Neplyaha S. Anesthesiological provision surgical treatment of mitral heart-diseases in the conditions of cardiopulmonary bypass without the use of donor blood and its components

In this dissertation we define the indications for intraoperative autologous blood reservation taking into account initial parameters of the peripheral blood, systemic hemodynamics and circulating blood volume values. We proved the efficiency of the criteria for the further successful autologous blood exfusion, the effectiveness of each method of autologous blood exfusion and possibilities of their application, as well as conditions of their combination. We also examined the state of the oxygen balance under various conditions of the autologous blood reservation, and have shown the safety of these procedures. It is proved that the autologous blood transfusion leads to normalization of blood elements and hemostatic system at the end of the operation and during the immediate postoperative period and thus reduces postoperative blood loss. To get better hemostasis the pharmacological support was improved with the use of aprotinin, aminocaproic acid and etamsylate. The methods used for autologous blood reservation do not require expensive equipment and components. The result of our work is a refusal of autologous blood transfusion for these patients, a decrease of postoperative infectious complications and length of stay in the intensive care unit. A protocol of anesthetic management of patients with the use of blood conservation techniques was designed.