Use of Transpulmonary Thermodilution-based Volumetric Monitoring During Cardiosurgical Interventions

Abstract

Objective. To present currently available information on the use of transpulmonary thermodilution, a new type of volumetric monitoring of hemodynamics.Materials and methods. The data available in the Russian and foreign medical literature on this problem are analyzed.Results. In the past recent years, transpulmonary thermodilution has come into wide use in modern anesthesiology and reanimatology, including during aortocoronary bypass surgery, correction of cardiac defects, and cardiac transplantation. The values obtained by transpulmonary thermodilution correlate with the results of other monitoring methods and can extend the capabilities of diagnosis of systemic and pulmonary hemodynamic disorders. The introduction of therapeutic algorithms based on the results of volumetric monitoring makes it possible to perform intensive therapy of cardio-surgical patients purposefully (infusion load, inotropic and vasopressor support, use of diuretics), which can improve a clinical outcome.Conclusion. The use of transpulmonary thermodilution-based volumetric monitoring during cardiosurgical interventions assures adequate control of the values of preload, myocardial contractility, pulmonary circulation, and vascular tone, which allows one to develop a differential approach to correcting hemodynamics in the perioperative period.