Anesteziologiia i reanimatologiia最新文献

{"title":"[CLINICAL SIGNIFICANCE OF CARDIAC BIOMARKERS INCREASING AND THEIR INTERRELATIONS IN SURGERY WITH CARDIO-PULMONARY BYPASS.]","authors":"I. Kozlov, V. Timerbaev, M. Chumakov","doi":"10.18821/0201-7563-2016-61-5-339-344","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-339-344","url":null,"abstract":"BACKGROUND\u0000Levelfor cardiac troponin I (TrI) and MB-fraction of creatine kinase (CKMB) increases in cardiomyocyte necrosis, and B-type natriuretic peptide (of BNP) increasing reflects ventricular overload.\u0000\u0000\u0000THE AIM\u0000to study the dynamics of BNP, TRI and CKMV in myocardial revascularisation with cardio-pulmonary bypass and to evaluate the clinical significance of these biomarkers elevated levels and establishing the relationship between BNP and markers of myocardial damage in the perioperative period Materials and methods. The study included 52 patients aged 62.5 (54.75; 70) years. Biomarkers concentrations was determined by immunofluorescence.\u0000\u0000\u0000RESULTS\u0000The initial value of BNP were 57.9 (38.675;88.5) pg/ml, and then increased (p<0,01): at the end of the operation up to 91.75 (59.6;132.75) pg/ml, at 1st day following surgery - up to 260 (157;407) pg/ml, and at 2nd day - up to 184 (115.25;274.5) pg/ml. TrI and CKMV increased (p<0,01) up to 0.95 (0.4175;1.4525) ng/ml and up to 13.1 (5.575;15.525) U/L at the end of surgery, and up to 1,355 (0.76;3.8) ng/ml and 10.5 (5;18.325) U/L at thr Istpostoperative day. Preoperative BNP level and TrI level at the end of surgery were the predictors (p<O. 05) of inotropes dosages at the end of surgery and in the postoperative period, and of the duration of the intensive care unit stay. Postoperative BNP values did not affect the studied clinical parameters, but had expressed connection with increased postoperative cardiac enzyme levels. Maximum postoperative BNP values correlate with maximum values of TrI (r = 0, 77; p <0,01) and CKMV (r = 0,81; p <0,01).\u0000\u0000\u0000CONCLUSIONS\u0000The identifed strong correlations give reason to consider the postoperative release of BNP as an adaptive reaction in response to a \"minor myocardial damage\" as a result of surgical trauma and myocardial, ischemia during aorta cross-clamping.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"12 1","pages":"339-344"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76777609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PRACTICE OF CLINICAL NUTRITION IN PEDIATRIC INTENSIVE CARE UNITS: RESULTS OF THE \"NUTRIPED-2015\" RESEARCH.]","authors":"A. Lekmanov, Yu V Ermuleva, S. G. Suvorov","doi":"10.18821/0201-7563-2016-61-5-376-380","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-376-380","url":null,"abstract":"The secondstudy of nutritional support in the pediatric intensive care unit in critical conditions in Russia \"NutriPed-2015\" were presented. The authors noted that modern clinical nutrition technologies were widely used among 167 critical patients aged 0 to 18 years in 31 PICU in Russia. The number ofpatients receiving all components of the preparations for parenteral nutrition has increased significantly in comparison with the study NutriPed-2013. There were the wider use of last generation lipids for parenteral nutrition, multi-chamber containers in children older than 2 years were used in 2 times more often, the vast number ofpatients was carried out calculation of energy needs in the present time. The main problems for solve are the individual methods ofcalculating energy andprotein needs, resolution dysfunction ofthe gastrointestinal tract, the active introduction of assessing the effectiveness of nutritional support in the PICU.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"76 1","pages":"376-380"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83840885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CLINICAL ASPECTS OF THE BLOOD LACTATE DYNAMICS DURING OPERATIONS ON THE HEART AND THE AORTA IN CONDITIONS OF CARDIOPULMONARY BYPASS.]","authors":"N. Trekova, B. Akselrod, I. I. Yudichev, D. A. Gus'kov, A. V. Markin, A. Popov","doi":"10.18821/0201-7563-2016-61-5-324-329","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-324-329","url":null,"abstract":"BACKGROUND\u0000The frequency and the causes for the development of hyperlactatemia during operations on the heart and aorta in conditions of cardiopulmonary bypass (CB) is not adequately described in the literature.