HEMODYNAMIC STATUS OF PATIENTS WITH DIFFERENT VARIANTS OF ISCHEMIC HEART DISEASE COMORBIDITY BEFORE AND AFTER CORONARY BYPASS GRAFTING

Abstract

TYPE: Abstract TOPIC: Cardiothoracic Surgery PURPOSE: Assessment of systemic and pulmonary hemodynamic for IHD patients with various comorbidity before and after CABG by transpulmonary thermodilution method. METHODS: 46 IHD patients were examined and divided into three groups based on comorbidity: cardiovascular, respiratory and metabolic. Parameters were recorded by transpulmonary thermodilution using «Pulsion Picco Plus» module of Drager Delta XL monitor (Germany) at 3 stages: after initiation of controlled mechanical ventilation (stage I), after CPB procedure completion (stage II) and after 24 hours surgery (stage III). RESULTS: In the group with respiratory comorbidity after CPB withdrawal and after 24 hours CABG, the highest level of systemic vascular resistance (2359.67 [2125.91; 2593.42] and 2294 [2070.7; 2517.3] dyne / sec / cm-5 / m2) were measured, moreover the minimum global ejection fraction values (18 [15; 22] and 19 [16; 21]%), and less noticeable (in relation to other patients groups) decreasion of global end-diastolic and pulmonary blood volumes. During all three stages, the maximum values of EVLWI and PVPI were recorded for patients with respiratory and metabolic comorbidity. Hemodynamic status disorders during follow-up dynamics were less pronounced for the patients with cardiovascular comorbidity. CONCLUSIONS: Volumetric and hemodynamic monitoring makes it possible to comprehensively assess the central and pulmonary circulation indicators for patients with coronary artery disease and various variants of comorbidity during operational and early postoperative periods dynamics. CLINICAL IMPLICATIONS: to develop a personalized approach to treatment and significantly improve the prognosis of morbidity DISCLOSURE: Nothing to declare. KEYWORD: CORONARY BYPASS GRAFTING