Abstract
Objective: to study the effect of adrenaline cardiotonic support on the condition of central hemodynamic, transport
and consumption of oxygen, as well as the severity of hyperlactatemia in the intraoperative period and in the first
postoperative day in patients operated on heart valves.
Material and methods. A single-center, randomized, prospective study, involving patients with heart valves diseases,
divided into two groups: the adrenaline group of 46 patients and the dobutamine group of 43 patients. The condition
of central hemodynamic, transport and consumption of oxygen were studied intraoperatively and in the first 12 hours
after the operation, serum lactate concentration during the operation and during the first postoperative day.
Results. After completion of bypass, the cardiac index and oxygen delivery were 3.21±0.1 l/min/m2 and
484±121 ml/min/m2 in the adrenalin group and 2.8±0.14 l/min/m2 and 427±125 ml/min/m2 in the dobutamine
group, unchanged for 12 hours after operation (p>0.05) and did not have intergroup differences since admission to
the intensive care unit (p>0.05). Oxygen consumption after completion of bypass was reduced in the adrenaline
group, 64±47 ml/min/m2 vs 90±67 ml/min/m2 in the dobutamine group (p<0.05) and increased to 12 hours to
82±48 ml/min/m2 in the adrenaline group (p<0.05) and 112±35 ml/min/m2 in the dobutamine group (p<0.05),
differing between groups by more than 27% (p<0.01). Hyperlactatemia was observed in the adrenaline group, reaching
maximum values of 8.7±4.2 mmol/l from the 6th to the 12th hours after operation.
Conclusion. In patients with heart valves diseases cardiotonic support of adrenaline causes of decrease of oxygen consumption
with its adequate delivery and causes the development of hyperlactatemia in the intraoperative period and
in the first postoperative day.
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About the authors
- Gennady V. Yudin, Cand. Med. Sc., Anesthesiologist; orcid.org/0000-0001-9976-6206
-
Mikhail M. Rybka, Dr. Med. Sc., Head of the Department of Anesthesiology; orcid.org/0000-0001-8206-8794
-
Dzhumber Ya. Khinchagov, Cand. Med. Sc., Anesthesiologist;
-
Nikolay A. Solov’ev, Resident Physician;
-
Maksim V. Lomakin, Anesthesiologist;
-
Yuris Yu. Aydashev, Anesthesiologist
