PREVENTION OF REPERFUSION-REOXYGENATION SYNDROME IN PATIENTS WITH CHRONIC CRITICAL ISCHEMIA OF THE LOWER EXTREMITIES BY CORRECTION OF ACID-ALKALINE STATUS OF BLOOD
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11315Keywords:
arterial insufficiency, reperfusion syndromeAbstract
Surgical treatment of chronic arterial insufficiency consists in reconstructive interventions on the main arterial bed of the lower extremities. Not enough attention is paid to disruption of acid-base balance in reoxygenation of the ischemic limb in the treatment of reperfusion-reoxygenation syndrome.
The aim – to improve the effectiveness of prevention of reperfusion-reoxygenation syndrome in patients with chronic critical ischemia of lower extremities by correction of acid-base balance of the blood.
Material and Methods. The study was performed in a total of 79 patients with atherosclerotic lesions of the aorto/iliac-femoral segment. Assessment of acid-base balance of blood was performed on a microgas analyzer ABL – 330 “Radiometer” and “Stat ProfAile ultrac”. Thirty patients at high risk of developing RRS were operated after preop care supplemented by the medication to correct acid-base balance (Trometamol).
Results and Discussion. The pH level of venous blood of the ischemic lower extremity in patients with stage IIB of CAI is in the range that corresponds to compensated, with stage IIIA – subcompensated, with stage IIIB-IV – decompensated metabolic acidosis. A noticeable, compared with the control group, decrease in H CO2 and SBC was found. The content of SBC is 1.4 times lower (p<0.05), and H CO3 – 1.3 (р<0.05) times lower compared to healthy individuals. The most significant changes in AAB are observed in patients with stage IIIB-IV CAI. The use of Trometamol makes it possible to increase partial pressure P CO2 and T CO2 in blood, pH up to 7.21 units, and 1.6 times (p<0.05) increase of the contents of SBC in venous blood and 1.4 times (p<0,05) of H CO3 contents.
Conclusions. Correction of acid-alkaline balance is necessary for the prevention of reperfusion injury during revascularization of the arterial bed of the lower extremities in patients with CAI.
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