«Саратовский научно-медицинский журнал» » Архив номеров » Volume 10, issue 2 » Публикация

Аннотация The aim: to use veloergometry test at patients of high anaeshtesiology-operative risk before traumatic operations for functional operability determination. Material and methods: Randomized prospective research with the double "blind" control has been performed at 95 patients of high risk (ASA>III), undergoing long and traumatic operations on thoracic and abdominal organs. Patients have divided into groups without complications and with complications (51 and 44 patients) which one day prior to operation have spent veloergometry test (VEMT). Average dynamic pressure (ADP), the general peripheral resistance of vessels (GPRV), a core index (Cl); arterio-venous (a-v) difference on oxygen, oxygen delivery to tissues, consumption of oxygen and coefficients extraction oxygen in tissues; energy consumption have been investigated. Statistics has been done by nonparametric methods. Results. In response to veloergometry test in both groups growth of Cl at the expense of a tachycardia and GPRV fall which in complication group remains above norm is noted. In group without complications coefficients extraction oxygen in tissues were normalised, a-v difference on 02 became above norm, in other group — coefficients extraction oxygen in tissues and a-v difference on 02 began to exceed norm, and oxygen consumption has grown almost in 2 times. After VEMT a-v a difference on О and oxygen consumption were essentially above in group with complications. Under the influence of VEMT markecT stabilization of function of vegetative nervous systems (VNS). The number of complications made 39: intraoperation cardiovascular — 23, postoperative respiratory — 16. Clinically important connection (p=0,069) of perioperative complications with growth a-v differences on oxygen and a power interchanging have been received. Conclusion. Thus, the oxygen-energy exchange and the vegetative status can be referred to clinical functional operability determination.