Neurocognitive dysfunctions in the remote postoperative period during cardiac surgery with artificial blood circulation

2018 ◽  
pp. 72-77
Author(s):  
◽  
О.А. Loskutov ◽  
О.M. Druzhyna ◽  
B.М. Todurov ◽  
◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Period ◽  
Blood Circulation ◽  
Artificial Blood ◽  
Artificial Blood Circulation ◽  
Neurocognitive Dysfunctions

PHARMACEUTICAL MARKET OF CARDIOPLEGIC DRUGS AND FEATURES OF THEIR APPLICATION IN RUSSIA

2021 ◽  
pp. 169-182
Author(s):  
Ovod A.I. ◽  
Novikova M.D.
Keyword(s):  
Cardiac Surgery ◽  
Blood Circulation ◽  
Public Procurement ◽  
Pharmaceutical Market ◽  
Open Heart ◽  
Surgical Interventions ◽  
Artificial Blood ◽  
Artificial Blood Circulation ◽  
Cardioplegic Solutions

Relevance. Surgical treatment of cardiovascular diseases with the use of artificial blood circulation is associated with the need to protect the myocardium. Various cardioplegic solutions are widely used in cardiac surgery to stop and protect the heart. Currently, a significant number of mixtures of drug solutions are used in "open" heart surgery. However, not all of them have been officially registered as cardioplegic solutions and not all have the appropriate indications in the instructions for medical use of the drug, which jeopardizes the safety and quality of medical care for patients. Goal. To study the pharmaceutical market of registered drugs for cardioplegia and to estimate the share of heart operations with the connection of artificial circulation performed without the use of officially registraited drugs for cardioplegia. Materials and methods. The following methods were used in the work: content analysis, statistical, marketing, graphic. The main information sources were: the State Register of Medicines; statistical indicators of surgical interventions in cardiac surgery, information on public procurement of medicines, instructions for the medical use of medicines, regulatory documents. Results. This study presents the results of a marketing analysis of the pharmaceutical market of drugs officially registered for cardioplegia. Three medicines have been registraited in Russia, which, in accordance with the instructions for use, can be used during surgical interventions in the quality of cardioplegic solutions. According to the ATC classification, all of them belong to the subgroup of the fifth level B05XA16 "Cardioplegic solutions". For the period 2018-2020. the volumes of purchases of cardioplegic solutions for the needs of medical organizations have been established and the volumes of drugs for surgical intervention in cardiac surgery during operations on the "open" heart have been determined. The comparison of morbidity rates and the estimated number of surgical interventions of the cardiac surgery service based on the data of public procurement of drugs for cardioplegia, revealed a discrepancy between the volumes of purchased cardioplegic solutions and the care provided. The data analysis shows that at least 23 thousand cardiac surgeries in Russia are performed annually without the use of registraited medicines for cardioplegia. Conclusion. When performing surgical interventions on an "open" heart with the connection of artificial blood circulation, it is necessary to use cardioplegic solutions that have an official indication in the instructions for medical use, in order to ensure the safety of patients and to perform medical interventions of appropriate quality.

scholarly journals Prevention of hemorrhagic complications during operations on the thoracic aorta

2018 ◽  
pp. 70-76
Author(s):  
D. C. Panfilov ◽  
B. N. Kozlov ◽  
V. V. Zatolokin ◽  
I. V. Ponomarenko ◽  
I. A. Khodashinsky ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Postoperative Period ◽  
Blood Circulation ◽  
Circulatory Arrest ◽  
Early Postoperative Period ◽  
Artificial Blood ◽  
Brachiocephalic Trunk ◽  
Hemorrhagic Complications ◽  
Artificial Blood Circulation

