Influence of Various Types of Start Infusion Therapy on Pre-Load Values in Patients with Infectious Toxic Shock
The main purposes of shock infusion therapy should be achievement of euvolemia and hemodynamic stabilization, correction of acid-base balance, rehydration of interstitial and intracellular sectors, maintenance of adequate gradient between colloid osmotic plasma pressure and pulmonary capillary wedge pressure, improvement of microvascular blood flow, prevention of cascade mechanisms activation and hypercoagulation, normalization of oxygen delivery to tissues. The aim of this study is to investigate reaction of hemodynamics parameters to various types of infusion therapy. The paper analyses and resumes the results of observation and treatment of 111 patients with different forms of severe infectious pathology. Depending on start infusion solution the patients were divided into 4 groups. The results of the study allow conclude that hemodynamic profile of the patient needed for rehydration could be considered as a hypodynamic one. Chloride sodium hypertonic solutions do not significantly enhance central venous pressure but increase pre-load, due to these properties their combination with dextran allows decrease pulmonary vascular resistance, so that improve pre-load at lower parameters of pressure in pulmonary artery. Resuscitation with 6% solution of НАЕ8 200/10% NaCl is associated with greater pulmonary vascular resistance that does not impede improving left ventricle pre-load.
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