Use of Alendronate in Postoperative Period for Prevention of Hip Implant Aseptic Instability

2009 ◽  
Vol 16 (3) ◽  
pp. 36-44
Author(s):  
Svetlana Semenovna Rodionova ◽  
T N Turgumbaev ◽  
S S Rodionova ◽  
T N Turgumbaev
Keyword(s):  
Calcium Carbonate ◽  
Bone Density ◽  
Bone Tissue ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Study Group ◽  
Surgical Team ◽  
Tissue Mass ◽  
Mineral Bone Density

Assessment of the alendronate influence upon the course of adaptive remodeling of bone tissue adjacent to the implant was performed. Dynamics of mineral bone density (BMD) changes in Gruen zones was compared for 2 groups of female patients. The groups were similar by age, nosology. All operations were performed by the same surgical team with application of one type of implant (Zweymuller). During the first post-operative year patients from the study group (n=38) were taken alendronate (Fosamax-70) once a week and at least 1200 mg of calcium carbonate daily (either as calcium containing food products or calcium carbonate preparations). Patients from control group (n=94) were taken only calcium carbonate by the same scheme within the first postoperative year. It was detected that although by 6th postoperative month alendronate did not decraese BMD loss as compared to controls, within the interval of 6-15 months it significantly increased bone tissue mass accretion. In group of alendronate patients monthly accretion of bone tissue in some Gruen zones (except for R4) was twice and more higher than in control group. Fifteen months later patients from the main group showed BMD deficit only in R4 zone. In the rest of zones bone tissue mass exceeded the basic values and in the majority of zones that increase was trustworthy. In control group BMD deficit was preserved in two proximal zones (R6 and R7) and in zone R6 it even increased as compared to the results of the previous study (12 months after operation).

Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

2018 ◽  
pp. 39-42
Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Paranasal Sinuses ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Sodium Hyaluronate ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

scholarly journals The influence of sports on indicators of mineral bone density among women descendants of migrants of KHMAO-Yugra

2016 ◽  
Vol 12 (1) ◽  
pp. 198-200
Author(s):  
Maxim V Stogov ◽  
Natalya V Chernitsyna ◽  
Roman V Kuchin
Keyword(s):  
Bone Density ◽  
Bone Mass ◽  
Bone Tissue ◽  
Preliminary Data ◽  
First Generation ◽  
Physical Culture ◽  
Mineral Density ◽  
Autonomous District ◽  
Middle Latitudes ◽  
Mineral Bone Density

The study shows that women descendants of migrants in the first generation, born and residing on the territory of KHMAO-Yugra, not engaged in physical culture and sports, according to densitometry mineral density of bone tissue shows signs of loss of bone mass, not observed in the residents of middle latitudes and the girls engaged in physical culture and sports, living in the Khanty-Mansiysk Autonomous district-Yugra. Preliminary data confirm the assumption that training in physical culture and sport contribute to the prevention of loss of bone mass in women living in the territory of KHMAO-Yugra.

EVALUATION OF THE EFFECTIVENESS OF A CLOSED CIRCUIT IN COMPARISON WITH AN OPEN CIRCUIT OF CARDIOPULMONARY BYPASS

2021 ◽  
pp. 44-47
Author(s):  
Berik Tuishiev ◽  
Gulzhan Bayzhan ◽  
Sabina Samitova
Keyword(s):  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Open Circuit ◽  
Closed Circuit ◽  
Control Group ◽  
Study Group ◽  
Valve Insufficiency ◽  
Group 5 ◽  
Group 2