Aim. To assess the efficiency of guideline for the prevention of hemorrhagic complications in the early postoperative period.Material and methods. In the period from 2008 to 2017, 166 patients with pathology of the thoracic aorta were operated. The patients were divided into 2 comparable groups: group 1 — patients with reconstructed aortic arch of the type “Hemiarch” (group “hemiarch”, n=90), group 2 — patients with fully reconstructed aortic arch (group “arch”, n=76). All operations were performed with artificial blood circulation, circulatory arrest with moderate hypothermia (25­28° C) and unilateral antegrade cerebral perfusion through the brachiocephalic trunk.Results. The reconstructions of the thoracic aorta in patients of the “hemiarch” group were accompanied by significantly less period of artificial blood circulation (p=0,027), cardiac arrest period (p=0,012), duration of circulatory arrest (p=0,019), and duration of antegrade brain perfusion (p=0,021). The volume of discharge through the drainage was 350 [192;506] ml and 400 [250;723] ml in the “hemiarch” and “arch” groups, respectively (p=0,29). Patients of the “arch” group more often required transfusion of packed red cells (p=0,003), fresh frozen plasma (p=0,0006), platelet concentrate (p=0,002) in comparison with patients of the “hemiarch” group. At the same time, the frequency of bleeding requiring reoperation was comparable in both groups (5,6% versus 5,3%, p=0,969). The 30­day mortality also had no statistically significant differences in patients of the “hemiarch” and “arch” groups (3,3% versus 9,2%, p=0,119).Conclusion. The frequency of hemorrhagic complications requiring reoperation in patients with a fully or partially reconstructed aortic arch does not have significant differences when using the guideline for preventing of hemorrhagic complications, which makes it possible to provide acceptable frequency of bleeding episodes and reoperations in the early postoperative period.

Logical unit for biocontrol of artificial blood circulation

1973 ◽  
Vol 7 (1) ◽  
pp. 12-15
Author(s):  
M. A. Belilovskii ◽  
G. N. Trofimova ◽  
O. A. Frolkin
Keyword(s):  
Blood Circulation ◽  
Artificial Blood ◽  
Artificial Blood Circulation ◽  
Logical Unit

scholarly journals SCIENTIFIC WORLDVIEW OF PROFESSOR A. DOGLIOTTI (1897-1966) (TO THE 120 ANNIVERSARY SINCE BIRTH)

2018 ◽  
Vol 12 (2) ◽  
pp. 129-133
Author(s):  
Temuri Sh. Morgoshiia
Keyword(s):  
Biliary Tract ◽  
Blood Circulation ◽  
Heart Surgery ◽  
Cardiovascular Surgery ◽  
Heart Diseases ◽  
Front Wall ◽  
Rubber Tube ◽  
Artificial Blood ◽  
Surgical Clip ◽  
Artificial Blood Circulation

Achilles Mario Dogliotti, the surgeon station wagon, the author a set of new interventions in neuro, onko-and a heart surgery performed the first-ever successful operation with use of the cardiopulmonary bypass on August 7, 1951. Dogliotti paid special attention and fruitfully was engaged in surgery of a liver and biliary tract. He developed a way of removal of bile in cases when it is impossible to use the general bilious channel with a resection of a part of the left share of a liver (Dogliotti’s way); operation at damage of outside bilious ways with sewing together of a channel on a rubber tube and removal of its disteel end through a front wall of a stomach and a front belly wall outside (Dogliotti’s operation); a way of drainage of biliary tract with carrying out a drainage tube with several side openings outside through the general bilious channel in a duodenum (Dogliotti’s way). A number of interesting innovations offered Dogliotti in cardiovascular surgery. So, it possesses a way of prosthetics of the mitralny valve the pericardium rag on a leg entered into a heart cavity through its wall and attached between the papillary muscles (Dogliotti’s method). He offered some modifications of operations at the inborn and acquired heart diseases. For partial compression of large vessels of Dogliotti developed the tool having three working bransh (a surgical clip of Dogliotti-Vishnevsky), I developed the device for artificial blood circulation and some other original tools for cardiovascular surgery. One of first-ever it made operation with use of extracorporal blood circulation in clinic. Also its researches and clinical application of a moderate and deep hypothermia in heart surgery are known. A. Dogliotti “The treatise on anesthesiology” (1952), “The operational equipment” (1956), “Surgery of bilious ways” (1958) published about 300 scientific works on surgery, including the monograph “Surgical Semiotics and Diagnostics” (1948). I created a number of original tools for cardiovascular surgery, I designed the device for artificial blood circulation, I offered some modifications of operations at the inborn and acquired heart diseases. One of first-ever I made operation in the conditions of extracorporal blood circulation.

