Abstract
Objective: to study the effect of 7.2% NaCl/hydroxyethyl starch 200/0.5 on extravascular lung water and respiratory and cardiovascular systems in patients with coronary heart disease (CHD) after myocardial revascularization under extracorporeal circulation (EC). Subjects and methods. A prospective, randomized study was conducted in 40 patients with coronary artery disease. A study group (n=20) received 7.2% NaCl/hydroxyethyl starch 200/0.5; a control group (n=20) had 0.9% NaCl in a dose of 4 ml/kg within 30 min before EC. Extravascular lung water and central hemodynamic parameters were assessed using transpulmonary thermodilution and a Swan-Ganz catheter; respiratory function was estimated by the arterial oxygenation index, alveolar-arterial oxygen tension difference, and venous shunt fraction. Plasma osmolality and Na concentration were determined using an Osmomat 030 device. Conclusion. The intraoperative use of 7.2% NaCl/hydroxyethyl starch 200/0.5 in patients with CHD leads to a significant reduction in extravascular lung water after myocardial revascularization, thereby effectively protecting pulmonary oxygenizing function. The single administration of 7.2% NaCl/hydroxyethyl starch causes a short-term increase in cardiac index and it is a relatively safe in preventing neurological disorders and heart failure. Key words: 7.2% NaCl/hydroxyethyl starch 200/0.5; extravascular lung water, respiratory function, cardiac index, osmolarity.
Highlights
A prospective, randomized study was conducted in 40 patients with coronary artery disease
Extravascular lung water and central hemodynamic parameters were assessed using transpulmonary thermodilution and a Swan Ganz catheter; respiratory function was estimated by the arterial oxygenation index, alveolar arterial oxygen tension difference, and venous shunt fraction
The intraoperative use of 7.2% NaCl/hydroxyethyl starch 200/0.5 in patients with coronary heart disease (CHD) leads to a significant reduction in extravascular lung water after myocardial revascularization, thereby effectively pro tecting pulmonary oxygenizing function
Summary
Основные демографические и клинические ха рактеристики обеих групп представлены в табл. 1 и достоверно между собой не различались. Основные демографические и клинические ха рактеристики обеих групп представлены в табл. 1 и достоверно между собой не различались. Данные по слеоперационного периода представлены в табл. 2. Продолжительность легочной вентиляции, объем кровопотери, частота инотропной поддержки и дли тельности нахождения в ОРИТ были сопоставимы в обеих группах. 2. Исходные значения ИВСВЛ были сопостави мы в обеих группах. Через 30 мин после окончания ИК и во всех последующих точках исследования в опытной группе отмечено достоверно меньшее содер жание внесосудистой воды легких по сравнению с контрольной
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