ACUTE BLOOD PURIFICATION METHODS IN INTENSIVE CARE OF COMPLICATIONS AFTER CARDIAC SURGERY.

Abstract

<h3>Objective</h3> Complications after cardiac surgery have serious negative consequences, prolonging intensive care (ICU) stay days and significantly increasing costs. Prevention and treatment of complications after cardiac surgery is a serious problem. According to numerous authors, the incidence of complications after cardiac surgery varies from 10 to 60%. The most common and prognostically significant complications are bleeding, acute kidney injury and infection. Advances in cardiac surgery have led to a reduction in the overall mortality associated with open-heart surgery, however, still extremely high among patients with complications. Impaired renal function, or active infectious process, sepsis has significant prognostic consequences which are the cause of up to 40% of deaths. As a solution may serve various methods of blood purification. In recent decades, the blood purification method of choice in the therapy of numerous pathological conditions is resistant to traditional therapy. This study details one centre's experience of acute blood purification application in the ICU. <h3>Materials and Methods</h3> Structural analysis of acute extracorporeal blood purification methods application to patients in ICU. The period from 2015 to the 2021 year. <h3>Results and Discussion</h3> For the period from 2015 to 2021 more than a thousand patients underwent extracorporeal methods of blood purification due to complications after cardiac surgery or the severity of the condition. Throughout the period effectiveness and safety were assessed. Blood purification is an option of therapy for numerous complications in the postoperative period(acute kidney injury, Systemic inflammatory response reaction syndrome, sepsis cytokine storm, fluid overload). We have a positive experience with extracorporeal blood purification application to patients after different types of cardiac surgery (open valve surgery, surgery of myocardium revascularization, implantation of left ventricular assist device, heart and lungs transplantation, transcatheter manipulation) in the immediate postoperative period. The structure of procedures and patients' characteristics are shown in table 1. <h3>Conclusion</h3> Acute extracorporeal blood purification methods are a significant option in therapy of complications after cardiac surgery. Procedures are effective and safe. This direction requires further development and study.