Аннотация
Хирургическое лечение больных с заболеваниями сердца в условиях искусственного кровообращения (ИК) сопряжено с риском развития периоперационного органного повреждения. При этом нарушение функционального состояния внутренних органов обусловливает увеличение сроков пребывания пациентов в отделении интенсивной терапии и повышение вероятности летального исхода после перенесенного оперативного вмешательства. Совершенствование подходов к профилактике органной дисфункции является принципиально важной задачей современной кардиоанестезиологии и направлено на повышение безопасности больных, оперируемых с применением ИК. В данном обзоре представлены структура органной дисфункции и распространенность каждого из ее видов в раннем послеоперационном периоде у пациентов кардиохирургического профиля. Описаны возможности фармакологической органопротекции галогенсодержащими ингаляционными анестетиками и левосименданом, а также приведены данные рандомизированных клинических исследований и метаанализов, которые свидетельствуют о наличии или отсутствии у этих препаратов клинически значимых органопротективных свойств. Освещены альтернативные подходы к профилактике органной дисфункции у кардиохирургических больных, основанные на модификации факторов риска органного повреждения, оптимизации периоперационной инфузионной терапии и совершенствовании мониторинга кровообращения.
Литература
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Об авторах
Юдин Геннадий Вячеславович, канд. мед. наук, врач – анестезиолог-реаниматолог;
ORCID