Objective is to evaluate the effectiveness of closed-loop surgeries with the planned duration of cardiopulmonary bypass more than 2 hours in the immediate postoperative period. Materials and methods. A study was carried out in the clinic over 10 patients (average age 47-56 years) with Diagnoses: Ascending aortic aneurysm, FC 3 aortic valve insufficiency, who underwent surgery for ascending aorta replacement, aortic valve replacement with coronary artery reimplantation. The patients were divided into 2 groups, the 1st group (5 patients) is the control group using an open cardiopulmonary bypass circuit, the 2nd group (5 patients) is the patients using a closed cardiopulmonary bypass circuit. The total time of cardiopulmonary bypass in both groups was 125-187 minutes. Results. In the 2nd study group, drainage blood loss significantly decreased, on average 60-100 ml compared to the control group, where the average drainage loss was 600-1500 ml. The need for blood transfusion was 5.1% in the 2nd group, compared with 43.4% in the control group. In the study group 2, the number of platelets in the postoperative period in patients was higher than in the control group. Conclusion. This study shows that a closed circuit, compared to an open one, allows complex heart surgeries with a planned duration of extracorporeal circulation of more than 2-3 hours.

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

On Possibility of Optimization of Bone Stress Remodeling in Knee Joint Arthroplasty

2009 ◽  
Vol 16 (4) ◽  
pp. 19-23
Author(s):  
Leonid Borisovich Reznik ◽  
M A Turushev ◽  
L B Reznik ◽  
M A Turushev
Keyword(s):  
Bone Density ◽  
Distal Femur ◽  
Main Group ◽  
Control Group ◽  
Radiographic Image ◽  
Bone Stress ◽  
Patient Groups ◽  
Total Knee ◽  
Drug Optimization ◽  
Bone Tissue Remodeling

Using standard photodensitometry bone remodeling was studied in proximal tibia and distal femur after total knee arthroplasty at terms up to 12 months. Out of 120 patients 60 patients (main group) received strontium ranelate (Bivalos) for 12 months after operation and in 60 patients (control group) drug correction was not performed. By the results of standard photodensitometry in both patient groups the density of radiographic image around the implant decreased by 22% at an average within the first 2 postoperative months and that was indicative of osteolysis activity. Later on during the period from 2 to 6 months after arthroplasty the increase of optic bone density was observed. By the end of 12 month in patients from the main group the optic bone density around the implant increased by 39.6% (to preoperative level) and by 25% in controls as compared with the level recorded in 2 months after surgery. Analysis of the total knee replacement by Lischolm scale showed that drug optimization of the processes of bone tissue remodeling enabled to shorten the terms of patients' rehabilitation and to decrease the rate of unsatisfactory results.

scholarly journals IMPROVING THE RESULTS OF TREATMENT OF PATIENTS WITH URETERAL CONCREMENTS AFTER CONTACT URETEROLITHOTRIPSY

2017 ◽  
Vol 4 (2) ◽  
pp. 8-12
Author(s):  
R. M. Solh ◽  
M. I. Andrukhin ◽  
O. V. Makarov ◽  
V. V. Fedchenkov
Keyword(s):  
Laser Therapy ◽  
Postoperative Period ◽  
Acute Pyelonephritis ◽  
Main Group ◽  
Ureteral Stones ◽  
Control Group ◽  
Results Of Treatment ◽  
Group 6 ◽  
Beta 2 ◽  
Beta 2 Microglobulin

Purpose. Im proving the results of treatment of patients with ureteral stones and reducing the dam aging effects of contact lithotripsy.Materials and methods. In this study, 48 patients were examined aged 20 to 63 years. All patients admitted to the urology department with diagnoses: urolithiasis, calculus of the ureter. In all cases contact ureterolithotripsy with stenting of the upper urinary tract were performed. The patients were divided into two groups: main and control. 25 patients (52 .1%) were included into the main group, which in the postoperative period, we used low-level laser therapy (L-therapy). 23 patients were included in a control group (47.9%) who did not receive low-laser therapy. Laboratory tests and ultrasound with Doppler renal blood vessels scan were performed on admission, on the first day after the operation and on the 5-th day of hospitalization. Low-intensity laser therapy was performed within 5 days after contact ureterolithotripsy on projection of placement of stone and kidney projection by series for 5 minutes.Results. All patients admitted to the hospital, were spared from ureteral stones. In the main group during the treatment with L-therapy a decrease in the level of beta-2 microglobulin to normal was observed. (4.8 ± 0.1 mg/l on the first day. On the 5th day 2 .3 + 0.1 mg/l). In the control group during the treatment without the use of L-therapy, the average level of beta-2 microglobulin decreased but did not reach normal levels. (5.5 ± 0.1 mg/l on the first day. On the 5th day 3,2 ±0, l mg/l).Resistance index in the study group decreased compared to the control. In the control group, cases of acute pyelonephritis were observed. The average hospital stay for patients of the main group (6 days) was less than in the control group (6 .5 + days).Conclusion. The use of laser therapy in the treatment of patients who did undergo ureterolithotripsy can reduce the length of stay of the patient in the hospital and reduce the risk of acute pyelonephritis in the postoperative period. Also it can reduce the damaging effect of lithotripsy on the renal tissues.

