Yarovenko V. Improvement in the method of extracorporeal circulation in open heart surgery

The dissertation is devoted to study, research and implementation of the clinic intraoperative best options for its operations in the correction of acquired heart defects, based on changes perfusate colloidal component in a solution of gelatin or HES 130/0.4 and the presence or absence of ultrafiltration blood during CPB. The work is based on a study of 117 patients. It is established that hemodilution and cooling regardless of perfusate, reduces the level of DO2, VO2, O2ER, the number of white blood cells and granulocytes. After the termination of CPB due to correction of acquired heart disease, they are just increasing. It is established that the severity of the inflammatory response depends on the qualitative composition of perfusate and the presence or absence of UF. On a background of gelatin, its activity is not reduced. The inclusion of the HES 130/0.4 in perfusate solution provides slight decrease inflammatory response, while joining the CPB UF, provides anti-inflammatory action due to significant reduction in IL 6 and IL 10. UF on the background of HES 130/0.4 provides the maximum reduction of inflammation response. Clinically it shows a decrease in the duration of ventilation time, the number of patients requiring inotropic support, reduced treatment duration of intensive care at 18,4% and the average duration of treatment in hospital at 28,3%.