THE EFFECT OF A LIBERAL REGIMEN OF INFUSION THERAPY ON HEMODYNAMICS IN PATIENTS WITH ACUTE ABDOMINAL PATHOLOGY

Abstract

Acute abdominal pathology is assosiated with a high mortality rate. One of the main reasons for the severity of the condition of patients is the initial pathophysiological change in fluid metabolism – volume depletion. The treatment of that is prove by infusion therapy. The aim of the study is to assess the effectiveness of the liberal regime of infusion therapy based on the state of central hemodynamics. We examined 50 patients who were operated on in emergency laparatomy. Perioperative infusion therapy in all patients was proved in a liberal regimen with balanced crystalloid solutions. We examined the clinical parameters of systemic hemodynamics and measured the central and peripheral hemodynamic parameters determined by the method of integral rheography with the apparatus “Diamant”. We evaluated tissue perfusion with the apparatus “+BIOMED” also. Unexpectedly we found that the correction of volumetric exhaustion by the liberal regimen of infusion therapy in patients with acute abdominal pathology forms hypodynamic state of circulation due to tachycardia and vasospasm in the first 6 perioperative hours. We note declined of cardiac index during all observation. Moreover, the lowest values of cardiac index were at 3-d and 7-th day after surgery. It was related with rising values of systemic vascular resistance and poor tissue perfusion. Thus, the insufficient effectiveness of the liberal regime of infusion therapy was established due to the formation of a hypodynamic state of circulation by significantly increasing the systemic vascular resistance and reducing tissue perfusion throughout the entire observation period.