scholarly journals AGE FEATURES OF BONE TISSUE DENSITY IN THE POSTERIOR AND INFERIOR WALLS OF THE FRONTAL SINUS

2019 ◽  
Vol 6 (1) ◽  
pp. 58-61
Author(s):  
V.V. Gargin ◽  
A.V. Lupyr ◽  
V.V. Alekseeva ◽  
N.O. Yurevych
Keyword(s):  
Bone Density ◽  
Bone Tissue ◽  
Frontal Sinus ◽  
Posterior Wall ◽  
Control Group ◽  
Inferior Wall ◽  
Tissue Density ◽  
Physiological Variability ◽  
Male Patients ◽  
Age Features

AGE FEATURES OF BONE TISSUE DENSITY IN THE POSTERIOR AND INFERIOR WALLS OF THE FRONTAL SINUSGargin V.V., Lupyr A.V., Alekseeva V.V., YurevychN.O.Chronic rhinosinusitis is a significant social, medical and economical problem. Elderly patients are unique among all groups of patients. The purpose of our study was to determine physiological variability of frontal sinus in the posterior and inferior walls and to compare it with variability in purulent-polypous rhinosinusitis. Subjects and methods: The study involved SCT examination of 40 male patients: 10 tomograms of patients aged 30-40 and 10 of patients aged 75-85. The tomograms of patients without ENT diseases were used for the control group. The study group included tomograms of patients aged 30-40 and 75-85 with chronic rhinosinusitis.  Results. An average bone density of the posterior and inferior walls of the frontal sinuses was calculated. The bone density of the group aged 30-40 was 191.5±11.6ͦHu in the inferior wall, 176.6±21ͦHu in the posterior and 169.1±16.8ͦHu and 164±21ͦHu in the group aged 75-85 according to the above order. The study showed pronounced changes in the bone density in purulent-polypous frontal sinusitis. In the group aged 30-40 it was as follows: 120.1±8.3ͦHu, 162.1±24ͦHu in the inferior wall and 101.4±6.95ͦHu, 127.4.8 ±15.4ͦHu in the posterior wall. Conclusions: It can be assumed that the decrease in the bone density is associated with age. And it is more severe in case of chronic frontal sinusitis.Key words: Frontal sinus, CT, elderly, bone density. ВІКОВІ ОСОБЛИВОСТІ ЩІЛЬНОСТІ КІСТКОВОЇ ТКАНИНИ ЗАДНЬОЇ ТА НИЖНЬОЇ СТІНКИ ЛОБНОГО СИНУСУАлєксєєва В.В., Гаргін В.В., Лупир А.В., Юревич Н.О.Хронічний риносинусит є значною соціальною, медичною та економічною проблемою. Пацієнти похилого віку займають особливе місце серед усіх пацієнтів. Метоюнашого дослідження стало визначення фізіологічної вікової мінливості задньої та нижньої стінок лобної пазухи та порівняння її з такою при хронічних гнійно-поліпозних фронтитах.Матеріали та методи. Ми дослідили результати 40 комп'ютерних томограм людей чоловічої статі: 10 томограм чоловіків 30-40 років та 10 - 75 - 85 років. без ознак ЛОР-патології та по 10 томограм пацієнтів віком від 30 до 40 років і 75 до 85 років з хронічним гнійно – поліпозним фронтитом. Результати. Була підрахована середня щільність кісткової тканини задньої та нижньої стінок фронтального синуса. Щільність кісткової тканинив групі чоловіків 30-40 років склала: в області нижньоїстінки 191,5 ± 11,6ͦHu. задньої - 176,6 ± 21ͦHu, а в групі чоловіків 75-85 років:. 