FIELD: medicine.
SUBSTANCE: characterization of constant potential (CP) dynamics in response to Stange's test is determined the day before the operation, in the morning prior to premedication. Then, a recruitment maneuver is performed during intraoperative ventilation within an hour after intubation. Then, anesthesia is provided each hour by a stage-by-stage manner: PEEP increase from 4 to 10 cm H2O for three breaths, then from 10 to 15 cm H2O for three breaths, and from 15 to 20 cm H2O for 10 breaths. Then PEEP is reduced to 12 cm H2O. In case of cardiovascular (CVS) and respiratory systems (RS) areactivity: absence of CP dynamics and high reactivity of CVS and RS (short-latency (5-15 s)) of moderate to severe intensity (6-28 mV) CP changes) a high risk of hemodynamic incidents during RM with the frequency of occurrence of 71.4% and 53% respectively is predicted. In case of low reactivity of CVS and RS (long-latency (25-60 s) moderate and weak intensity (2-12 mV) or medium-latency (15-25 s) low intensity (2-5 mV) CP changes) and at optimum reactivity of CVS and RS (medium-latency (15-25 s) moderate intensity (6-12 mV) CP changes) stable hemodynamics during the recruitment maneuver is predicted, wherein the frequency of hemodynamic incidents does not exceed 31.6% and 20%, respectively.
EFFECT: method allows to prevent cardiovascular complications due to non-invasive evaluation of patient condition.
4 tbl, 4 ex
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Authors
Dates
2017-03-16—Published
2016-02-04—Filed