 2022; 19 (3): 193-286 ➤ Стратегия инфузионной терапии при операциях аортокоронарного шунтирования без искусственного кровообращения

Стратегия инфузионной терапии при операциях аортокоронарного шунтирования без искусственного кровообращения

Авторы: Хинчагов Д.Я., Рыбка М.М.

Организация:
ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава России, Москва, Российская Федерация

Для корреспонденции: Сведения доступны для зарегистрированных пользователей.

Раздел: Обзоры

DOI: https://doi.org/10.24022/1814-6910-2022-19-3-201-210

УДК: 616.132.2-089

Библиографическая ссылка: Клиническая физиология кровообращения. 2022; 3 (19): 201-210

Цитировать как: Хинчагов Д.Я., Рыбка М.М. . Стратегия инфузионной терапии при операциях аортокоронарного шунтирования без искусственного кровообращения. Клиническая физиология кровообращения. 2022; 3 (19): 201-210. DOI: 10.24022/1814-6910-2022-19-3-201-210

Ключевые слова: аортокоронарное шунтирование без искусственного кровообращения, стратегия инфузионной терапии

Поступила / Принята к печати:  08.02.2022 / 03.03.2022

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Аннотация

При операциях аортокоронарного шунтирования без применения искусственного кровообращения (АКШ без ИК) инфузионная терапия является важной и неотъемлемой частью анестезиологического пособия. Проводимая инфузионная терапия должна обеспечить стабильность гемодинамики, не оказывая отрицательного влияния на оксигенирующую функцию легких и на частоту развития органной дисфункции. Решение проблем волемических нарушений позволит повысить безопасность пациента при операциях АКШ без ИК. В настоящее время существуют 3 стратегии инфузионной терапии: «либеральная», «рестриктивная» и «целенаправленная». Распространенные в последнее время «рестриктивная» и «целенаправленная» стратегии инфузионной терапии доказали свое преимущество при операциях повышенного риска сложности в сравнении с «либеральной» инфузионной терапией. В данной обзорной статье освещены современные представления о стратегиях инфузионной терапии при операциях у взрослых пациентов, описаны и проанализированы существующие в настоящее время исследования, посвященные стратегиям инфузионной терапии при операциях АКШ без ИК.

Литература

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****
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  13. Singh S., Kuschner W.G., Lighthall G. Perioperative intravascular fluid assessment and monitoring: a narrative review of established and emerging techniques. Anesthesiol. Res. Pract. 2011; 231493. DOI: 10.1155/2011/231493
  14. Kendrick J.B., Kaye A.D., Tong Y., Belani K., Urman R.D., Hoffman C., Liu H. Goal-directed fluid therapy in the perioperative setting. J. Anaesthesiol. Clin. Pharmacol. 2019; 35: 29–34. DOI: 10.4103/joacp. JOACP_26_18
  15. Harrois A., Baudry N., Huet O., Kato H., Dupic L., Lohez M. et al. Norepinephrine decreases fluid requirements and blood loss while preserving intestinal villi microcirculation during fluid resuscitation of uncontrolled hemorrhagic shock in mice. Anesthesiology. 2015; 122 (5): 1093–102. DOI: 10.1097/ALN. 0000000000000639
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  18. Romagnoli S., Rizza A., Ricci Z. Fluid status assessment and management during the perioperative phase in adult cardiac surgery patients. J. Cardiothorac. Vasc. Anesth. 2016; 30 (4): 1076–84. DOI: 10.1053/j.jvca.2015.11.008
  19. Sedehi D., Cigarroa J.E. Precipitants of myocardial ischemia in chronic coronary artery disease: a companion to braunwald's heart disease. 2018: 69–77. Elsevier. DOI: 10.1016/B978-0-323-42880-4.00006-6
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Об авторах

  • Хинчагов Джумбер Яковлевич, канд. мед. наук, врач – анестезиолог-реаниматолог; ORCID
  • Рыбка Михаил Михайлович, д-р мед. наук, руководитель отделения анестезиологии-реанимации и интенсивной терапии; ORCID

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