169,1 ± 16,8ͦHu і 164 ± 21ͦHu. згідно до наведеного вище порядку. Ми відмітили також зміни щільності кісткової тканини при гнійно-поліпозному фронтальному синуситі. У віці від 30 до 40 років вона склала: в області нижньої стінки – 120,1 ± 8,3ͦHu, а задньої стінці - 162,1 ± 24ͦHu (група віком 30 – 40 років) та 101,4 ± 6,95ͦHu, 127,4,8 ± 15,4ͦHu відповідно (група чоловіків 75 – 85 років)Висновки: Можна припустити, що вік впливає нащільність нижньої та задньої стінки кістковоїтканини лобного синусу. В той же час наявність хронічного запального процесу (хронічного гнійно – поліпозного фронтального синуситу) посилює цей вплив.Ключові слова: фронтальний синус, CКT, старіння, щільність кісток. ВОЗРАСТНЫЕ ОСОБЕННОСТИ ПЛОТНОСТИ КОСТНОЙ ТКАНИ ЗАДНЕЙ И НИЖНЕЙ СТЕНКИ ЛОБНОГО СИНУСААлексеева В.В., Гаргин В.В., Лупырь А.В., Юревич Н.А.Хронический риносинусит является значительной социальной, медицинской и экономической проблемой. Пациенты пожилого возраста занимают особое место среди всех групп пациентов. Целью нашего исследования стало определение физиологической возрастной изменчивости задней и нижней стенок лобной пазухи и сравнение ее с таковой при хронических гнойно-полипозных фронтитах. Материалы и методы: мы исследовали результаты 40 компьютерных томограмм людей мужского пола: 10 томограмм мужчин 30-40 лет и 10 – 75 - 85 лет без признаков ЛОР-патологии и по 10 томограмм пациентов в возрасте от 30 до 40 лет и 75 до 85 лет с хроническим гнойно - полипозных фронтитом. Результаты. Была подсчитана средняя плотность костной ткани задней и нижней стенок фронтального синуса. Плотность костной ткани в группе мужчин 30-40 лет составила: в области нижней стенки 191,5 ± 11,6ͦHu. задней - 176,6 ± 21ͦHu, а в группе мужчин 75-85 лет:. 169,1 ± 16,8ͦHu и 164 ± 21ͦHu. согласно приведенному выше порядке. Мы отметили также изменения плотности костной ткани при гнойно-полипозных фронтальном синусите. возрасте от 30 до 40 лет она составила: в области нижней стенки - 120,1 ± 8,3ͦHu, а задней стенке - 162,1 ± 24ͦHu (группа в возрасте 30 - 40 лет) и 101,4 ± 6,95ͦHu, 127 , 4,8 ± 15,4ͦHu соответственно (группа мужчин 75 - 85 лет). Выводы: Можно предположить, что возраст влияет на плотность нижней и задней стенки костной ткани лобного синуса. В то же время наличие хронического воспалительного процесса (хронического гнойно - полипозного фронтального синусита) усиливает это отрицательное влияние.Ключевые слова: фронтальный синус, CКT, старение, плотность кости

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals Magnetic levitation pump versus constrained vortex pump: a pilot study on the hemolysis effect during minimal invasive extracorporeal circulation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ignazio Condello ◽  
Giuseppe Santarpino ◽  
Giuseppe Filiberto Serraino ◽  
Pasquale Mastroroberto ◽  
Giuseppe Speziale ◽  
...  
Keyword(s):  
Pilot Study ◽  
Minimally Invasive ◽  
Postoperative Period ◽  
Extracorporeal Circulation ◽  
Magnetic Levitation ◽  
Control Group ◽  
Study Group ◽  
Centrifugal Pumps ◽  
Free Hemoglobin ◽  
Centrifugal Blood Pump

