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  • Title: [A risk of myocardial ischemia and the nature of infusion-transfusion therapy in scheduled surgical treatment of infrarenal aneurisms of the aorta].
    Author: Merkulov IV, Neĭmark MI.
    Journal: Anesteziol Reanimatol; 2004; (4):11-4. PubMed ID: 15468546.
    Abstract:
    The authors analyzed effects produced by different variations of the infusion-transfusion therapy on the risk of cardiovascular complications that can develop in the scheduled surgical treatment of the aorta abdominal part. The patients were randomized in 2 groups. Intraoperative hemodilution was made in group-1 patients (n = 50) before aorta clipping. Hemodynamics was stabilized by colloids and crystacolloids during clip removal; donor packed red blood cells were used at the hemoglobin level below 80 g/l. Group 2 comprised 66 patients for whom autoblood was prepared preoperatively. The infusion volume was limited before aorta clipping; blood losses were compensated for by autoblood and autoerythrocytes collected from surgical blood by "Cell Saver". The below results were obtained on the basis of conducted research: preventive infusion load aggravates, before aorta clipping, the risk of cardiac complications. Maintenance of Hb below the level of 90 g/l is accompanied by an impaired transport of oxygen to tissues; it speeds up the heart beat and provokes an increased cardiac need in oxygen, which enhances the risk of myocardium ischemia. Preparation of autoblood and hardware-based reinfusion of autoerythrocytes provide for an adequate compensation of blood losses and diminish the risk of cardiac complications in the scheduled surgical treatment of infrarenal aneurisms of the aorta.
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