Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass


Keywords: postoperative course, surgical pathology of the aorta, surgery, extracorporeal circulation, correlation coefficient

Abstract

The aim of the work was to analyze the results of the observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. 118 patients with surgical aortic pathology (SAP) were examined. Patients were divided into 2 groups. Group I included 46 patients who were additionally prescribed a solution of meglumin sodium succinate (reamberin), group II included 46 patients who were additionally assigned a solution of D-fructose-1,6-diphosphate sodium hydrate salt (esophosphine). The control group (K) consisted of 26 patients who had surgical pathology of the aorta, all the criteria coincided with patients of groups I and II, but did not have additional substances as part of intensive care (IT) in order to prevent postoperative cognitive dysfunction (PСD). Analyzed the patient's condition on a scale of postoperative mortality prediction EuroSCORE II, the depth of anesthesia with a BIS monitor, the qualitative composition of the leukocyte formula, nasal and rectal temperature, blood gas composition, electrolyte level, glucose, lactate, coagulogram indices, hemolysis and phosphates; levels of autoantibodies to brain antigens (MBP, calcium binding protein S-100, NSE and GBA) were determined in the serum by ELISA a day before the operation and on the first, third, seventh and fourteenth day after surgery. The morphometric and functional properties of erythrocytes were investigated the day before the operation (starting level), 12:00 after the operation, and on the third day of hospital stay. The initial assessment of the cognitive abilities of the patients was made the day before the operation, on the third, seventh and fourteenth day of hospital stay. Used to determine the magnitude of the coefficient of linear Pearson correlation. In the analysis, no significant differences were found between the preliminary data on the phosphorus content in the patients' blood, however, the recovery dynamics of its numbers differed in the K, I and II patients. So, in group K and in group I, after 12:00 after surgery, the level of phosphatemia was 0.86 ± 0.21 mmol/l and 0.85 ± 0.18 mmol / l, on the 3rd day of hospital stay — 0,94 ± 0.08 mmol/l and 0.97 ± 0.04 mmol/l, on the 7th day — 1.04 ± 0.16 mmol/l and 1.07 ± 0.21 mmol/l and on The 14th day — 1.08 ± 0.12 mmol/l and 1.1 ± 0.14 mmol/l. It can be noted that the dynamics of blood phosphatemia in patients of groups K and I was identical, its figures almost coincided in terms of the level of phosphorus in the blood and the corresponding number of patients in the variation rows of patients in both groups. It may be noted that there is an unconditional positive effect on the course of the perioperative period of the option of infusion therapy in the IT complex in patients of group II.

 

References

1. Isaev, S. V., Lihvancev, V. V., &Kichin, V. V. (2007). Vliyanie perioperacionnyh faktorov i vybora metoda anestezii na chastotu kognitivnyh rasstrojstv v posleoperacionnyj period [The influence of perioperative factors and the choice of anesthesia method on the incidence of cognitive impairment in the postoperative period]. Vestnik intensivnoj terapii – Intensive care unit, 3, 67–69.

2. Abraham, M. (2014). Protecting the anaesthetized brain. Journal of Neuroanaesthesiology & Critical Care, 1 (1), 20–39. DOI: 10.4103/2348-0548.124841.

3. Ciruela, F., & Sotelo, E. (2017). Special Issue: Adenosine Receptors. Molecules, 22 (7), 1220. doi:10.3390/molecules22071220.

4. Kadoi, Y., & Goto, F. (2007). Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery. Journal of Anesthesiology, 21 (3), 330–335. DOI:10.1007/s00540-007-0537-7.

5. Komiyama, T., Katsyama, K., Sudo, M., Ishida, K., Higaki, Y., & Ando, S. (2017). Cognitive function during exercise under severe hypoxia. Scientific Reports, 7 (1), 10000. doi: 10.1038/s41598-017-10332-y.

6. Loepke, A. K., & Soriano S. G. (2008). An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesthesia & Analgesia, 106 (6), 1681–1707. doi: 10.1213/ane.0b013e318167ad77.

7. Rasmussen, L. S., Jonson T., Kuipers, H. M., Kristensen, D., Siersma, V. D., Vila, P., … Moller, J. T. (2003). Does anesthesia cause postoperative cognitive dysfunction? A randomized study of regional versus general anesthesia in 438 elderly patients. Acta Anesth. Scand, 47 (9), 1188–1194. DOI: 10.1034/j.1399-6576.2003.00057.x.

8. Scharbarg, E., Daenens, M., Lemaitre, F. Geoffroy, H., Guille-Collignon, M., Gallopin, T., & Rancillac, A. (2016). Astrocyte-derived adenosine is central to the hypnogenic effect of glucose. Scientific Reports, 6, 19107. doi: 10.1038/srep19107.

9. Suliman, N. A., Mat Taib, C. N., Mohd Moklas, M. A., Adenan, M. I., Hidayat Baharuldin, M. T., & Basir, R. (2016). Establishing Natural Nootropics: Recent Molecular Enhancement Influenced by Natural Nootropic. Evidence-Based Complementary and Alternative Medicine, 1, 165–169. doi: 10.1155/2016/4391375.

10. Tamura, R., Ohta, H., Satoh, Y., Nonoyama, S., Nishida, Y., & Nibuya, M. (2016). Neuroprotective effects of adenosine desaminase in the striatum. Journal of Cerebral Blood Flow & Metabolism, 36 (4), 709-720. doi: 10.1177/0271678X15625077.

11. Warner, D. S., & Sheng, H. Anesthetic Neuroprotection? It’s Complicated. Anesthesiology, 126 (4), 579–581. doi:10.1097/ALN.0000000000001535.

12. Xu, D., Wang, B., & Zhao, X. (2017). General anesthetics protects against cardiac arrest-induced brain injury by inhibiting calcium wave propagation in zebrafish. Molecular Brain, 10, 44. doi: 10.1186/s13041-017-0323-x.
Published
2019-06-27
How to Cite
Khyzhniak, K. A., Volkova, Y. V., Sharlai, K. Y., & Khartanovych, M. V. (2019). Results of observation of the postoperative period in patients with surgical aortic pathology after surgical intervention using cardiopulmonary bypass. Reports of Vinnytsia National Medical University, 23(2), 267-276. https://doi.org/https://doi.org/10.31393/reports-vnmedical-2019-23(2)-16