\u0000\u0000\u0000THE AIM\u0000To study the clinical significance of the lactate dynamics in arterial blood depending on the source ofpathology, stages of operation, basic parameters of cardiopulmonary bypass, the characteristics of the post-perfusion period, and to identify ways to prevent the development of intraoperative hyperlactatemia in surgical interventions on the heart and aorta.\u0000\u0000\u0000MATERIALS AND METHODS\u0000420 adult cardiac surgery patients operated on the heart and ascending aorta were examined. All patients were operated on under balanced General anesthesia, CB in hypothermic or normothermic mode. Lactate level in arterial blood and the frequency of hyperlactatemia were analyzed at the following stages of operation: after induction of anesthesia, prebypass period, during CB, in the postbypass period and at the time of admission of the patient in the ICU. During CB we analyzed the duration of the CB, the degree of hemodilution, calculated value of oxygen delivery. Oxygen consumption was recorded in the current mode, the monitor CDI-500. Hyperlactatemia was considered the concentration of lactate above 3 mmol/L.\u0000\u0000\u0000RESULTS\u0000Preperfusion period in all groups of cardiac surgery patients was characterized by a normal level of blood lactate in the absolute majority ofpatients, the frequency of hyperlactatemia did not exceed 1%. Hemodynamic stability was achieved without the use of catecholamines by optimizing volemia and heart rate. While CB showed a trend of increasing lactate on average in comparison with the previous period in patients operated on the heart. Duration CB less than 3 hours was not a factor in the development of hyperlactatemia, provided that oxygen delivery in all patients during perfusion exceeded 300 ml/min/m2, hematocrit ofperfusate at the end of CB was at 25-27% in most patients. To maintain it at a large hemodilution the ultrafiltration hemoconcentration was used. The frequency of hyperlactatemia was 3%. A significant increase in lactate concentration at the end of the CB to 3.39k1,3 mmol/l (range of 2.1-7.2 mmol/l) on the background of metabolic acidosis found only in patients with circulatory arrest due to receipt of blood products of anaerobic glycolysis after the resumption of the CB. They have frequency of hyperlactatemia risen to 29%. The lac- tate average value at admission ofpatients in the ICU with application of 50-60% ofpatients in dopamine/dobutrex at a dose of 5 mcg/kg/min and reaching the targets of transfusion therapy was slightly higher in the baseline period and corresponded to the upper level of normal values. Only during operations on the aortic arch under conditions of circulatory arrest, the concentration of lactate at the end of the operation was 3,4+1,1 mmol/l with a tendency to decrease in comparison with the per","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"49 1","pages":"324-329"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77887679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PRACTICE OF CLINICAL NUTRITION IN PEDIATRIC INTENSIVE CARE UNITS: RESULTS OF THE \"NUTRIPED-2015\" RESEARCH.]","authors":"A U Lekmanov,&nbsp;Yu V Ermuleva,&nbsp;S G Suvorov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The secondstudy of nutritional support in the pediatric intensive care unit in critical conditions in Russia \"NutriPed-2015\" were presented. The authors noted that modern clinical nutrition technologies were widely used among 167 critical patients aged 0 to 18 years in 31 PICU in Russia. The number ofpatients receiving all components of the preparations for parenteral nutrition has increased significantly in comparison with the study NutriPed-2013. There were the wider use of last generation lipids for parenteral nutrition, multi-chamber containers in children older than 2 years were used in 2 times more often, the vast number ofpatients was carried out calculation of energy needs in the present time. The main problems for solve are the individual methods ofcalculating energy andprotein needs, resolution dysfunction ofthe gastrointestinal tract, the active introduction of assessing the effectiveness of nutritional support in the PICU.