Key result
A differentiated approach to hemodynamic correction in CABG patients significantly reduced the required doses and duration of sympathomimetics, frequency of atrial fibrillation, and duration of artificial ventilation compared to standard care.
Why the study?
Multiple perioperative factors influence hemodynamics during surgical revascularization, prompting the need to improve treatment results in cardiac surgery patients with heart failure undergoing CABG with extracorporeal circulation by improving diagnostic methods.
Does a differentiated approach to hemodynamic correction reduce the need for sympathomimetics and improve postoperative outcomes in patients with heart failure undergoing CABG?
Cohort (n=100)
No
Does a differentiated approach to hemodynamic correction reduce the need for sympathomimetics and improve postoperative outcomes in patients with heart failure undergoing CABG?
p-value: p=<0.05
A differentiated approach to postoperative hemodynamic management in CABG patients with heart failure may reduce the need for sympathomimetics and shorten mechanical ventilation time.
Introduction. Coronary heart disease, the complexity of the surgery conducted, inflammatory reaction to extracorporeal circulation and the need for perioperative anticoagulation influence perioperative state of hemodynamics during the surgical revascularization of a myocardium in patients with coronary heart disease. The aim. To improve the results of treatment of cardiac surgery patients with heart failure who underwent surgery, namely, coronary artery bypass grafting using extracorporeal circulation by improving methods of diagnosing heart failure. Materials and methods. 100 cardiac surgery patients with coronary heart disease were operated on at State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department. In all the cases, coronary artery bypass grafting was performed using artificial circulation. In patients of group 1 (40 patients) in the postoperative period, the correction of hemodynamic disorders was performed according to the standard protocol. In group 2 (60 patients) - a differentiated approach to the correction of hemodynamic disorders was used. Results. It was found that in group 2 for stabilization of hemodynamics, oxygen status, microcirculation, smaller doses of sympathomimetics and shorter duration of their use, P <0.05 than in 1 were applied. Conclusions. The results of the studies indicate the possibility of using the method of phasography, in particular, the analysis of symmetry of the T wave, as a marker of ischemic changes in the myocardium in cardiac patients who underwent coronary artery bypass grafting using artificial circulation. The obtained data show that the developed algorithm of perioperative management of cardiac surgery patients with heart failure makes it possible to significantly accelerate the rehabilitation of cardiac surgery patients, increase patient comfort and reduce the length of their hospitalization. The possibility of using phasography for monitoring of myocardial condition in patients undergoing coronary artery bypass surgery has been investigated.
No takes yet. Share an insight, caveat, or question.
Cherniy et al. (2021) conducted a cohort in Coronary heart disease with chronic heart failure (n=100). Differentiated approach to hemodynamic correction vs. Standard protocol was evaluated on Dose and duration of sympathomimetics, frequency of atrial fibrillation, and duration of artificial ventilation (p=<0.05). A differentiated approach to hemodynamic correction in CABG patients significantly reduced the required doses and duration of sympathomimetics, frequency of atrial fibrillation, and duration of artificial ventilation compared to standard care.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: