METHOD FOR INTRAOPERATIVE STABILIZATION OF PATIENT'S HOMEOSTASIS IN CARDIOSURGICAL INTERVENTION IN CONDITIONS OF PROLONGED ARTIFICIAL BLOOD CIRCULATION Russian patent published in 2020 - IPC A61M1/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely perfusion, anaesthesiology and resuscitation. Preoperative assessment of presence of risk factors of systemic inflammatory response and intraoperative extracorporeal blood purification from inflammatory mediators. At the same time such risk factors are identified as: patient's age older than 65 years, duration of artificial blood circulation more than 60 minutes, presence of comorbid pathology on respiratory, renal and endocrine systems, as well as the planned ≤ 34 °C body hypothermia. Prior to the IC infusion into the perfusion contour of the apparatus, the hemofilter is integrated and high-volume haemofiltration is carried out using 5000 ml polyionic buffer solution containing K ⁺ in concentration of 4 mmol/l, calculating its feed rate as a ratio of the total volume of the solution in the reservoir in ml (V) to the predicted perfusion time in minutes (t). If observing the patient's risk factors, such as age of the patient older than 65 years, duration of the artificial circulation more than 60 minutes, or detection of these factors combined with the planned hypothermia, the solution is delivered from 60 minutes of extracorporeal circulation. If observing the patients older than 65 years old, the length of the artificial blood circulation being more than 60 minutes, the comorbid pathology with or without the planned hypothermia, the solution is supplied simultaneously with the onset of IC, wherein simultaneous supply of solution to reservoir initiates hemofiltration process by opening arterial and venous segments of haemophilus. In a particular case, when obtaining a total volemic load on a patient during haemofiltration exceeding 10 ml/kg, procedure of haemoconcentration is performed by creation of vacuum rarefaction (-) of 80 cm of water on hemofilter. In a particular case, when a dose of the substitute solution corresponding to the amount of the effluent is reached, the high-volume haemofiltration procedure is terminated. In the particular case hemofilter has the following parameters: the filter surface area - 0.71 cm², priming volume - 58 ml, filtration capacity - 39 ml/min and a pore diameter - 17,000 Da.

EFFECT: method enables improving the effectiveness of extracorporeal homeostasis stabilization methods in cardiosurgical patients operated under conditions of prolonged artificial blood circulation, including in the presence of an unfavourable comorbid background, by eliminating mediators of systemic inflammation from the circulating blood flow.

4 cl, 5 tbl, 3 ex