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"376-380"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[MODERN ASPECTS OF THE SAFE USE OF EXTENSION QT INTERVAL MEDICINES.]","authors":"E V Shikh,&nbsp;A D Ismaailov,&nbsp;M N Dorofeeva,&nbsp;Zh-M Sizava","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Prolongation of QTinterval is apredictor offatal cardiac arrhythmias and sudden death. In clinical practice, medicines with possible and conditional risk of QTprolongation are combine. The danger of such interactions could be enhanced if medi- cines interact themselves at metabolic rate. The interaction of drugs with possible and conditional risk of QTprolongation and interaction of these drugs with drugs that can influence the metabolic activity of cytochrome P450 isoenzymes require specific attention from physicians. Predictability of QTprolongation by drug-drug interactions at metabolic rate in drug administration will increase the safety of pharmacotherapy of drugs with possible and conditional risk of QTprolongation.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"386-390"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CLINICAL ASPECTS OF THE BLOOD LACTATE DYNAMICS DURING OPERATIONS ON THE HEART AND THE AORTA IN CONDITIONS OF CARDIOPULMONARY BYPASS.]","authors":"N A Trekova,&nbsp;B A Akselrod,&nbsp;I I Yudichev,&nbsp;D A Gus'kov,&nbsp;A V Markin,&nbsp;A M Popov","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The frequency and the causes for the development of hyperlactatemia during operations on the heart and aorta in conditions of cardiopulmonary bypass (CB) is not adequately described in the literature.</p><p><strong>The aim: </strong>To study the clinical significance of the lactate dynamics in arterial blood depending on the source ofpathology, stages of operation, basic parameters of cardiopulmonary bypass, the characteristics of the post-perfusion period, and to identify ways to prevent the development of intraoperative hyperlactatemia in surgical interventions on the heart and aorta.</p><p><strong>Materials and methods: </strong>420 adult cardiac surgery patients operated on the heart and ascending aorta were examined. All patients were operated on under balanced General anesthesia, CB in hypothermic or normothermic mode. Lactate level in arterial blood and the frequency of hyperlactatemia were analyzed at the following stages of operation: after induction of anesthesia, prebypass period, during CB, in the postbypass period and at the time of admission of the patient in the ICU. During CB we analyzed the duration of the CB, the degree of hemodilution, calculated value of oxygen delivery. Oxygen consumption was recorded in the current mode, the monitor CDI-500. Hyperlactatemia was considered the concentration of lactate above 3 mmol/L.</p><p><strong>Results: </strong>Preperfusion period in all groups of cardiac surgery patients was characterized by a normal level of blood lactate in the absolute majority ofpatients, the frequency of hyperlactatemia did not exceed 1%. Hemodynamic stability was achieved without the use of catecholamines by optimizing volemia and heart rate. While CB showed a trend of increasing lactate on average in comparison with the previous period in patients operated on the heart. Duration CB less than 3 hours was not a factor in the development of hyperlactatemia, provided that oxygen delivery in all patients during perfusion exceeded 300 ml/min/m2, hematocrit ofperfusate at the end of CB was at 25-27% in most patients. To maintain it at a large hemodilution the ultrafiltration hemoconcentration was used. The frequency of hyperlactatemia was 3%. A significant increase in lactate concentration at the end of the CB to 3.39k1,3 mmol/l (range of 2.1-7.2 mmol/l) on the background of metabolic acidosis found only in patients with circulatory arrest due to receipt of blood products of anaerobic glycolysis after the resumption of the CB. They have frequency of hyperlactatemia risen to 29%. The lac- tate average value at admission ofpatients in the ICU with application of 50-60% ofpatients in dopamine/dobutrex at a dose of 5 mcg/kg/min and reaching the targets of transfusion therapy was slightly higher in the baseline period and corresponded to the upper level of normal values. Only during operations on the aortic arch under conditions of circulatory arrest, the concentration of lactate at the end of ","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"324-329"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[CONTINUOUS HEMOGLOBIN MONITORING USING PULSE CO-OXIMETRY IN CARDIAC SURGERY.]","authors":"P I Len'kin,&nbsp;A A Smetkin,&nbsp;A Husseyn,&nbsp;E V Fot,&nbsp;A I Len'kin,&nbsp;K V Paromov,&nbsp;A A Ushakov,&nbsp;M A Krygina,&nbsp;M Yu Kirov","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>The aim: </strong>To assess the accuracy ofcontinuous hemoglobin monitoring using pulse co-oximetry and revealfactors affecting the results of the measurements during early postoperative period in cardiac surgery.