The dynamics of indicators of inflammation, antioxidant defense and myocardium ischemia under coronary bypass surgery using artificial blood circulation and on functioning heart

2016 ◽  
Vol 22 (3) ◽  
pp. 116-120
Author(s):  
Olesya A. Rubanenko ◽  
O. V Fatenkov ◽  
S. M Khokhlunov ◽  
L. V Limareva
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Blood Circulation ◽  
Bypass Surgery ◽  
Antioxidant Defense ◽  
Coronary Bypass ◽  
Ischemic Heart ◽  
Coronary Bypass Surgery ◽  
Artificial Blood ◽  
Artificial Blood Circulation

The article considers evaluation of indicators of inflammation, antioxidant defense and myocardium ischemia in patients with ischemic heart disease exposed to coronary bypass surgery using artificial blood circulation or on functioning heart. The sampling included 96 patients distributed to two groups. The first group included 84 patients (81% of males, average age 62,2±7,7 years) exposed to coronary bypass surgery in conditions of artificial blood circulation. The second group included 12 patients (91,7% of males, average age 59,8±8,0 years) exposed to coronary bypass surgery on functioning heart without artificial blood circulation. The study demonstrated significant increasing of level of interleukin-6 in patients with ischemic heart disease after application of coronary bypass surgery with extra-corporal blood circulation that confirms high activity of inflammation factors at the given disease. The reconstructing operations on hearts in conditions of artificial blood circulation are accompanied by decreasing of concentration of superoxiddismutase. At that, the level of analyzed bio-marker remains as compared with operation on functioning heart. This occurrence testifies activation of oxidative process and intensified consumption of as factor of antioxidant defense in the course of direct re-vascularization of myocardium. The concentration of troponin increases in post-operational period of reconstructing operation but differences are unreliable when analyzed groups are compared.

scholarly journals Prophylaxis of cerebro-vascular complications while performance of aorto-coronary shunting in conditions of artificial blood circulation

2019 ◽  
Vol 86 (6) ◽  
pp. 14-18
Author(s):  
D. О. Radіushin ◽  
О. А. Loskutov ◽  
P. V. Кіstruga
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Blood Circulation ◽  
Comparison Group ◽  
Standard Procedure ◽  
Vascular Complications ◽  
Early Postoperative Period ◽  
Cognitive Status ◽  
Artificial Blood ◽  
Artificial Blood Circulation

Objective. To estimate the efficacy of application of vasodilator nitroglycerine on background of high volumic speed of perfusion for prophylaxis of the cerebral vessels microembolism while performance of the aorto-coronary shunting (ACSH) operations in conditions of artificial blood circulation. Маterials and methods. The investigation was conducted in 72 patients, suffering the ischemic heart disease, to whom aorto-coronary shunting operation was accomplished in conditions of artificial blood circulation in the Odessa Regional Clinical Hospital. Median age of the patients have constituted (67.3 ± 5.2) yrs old, median body mass index - (27.4 ± 5.2) kg/m2, average duration of the operation - (269.4 ± 7.8) min, including the artificial blood circulation stage - (145 ± 4.5) min. General statistical sampling of the patients examined was randomized in accordance to the comparison group (n=34) and the investigated (n=38) group. For prophylaxis of the air microembolism in patients of the comparison group before the artificial blood circulation apparatus switching on during 9 - 10 min nitroglycerine was infused in the dose 8 - 10 mcg/kg × min on background of high (120 - 130% from the calculated one) volumic speed of perfusion with support of median index of arterial pressure on the level 50 - 60 mm Hg. Іntraoperative monitoring of cerebral blood flow was done, using transtemporal access in accordance to standard procedure. Cognitive status of the patients was estimated with the help of verbal and nonverbal tests (day before and on the fifth postoperative day). Results. The investigation accomplished have revealed, that in all the patient the ACSH operation in conditions of artificial blood circulation was accompanied by microembolism in the system of cerebral blood flow of the discrete character. Іntraoperative creation in cerebral blood flow of more than 750 microemboli causes occurrence of a clinically significant lowering of the brain cognitive functions in early postoperative period. Application of nitroglycerine as a kind of peripheral vasodilator in the dose 8 - 10 mcg/kg × min on background of high (120 - 130% of the calculated) volumic speed of perfusion have caused the reduction of the cognitive dysfunction severity by 15 - 20%.

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