Koltunova A. Prevention and treatment of respiratory failure in patients with infective endocarditis operated under extracorporeal circulation.

The scientific work is devoted to the problems of intraoperative protection of the lungs in patients with infective endocarditis operated under extracorporeal circulation, in order to reduce the rate of postoperative respiratory failure. After the standard protocol of intraoperative management the incidence of postoperative respiratory insufficiency was determined. The preoperative risk factors were identified and the predictive model of postoperative respiratory failure was built. The pathomorphological study of lung tissue in patients with infective endocarditis, operated with standard protocol of intraoperative management, was performed. Scientific necessity of saving mechanical ventilation and pulmonary artery perfusion during aortic cross-clamping was justified. The modified protocol of intraoperative management of patients with infective endocarditis, operated under extracorporeal circulation,was developed and put into practice. As a result the pathomorphological study of lung tissue revealed decrease in the incidence of acute lung injury signs registration. Development of modified intraoperative protocol and maintenance of new lung protective methods into the clinical practice have reduced the incidence of postoperative respiratory failure from 7.9 to 2.8% cases.