Abstract Background Elevated plasma free hemoglobin is associated with multi-organ injury. In this context, minimally invasive extracorporeal technologies represent a way to reduce this complication following cardiac surgery. Methods We present a pilot study focused on plasma free hemoglobin levels in 40 patients undergoing isolated coronary artery bypass grafting (CABG). The same circuits for minimally invasive extracorporeal circulation (MiECC) were used in all patients. The ECMOLIFE magnetic levitation pump was used in the study group (n = 20), and the AP40 Affinity CP centrifugal blood pump was used in the control group (n = 20). Results In the immediate postoperative period, plasma free hemoglobin (PFH) and lactate dehydrogenase (LDH) were significantly lower in the study group than in the control group (10.6 ± 0.7 vs 19.9 ± 0.3 mg/dL, p = 0.034; and 99.16 ± 1.7 vs 139.17 ± 1.5 IU/L, p = 0.027, respectively). Moreover, patients treated with the magnetic levitation pump showed lower creatinine and indirect bilirubin (0.92 vs 1.29 mg/dL, p = 0.030 and 0.6 ± 0.4 vs 1.5 ± 0.9 mg/dL, p = 0.022, respectively) at 24 h after the procedure, and received fewer transfusions during the whole postoperative period (3 vs 9 red blood cell units (RBC), p = 0.017). Conclusion Our pilot study suggests that the use of magnetically levitated centrifugal pumps for extracorporeal circulation support is associated with a lower risk of hemolysis, though larger studies are warranted to confirm our results.

scholarly journals Evaluation of the clinical efficacy and safety of nitric oxide synthesized from room air in the postoperative period of cardiac surgery

2021 ◽  
Vol 8 (1) ◽  
pp. 38-50
Author(s):  
A. E. Bautin ◽  
V. D. Selemir ◽  
A. I. Shafikova ◽  
K. Yu. Afanasyeva ◽  
E. S. Kurskova ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiac Surgery ◽  
Side Effects ◽  
Pulmonary Artery ◽  
Clinical Efficacy ◽  
Median Duration ◽  
Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Efficacy And Safety

Background. Inhaled nitric oxide is a highly selective pulmonary vasodilator, the potential benefits of which include reduced resistance and pressure in the pulmonary artery without systemic arterial hypotension, vasodilation in well-ventilated areas of the lungs, rapid onset of action, and a fairly low incidence of side effects in the therapeutic dose range. Objective. Тс estimate the clinical efficacy and safety of the method for synthesizing nitric oxide from room air in the postoperative period of cardiac surgery. Design and methods. A total of 110 patients were enrolled in the study: 55 patients were included in the main group (nitric oxide was synthesized from room air by AIT-NO-01 device), 55 patients were enrolled in the retrospective control group (nitric oxide was inhaled from the balloon). Inclusion criteria were: undergone heart surgery, mean pulmonary artery pressure (PAPm) ≥ 25 mm Hg., pulmonary artery wedge pressure (PAWP) ≤ 15 mm Hg. Results. After one hour of nitric oxide inhalation in the main group, there were a 35 % decrease in PVR and a 16 % decrease in PAPm. In the control group, there were a decrease in PVR by 40 % and decrease in PAPm by 19 %. Inhalation of nitric oxide did not affect the systemic circulation hemodynamics both in the main and in the control groups. The median duration of the mechanical ventilation (MV) was 7.3 (4.5; 13.8) h and the median length of stay (LOS) in the ICU was 23.2 (21.3; 46) h in the main group. In the retrospective control group, the median duration of MV was 8.2 (5; 14.1) h, and the length of ICU stay was 24 (22; 45.3) h; found no differences between the groups. Conclusion. Nitric oxide synthesized from room air significantly reduces PVR and PAPm in patients with precapillary pulmonary hypertension after cardiac surgery. There were no significant differences in the effect on a pulmonary circulation, clinical data and side effects between the methods of synthesis of nitric oxide from room air and dosing from balloons.

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