Comparative evaluation of visceral and renal protection methods during thoracoabdominal aortic repair (Experience of Russian Surgery Research Center named after B.V. Petrovsky)

Вестник анестезиологии и реаниматологии

E. R. Charchyan¹  O. V. Dymova²  A. A. Eremenko²  E. Yu. Chepurnyak²  K. A. Zinoviev²  B. A. Аkselrod²  A. V. Panov²  L. S. Lokshin²  Yu. V. Belov² 

[1] I. M. Sechenov First Moscow State Medical University (Sechenov University);Russian Surgery Research Center Named after B.V. Petrovsky;

关键词: thoracoabdominal aortic aneurysm;    left atrial-femoral bypass;    cardiopulmonary bypass;    selective visceral perfusion;    selective renal perfusion;   

DOI  :  10.21292/2078-5658-2021-18-2-48-55

来源: DOAJ

【 摘 要 】

The objective: to compare the effectiveness of visceral and renal protection methods during thoracoabdominal aortic (TAA) repair: left atrial-femoral bypass (LAFB) and cardiopulmonary bypass (CPB) in conjunction with selective perfusion (SP) of these organs.Subjects: 81 patients who underwent TAA repair were enrolled in retrospective analysis: LAFB was used in 29 patients (Group 1), CPB and SP ‒ in 52 patients (Group 2).Results. In Group 2, there were lower intraoperative blood loss volume (1,500 ml vs 4,200 ml, p < 0.001), significantly lower levels of direct bilirubin, blood creatinine, blood alpha-amylase in postoperative period, significantly shorter duration of hospital stay, ICU stay and duration of mechanical ventilation. Also in this group, there were lower incidence of multiple organ dysfunction (11.5% vs 37.9%, p = 0.005), stroke (0 vs 10.3%, p = 0.043), lower need for requirement (3.8% vs 20.7%, p = 0.022) and mortality (3.8% vs 27.6%, p = 0.003).Conclusion: During TAA repair, CPB in conjunction with selective visceral and renal perfusion is more beneficial for organ protection as compared with LAFB.

【 授权许可】

Unknown