The state of the oxygen budget in patients with acute coronary syndrome in coronary artery bypass graft in the perioperative period

M.V. Khartanovich, B.M. Todurov, A.A. Khizhnyak, Yu.V. Volkova

Abstract


Background. Among the diseases of the circulatory system, which are the main cause of death among middle-aged people and the elderly in many developed countries of the world, ischemic heart disease is one of the most common. At the same time, the high incidence of risk factors and the absence of a unified approach to preventing their impact on the body determine the importance of finding the best ways to treat these patients. The purpose of the study: to investigate the course of the perioperative period in patients who underwent coronary artery bypass graft for acute coronary syndrome. Materials and methods. The course of anesthesia and early postoperative period was studied in 37 patients with acute coronary syndrome who underwent coronary artery bypass surgery. The studies were carried out at the following stages: 1) before the operation; 2) at the exit from perfusion; 3) transfer to the intensive care unit; 4) transfer from the intensive care unit. At these stages, the final diastolic and systolic volume, the frequency of cardiac contraction, the parameters of systemic oxygen transport in the body were recorded. Results. It was found that acute coronary syndrome is accompanied in most cases by the development of acute heart failure, which is confirmed by a decrease in the cardiac index to less than 2.5 l/min ∙ m2 in 73.0 ± 7.3 % of patients. The use of the anesthesia protocol for coronary artery bypass grafting, including the use of β1-blocker metoprolol tartrate and nitroglycerin against dobutamine infusion, allows the cardiac index to be normalized in 94.6 ± 3.7 % of patients with acute coronary syndrome. Conclusions. The protocol using β1-blocker metoprolol tartrate and nitroglycerin against the background of dobutamine infusion is highly effective in patients with acute coronary syndrome during coronary artery bypass surgery, which allows to maintain the preoperative level and to normalize the lactate level in the vast majority of patients (94.6 ± 5.4 %).


Keywords


coronary artery bypass graft; acute coronary syndrome; β1-blockers; lactate

References


Saenger A.K., Jaffe A.S. The Use of Biomarkers for the Evaluation and Treatment of Patients with Acute Coronary Syndromes // Med. Clin. N. Amer. — 2007. — Vol. 91. — P. 657-681.

Response to Letter by Zaugg et al. STAT5 Activation and Cardioprotection by Remote Ischemic Preconditioning in Patients Undergoing Coronary Revascularization During Isoflurane Anesthesia / G. Heusch, J. Musiolik, E. Kottenberg, J. Peters, H. Jakob, M. Thielmann // Circulation Research. — 2012. — Vol. 110. — 44-45.

Epidemiology and Prevention of CV Disease: Physiology, Pharmacology and Lifestyle — Session Title: Obesity in CVD Risk and Prevention II 18164: Obesity Paradox in the Extremely Obese: Evaluaion of In-Hospital and Long Term Clinical Outcomes After Percutaneous Coronary Interventions / M. Singh, A. Mishra, D. Sporn // Circulation. — 2014. — Vol. 130. — A18164.

Editor’s Perspective Percutaneous Coronary Interventions in ST-Segment–Elevation Myocardial Infarction: Shifting Paradigms and Future Perspectives / Dominick J. Angiolillo, Theodore A. Bass // Circ. Cardiovasc. Interv. — 2013. — Vol. 6. — P. 593-595.

Coronary Interventions Optical Coherence Tomography Guided Percutaneous Coronary Intervention With Nobori Stent Implantation in Patients With Non-ST-Segment-Elevation Myocardial Infarction (OCTACS) Trial: Difference in Strut Coverage and Dynamic Malapposition Patterns at 6 Months / L. Antonsen, P. Thayssen, A. Maehara, H.S. Hansen, A. Junker, K. Veien, K. Hansen, M. Hougaard, G.S. Mintz, L. Jensen // Circ. Cardiovasc. Interv. — 2015. — Vol. 8. — e002446.

Coronary Physiologic Assessment and Imaging Assessment of Fractional Flow Reserve in Patients With Recent Non–ST-Segment–Elevation Myocardial Infarction: Comparative Study With 3-T Stress Perfusion Cardiac Magnetic Resonance Ima­ging / J. Layland, S. Rauhalammi, S. Watkins, N. Ahmed, J. McClure, M.Y. Lee, D. Carrick, A. O’Donnell, A. Sood, M.C. Petrie, H. Eteiba, M. Lindsay, M. McEntegart, K.G. Oldroyd, A. Radjenovic, C. Berry // Circ. Cardiovasc. Interv. — 2015. — Vol. 8. — e002207.

