OXYGEN BALANCE AND ITS CORRECTION IN PATIENTS WITH ISCHEMIC HEART DISEASE IN THE PREOPERATIVE PERIOD
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i4.15788Keywords:
myocardial ischemia, hypoxia, oxygen delivery, energy metabolismAbstract
SUMMARY. The aim – to investigate the features of oxygen balance disorders in patients with ischemic heart disease and, based on the correction of these disorders, to optimize their preparation for coronary artery bypass grafting surgery.
Material and Methods. The study included 115 patients with ischemic heart disease who were treated at the Department of Cardiac Surgery and Transplantation of Ternopil Regional Clinical Hospital during 2022–2025. 85 of them (73.9 %) were diagnosed with concomitant pathology – hypertension, and 62 (53.9 %) – with diabetes mellitus.
Results. In patients with ischemic heart disease, in the preoperative period, peripheral blood parameters (hemoglobin, methemoglobin), its gas composition (saturation, oxygen tension and its content in arterial and mixed venous blood), hemodynamic parameters (blood pressure – systolic, diastolic, pulse and mean values; central venous pressure; total peripheral vascular resistance), oxygen-transport function of the blood; intensity of tissue metabolism (basic and energy metabolism, tissue respiration indicators – according to generally accepted formulas); degrees of hypoxia (hemic, pulmonary, circulatory, integral indicator of oxygen insufficiency), lactic acid level were calculated.
Conclusions. An increase of the "safety margin" in terms of the degree of hemic hypoxia due to anemia by 6.7±0.9 %, a decrease in its reserve due to the use of nitro compounds by 4.3–5.5 %, an increase in the degree of circulatory hypoxia to 21.2±0.6 % and the integral indicator of oxygen deficiency to 14.5±0.2 % on the background of increased energy metabolism and the intensity of tissue respiration to (113.5±3) % were established. Correction of oxygen balance is proposed.
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