</p><p><strong>Materials and methods: </strong>27 patients undergoing off-pump CABG and 16patients after elective complex (repair or replacement of two or more valves) or combined (valve and coronary artery) cardiac surgery requiring CPB were enrolled into a prospective observational study. Both groups received continuous hemoglobin monitoring using pulse co-oximetry (SpHb). During early postoperative period SpHb was compared with hemoglobin concentration in the arterial blood (Hbart).</p><p><strong>Results: </strong>Wefoundpositive correlation between SpHb and Hb in both groups (rho =0,29, p < 0,05 u rho=0,34; p<0.005 respectively). The Bland-Altman analysis showed a bias ? limits of agreement (?I.96 SD) between the continuously measured hemoglobin and reference arterial blood hemoglobin concentration of -6,0 ? 41,0 g/l in the off-pump group and 7,7 k 31,0 g/l in the CPB group.</p><p><strong>Conclusions: </strong>Hemoglobin measurement using pulse co-oximetry does not provide acceptable accuracy during early postoperative period in cardiac surgery. Applicability of this technology is influenced by vascular tone, systemic and regional tissue hypoperfusion.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"329-334"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[INDICATIONS FOR RESPIRATORY SUPPORT AT PATIENTS WITH STROKE AND NOSOCOMIAL PNEUMONIA.]","authors":"T Yu Nedorostkova,&nbsp;E V Eliseev","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>80 patients with cerebral stroke and nosocomial pneumonia ofwhich formed 2 groups of 40 patients each were included in the study. The groups were matched for severity at the beginning of the study. All patients received comprehensive treatment in the conditions of the neurological intensive care unit in 2011-2015 in the O.M Filatov clinical city hospital N2 15, Moscow. Patients from both groups were transferred on mechanical lung ventilation: group I - in the presence of severe clinical picture of respiratory distress and/or depression of consciousness, and group 2 -with deviations from the norm of acid-base status of blood parameters. The results of the study shows the first clinical and laboratory criteria for the transfer patients on mechanical lung ventilation, which are the changes of indicators in blood acid-base status (pH, lactate, glucose, pCO₂, po₂) and the degree of neurological deficit, not the clinical picture in the form of severe respiratory failure in patients with cerebral stroke.</p>","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"367-372"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[THE ROLE OF INTESTINE ISCHEMIA IN METABOLIC DISORDERS DURING THE AORTIC CLAMPING ABOVE THE CELIAC TRUNK.]","authors":"O. Novikova, A. Yavorovsky, R. Komarov, I. L. Zhidkov, A. Popov, N. V. Pojufina","doi":"10.18821/0201-7563-2016-61-5-344-348","DOIUrl":"https://doi.org/10.18821/0201-7563-2016-61-5-344-348","url":null,"abstract":"THE AIM\u0000To identify the role of the intestine in the development of metabolic disorders with operations in the thoracoabdominal aorta developing after clamping of the aorta above the celiac trunk Materials and methods. The study was conducted in pigs (n = 6) with similar body weight (m = 35-39 kg). After the intoduction of animal anesthesia, surgery was performed by access to the visceral veins (upper and lower mesenteric kidney, liver spleen andfemur), from which the Blood samples to determine the concentration of lactate, glucose, as well as indicators of acid-base status. Then placing the clamp on the aorta above the level of discharge of the celiac trunk. Blood sampling and laboratory diagnosis carried out twice: before clamping the aorta and blood flow before the start after 60 minutes of ischemia. Histological study intestinal tissue also conducted.