Editorial Non-ST-Segment-Elevation Myocardial Infarction: A Novel and Robust Approach for Early Detection of Patients at Risk / Robert L. Lux // J. Am. Heart Assoc. — 2015. — Vol. 4. — e002279.

Correspondence Response to Letter Regarding Article, “Evolution From Fibrinolytic Therapy to a Fibrinolytic Strategy for Patients With ST-Segment–Elevation Myocardial Infarction” / Eric R. Bates // Circulation. — 2015. — Vol. 132. — 12.

Editorial Oxygen for ST-Segment-Elevation Myocardial Infarction: Still Up in the Air / Zoran S. Nedeljkovic, Alice K. Jacobs // Circulation. — 2015. — Vol. 131. — P. 2101-2103.

Epidemiology and Prevention Atrial Fibrillation and Risk of ST-Segment-Elevation Versus Non-ST-Segment-Elevation Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) Study / E.Z. Soliman, F. Lopez, W.T. O’Neal, L.Y. Chen, L. Bengtson, Z.-M. Zhang, L. Loehr, M. Cushman, A. Alonso // Circulation. — 2015. — Vol. 131. — P. 1843-1850.

Cardiac Catheterization Underutilization of Radial Access in Patients Undergoing Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium / M.J. Howe, M. Seth, A. Riba, G. Hanzel, M. Zainea, H.S. Gurm // Circ. Cardiovasc. Interv. — 2015. — 8. — doi: 10.1161/CIRCINTERVENTIONS.114.002036.

Coronary Interventions Activated Clotting Time and Outcomes During Percutaneous Coronary Intervention for Non-ST-Segment-Elevation Myocardial Infarction: Insights From the FUTURA/OASIS-8 Trial / G. Ducrocq, S. Jolly, S.R. Mehta, S.V. Rao, T. Patel, R. Moreno, P. Gao, P. Steg // Circ. Cardiovasc. Interv. — 2015. — 8. — doi: 10.1161/CIRCINTERVENTIONS.114.002044.

Myocardial Infarction Complete Versus Culprit-Only Revascularization for ST-Segment-Elevation Myocardial Infarction and Multivessel Disease: A Meta-Analysis and Trial Sequential Analysis of Randomized Trials / S. Bangalore, B. Toklu, J. Wetterslev // Circ. Cardiovasc. Interv. — 2015. — 8. — doi: 10.1161/CIRCINTERVENTIONS.114.002142.

Coronary Interventions Cerebrovascular Events After a Primary Percutaneous Coronary Intervention Strategy for Acute ST-Segment-Elevation Myocardial Infarction: Analysis From the ­HORIZONS-AMI Trial / E. Nikolsky, R. Mehran, G.D. Dangas, K. Xu, R. Parvataneni, B. Witzenbichler, G. Guagliumi, R. Kornowski, P. Généreux, S.J. Brener, G.W. Stone // Circ. Cardiovasc. Interv. — 2015. — 8. — doi: 10.1161/CIRCINTERVENTIONS.114.002283.

Right Ventricular Dysfunction Predisposes to Inducible Ventricular Tachycardia at Electrophysiology Studies in Patients With Acute ST-Segment–Elevation Myocardial Infarction and Reduced Left Ventricular Ejection Fraction / J.B. Thakkar, S. Zaman, K. Byth, A. Narayan, A. Thiagalingam, C. Chow, S.P. Tho­mas, G. Sivagangabalan, D. Farlow, R. Barnett, P. Kovoor // Circ. Arrhythm. Electrophysiol. — 2014. — Vol. 7. — P. 898-905.

Editorial Evolution From Fibrinolytic Therapy to a Fibrinolytic Strategy for Patients With ST-Segment-Elevation Myocardial Infarction / Eric R. Bates // Circulation. — 2014. — Vol. 130. — P. 1133-1135.

Impact of Time of Presentation on Process Performance and Outcomes in ST-Segment-Elevation Myocardial Infarction: A Report From the American Heart Association: Mission Lifeline Program / T.W. Dasari, M.T. Roe, A.Y. Chen, E.D. Peterson, R.P. Giugliano, G.C. Fonarow, J.F. Saucedo // Circ. Cardiovasc. Qual. Outcomes. — 2014. — Vol. 7. — P. 656-663.




DOI: https://doi.org/10.22141/2224-0586.7.86.2017.116886

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