Dyachenko H. Optimization of anesthesia in surgical patients with overweight

The dissertation provides a theoretical generalization and a new solution to an urgent scientific problem related to improving the treatment of overweight patients with surgical development by developing algorithms for perioperative intensive care for the successful implementation of the ERAS protocol. Treatment of patients with surgical profile with excess body weight is an actually problem today. Based on current data, excess body weight, body mass index 25.0 - 29.9, is considered depending on the duration of weight gain, which is undoubtedly a prerequisite for the occurrence of metabolic disorders associated with the influence of secretory activity of visceral adipose tissue. This issue is especially important when there is a need for planned surgical treatment in the management of patients under the program of accelerated recovery (ERAS), when in determining metabolic disorders of the patient at the screening stage can be corrected by adjunctive therapy, and thus successfully implement the ERAS protocol. An important point is to understand that the program of accelerated recovery after elective surgery significantly reduces the number of postoperative complications and improves the general condition of patients and their quality of life in general. Currently, in the first place in this group of patients are problems associated with the activity of visceral adipose tissue as an independent endocrine organ, which makes the seemingly subjectively satisfactory condition before surgery such that in most cases prevents patients from meeting sufficiently stringent requirements for postoperative activation. ERAS program. In this context, pathogenic changes in the body of patients with excess body weight lasting more than 10 years in the history of vitamin D deficiency / deficiency at the stage of screening with no clinical manifestations / complaints with relevant disorders of calcium-phosphorus metabolism are currently coming to the fore. , including conditions of sarcopenia and reduced quality of neuromuscular ratios. Due to current trends to minimize the length of hospital stay, which is the key to a positive prognosis after elective surgery, it is important to timely assess possible key pathogenetically determined metabolic changes in the body, and develop and implement in clinical practice appropriate supplements to the standard intensive care unit protocol. . That is why the issue of optimizing the treatment of patients with surgical profile with excess weight remains open, relevant and meets the needs of modern surgical services.