| Popis: |
Seventy-three patients with ischemic heart disease (IHD), who underwent coronary artery bypass grafting with artificial circulation (AC), were examined within a prospective randomized study. The patients were randomized between three groups. The group-1 patients were administered trasilol (T) according to the below scheme: 1 mln KIU from patient's admission to the surgery room to the time the skin incision is made plus 2 mln KIU from the moment the surgical approach is preformed to the beginning of AC. KIU was added to the artificial circulation apparatus (ACA) when it was initially filled (total T dose of 6 min KIU). T was administered in the group-2 patients similarly to the scheme used in group 1; however, it was not added to the ACA (total T dose of 3 mln KIU). And T was not used at all in the group-3 patients. The dose of mezatone administered at the AC stage was reliably higher in groups 3 and 4 versus group 1 (p0.05 and p0.1, respectively). Doses of mezatone that were used for the vasopressin management did not differ significantly between the groups after surgery. A statistically more significant increase of stroke index (deltaSI) and a decrease of general peripheral vascular resistance (GPVR--deltaGPVR) were registered in 12 hours after surgery in group 3 versus group 1, p0.05 and p0.01, respectively. The negative deltaGPRV was also more pronounced versus the parameters observed in group 1 and 2 (p0.01 and p0.02, respectively). Therefore, T, when used at 6 mln KIU in AC, provides for a smaller-scope vasopressin management in AC. And, when it is used before AC at 3 mln KIU, T dose not diminish the dose of vasopressin management in AC. The intraoperative use of T (6 or 3 mln KIU) arrests a pronounced decreased postoperative deltaGPRVR and an increased postoperative CI irrespective of a dose. |
