Effect of hypertonic-hyperoncotic solution infusion on tissue perfusion during surgical treatment of the abdominal aorta
| Autor: | Mladen J. Kocica, Lazar Davidovic, Nataša S. Kovačević, Ljiljana Soskic, Tijana Simic, Biljana Milicic |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2007 |
| Předmět: |
Plasma Substitutes
Hemodynamics saline solution Sodium Chloride fluid therapy medicine.artery Medicine Humans Pharmacology (medical) Aorta Abdominal Vein Oxygen saturation (medicine) Aged Aorta lcsh:R5-920 dextrans business.industry Abdominal aorta Osmolar Concentration parenteral hypertonic Middle Aged reconstructive surgical procedures infusions Plasma osmolality Oxygen aorta medicine.anatomical_structure Anesthesia Shock (circulatory) abdominal medicine.symptom Isotonic Solutions business lcsh:Medicine (General) Perfusion |
| Zdroj: | Vojnosanitetski Pregled, Vol 64, Iss 10, Pp 685-689 (2007) ResearcherID |
| ISSN: | 0042-8450 |
| Popis: | Background/aim Decreasing of arterial flow below the critical level leads to capillary endothelium edema and to further worsening of tissue perfusion. Hypertonic solution infusion provides mild and short plasma osmolality increasing, while colloidal solutions intensify that effect. The aim of this study was to investigate the effect of hypertonic-hyperoncotic solution (HH) on the organs perfusion during reconstructive surgical procedure on the abdominal aorta (AA). Methods The study included 40 patients submitted to AA reconstruction due to aneurysm or Leriche's syndrome. A clamp was put transversally to the aorta, under the outlets of the renal arterias. According to the solution received when a clamp was on the aorta, the patients were divided into two groups containing 20 patients each: the tested group (A) which received 4 ml/kg of the solution (7.2% NaCl/10% dextran), and the control group (B) which received 0.9% NaCl. The study excluded the patients with the preoperative creatinine level more than 139 micromol/l, and ejection heart fraction less than 40%. Results The mixed venous blood oxygen saturation increased from 73.3+/-7.33 to 74.95+/-6.19% in the group A, while it decreased from 65.35+/-10.39 to 62.65+/-10.42% in the group B (p = 0.001). The quantity of the provided oxygen in the group A increased significantly from 684.44+/-244.34 to 1362.45+/-2351.01 ml/min, while it decreased from 668.2+/-382.12 to 651.7+/-313.98 ml/min in the group B (p = 0.016). Alveolo-arterial difference in oxygen decreased from 23.12+/-14.74 to 21.1+/-10 mmHg in the group A, while it increased from 23.79+/-15.22 to 26.33+/-13.78 mmHg in the group B (p = 0.05). Conclusion Satisfactory perfusion of organs during the AA surgery is obtained by using both HH and an isotonic solution. Due to maintaining the optimal values of the minute heart volume, saturation of vein blood blended with oxygen, and al-veolo-arterial difference in oxygen, it is recommended to use HH solution for reanimation of patients in declamping shock. |
| Databáze: | OpenAIRE |
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