METHOD FOR STABILIZING HEMODYNAMICS IN PATIENTS WITH COMPLICATED CERVICAL SPINE INJURY Russian patent published in 2023 - IPC A61B5/02 A61K31/165 A61K38/22 A61P9/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to resuscitation and intensive care, and can be used to stabilize central hemodynamics in patients with complicated trauma of the cervical spine. To do this, indicators of central hemodynamics are determined by means of non-invasive monitoring of central hemodynamics upon admission, and then daily, on the basis of which the type of violation of central hemodynamics is determined and therapy is prescribed. With a cardiac index (CI) within the conventional norm and a reduced total peripheral vascular resistance (TPVR), type 1 disorder is diagnosed; in addition, for this type of disorder, the heart rate (HR) is determined. With a heart rate of less than 65 beats/min, Dopamine is prescribed, and with a heart rate of more than 65 beats/min, Norepinephrine is prescribed. With reduced CI and TPVR within the conventional norm, type 2 disorders are diagnosed and Dobutamine is prescribed. With reduced CI and reduced TPVR, type 3 disorders are diagnosed and combination therapy Dobutamine + Norepinephrine is prescribed. Additionally, at admission and then daily, the volemic status is determined by the passive leg elevation test by comparing cardiac output (CO) values ​​in the supine position and with the legs raised. With an increase in CO with raised legs relative to CO in the supine position by 10% or more, in addition to the previously prescribed therapy, emergency rehydration in a volume of 10 ml/kg/h is prescribed. And with an increase of less than 10%, in addition to the previously prescribed therapy, infusion therapy is prescribed in the amount of 30-40 ml/kg/day. In the case of emergency rehydration immediately after it, the volemic status is re-determined, according to which emergency rehydration or infusion therapy is similarly prescribed. The determination of the volemic status is repeated until normovolemia is reached. Further adjustment of therapy is carried out according to the determination of hemodynamic parameters and volemic status on a daily basis.

EFFECT: invention provides the possibility of rapid stabilization of central hemodynamics in this category of patients in the shortest possible time and with minimal doses of drugs, which in turn allows emergency surgery with stable blood pressure and heart rate.

1 cl, 8 ex