\u0000\u0000\u0000RESULTS\u0000It is shown that the aorta cross-clamping develops pronounced metabolic disorders, manifested in the form of increased levels of lactate and glucose concentrations in all investigated parts of the splanchnic region. The most pronounced increase in lactate after clamping the aorta was observed in the blood samples flowing from the intestine. The results of histological studies show that intestinal hypoperfusion leads to severe pathological changes, that is a predisposing factor leading to the translocation of bacterial agents into the systemic circulation, to the process of expression of systemic inflammatory response and a powerful oxidative stress.\u0000\u0000\u0000CONCLUSION\u0000Our experimental data show that when aortic clamping above the celiac trunk (ischemia mesenteric region) the greatest quantitative contribution to metabolic disorders the body of the animal created in a pathophysiological situation contributes to intestinal hypoperfusion. In this regard, one of the main tactics of the anaesthetist in the perioperative period should be the protection of the intestine against ischemia and its consequences.","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"17 1","pages":"344-348"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81604730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[PHARMACOLOGICAL POSTCONDITIONING BY SEVOFLURANE DURING CARDIAC SURGERY.]","authors":"A V Grishin,&nbsp;A G Yavorovskiy,&nbsp;E R Charchian,&nbsp;S V Fedulova,&nbsp;M A Chamaia","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Optimization of myocardial protection during cardiac surgery with a long period of anoxia infarction using sevoflurane postconditioning of myocardium.</p><p><strong>The aim: </strong>to develop the optimal pharmacological postconditioning protocol with sevoflurane for infarction patients ,undergoing cardiac surgery.</p><p><strong>Materials and methods: </strong>Two groups were formedfor this study: CON] 00 (n-32) with aortic cross-clamping time 114±15 min and SEV100 group (n-34), where the myocardium anoxia was 119±22 minutes. According to previously developed in the pilot study Protocol, we added sevofturane in the circuit of extracorporeal circulation in a dose of 2.0 vol. % 20 minutes before removing the clamp from the aorta and the first 20 min of reperfusion in the group SE V100. In the group CON1 00 pharnacological postconditioning wasn't conducted. To assess the adequacy of the cardioprotection against ischemic damage in operated patients, we used the following clinical and laboratory parameters: changing the level of troponin T; the concentration of lactate and glucose as a marker of severity of anaerobic metabolism; concentration of proinflammatory cytokines IL-6, IL-8, TNF-alpha in blood serum as reperfusion injury markers. Also we used the registration of central hemodynamics data: measuring the mean invasive blood pressure; central venous pressure; Cardiac output was measured by the method of transesophageal echocardiography TEEcho-CG, calculated left ventricular ejection fraction by Simpson. We evaluated the clinical course of the perioperative period: incidence ofperioperative myocardial ischemia; the need and the duration ofuse of cardiotonic drugs in the perioperative period; the incidence of reperfusion arrhythmias; the frequency of self-recovery heart rate.</p><p><strong>Results: </strong>According to the results of anaerobic metabolism markers, we can conclude that the period of the myocardium anoxia ofpatients in both groups experienced no significant difference. However; a completely different pattern was observed when comparing the proinflammatory cytokines, such as IL-6, IL-8, TNF-a. This confirms that the group SEV] 00 survived the reperfusion is much better than the group CON100. Instrumental examination also showed that the group ofpatients in which pharmacological postconditioning with sevofturane was held signficantly better suffered ischemia and reperfiision injury compared to control group. Self-recovery heart rate after removing the aorta clamp in the group CON100 was observed in 81%, in group SEV100 same - 93%. Similarly, the frequency of myocardial ischemia episodes on the ECG in reperfusion period was two times lower in the group SEV100 compared with group CON100 - 5.8% and 12.5% respectively. Reperfusion arrhythmia is almost 3 times more frequent in the group CON100 - 21,8%, in the group SEV100, where he conducted pharmacological postconditioning with sevoflurane is 8.8%..</p><p><","PeriodicalId":7795,"journal":{"name":"Anesteziologiia i reanimatologiia","volume":"61 5","pages":"348-352"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35869920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}