POSSIBILITIES OF USING PERIOPERATIVE ENERGY MONITORING IN INTENSIVE CARE IN PATIENTS WITH ACUTE CALCULOUS CHOLECYSTITIS.

Abstract

The aim: To study possibilities of using perioperative energy monitoring in intensive care in patients with acute calculous cholecystitis (ACC). Materials and methods: 131 patients with ACC, who underwent laparoscopic cholecystectomy (LC) under general anesthesia were studied. Risk of ASA II-IV. Group I (n = 63) - intensive care aimed at maintaining vital functions. Group II (n = 68) - additional use of indirect calorimetry data. Results: At the stages of the reverse position of Trendelenburg, pneumoperitoneum and the beginning of the operation, a decrease in hemodynamic, a violation of the oxygen status and metabolism were observed with more pronounced manifestations in the I group, where there was a longer recovery. In patients of group II, on the background of enhanced infusion therapy and administration of glucocorticoids, their recovery was more intense, they woke up faster and were transferred to the ward. These patients had 2,4 times less nausea and vomiting, and less postoperative pain upon awakening (p<0,05). Conclusions: In patients with ACC, correction of hemodynamic, oxygen status and metabolism, makes LC safer.