Клінічна хірургія (Jun 2020)
Impact of iron hydroxide (III) on level of postoperative anemia in patients with combined mitral and aortal heart failures
Abstract
Objective. To investigate a combined impact of iron hydroxide (III) on the anemia level after prosthesis of mitral and aortal valves in accordance to the blood-preserving technology in conditions of artificial blood circulation. Materials and methods. In 52 patients with combined mitral-aortal heart failures the levels of hemoglobin, hematocrit, iron and enzymes were investigated. Group C of the patients was delineated with anemia in chronic diseases and low values of levels of iron, ferritin, hemoglobin, hematocrit, in whom preoperatively correction of low iron content in the blood serum was conducted. After preoperative correction, using iron hydroxide (III), in patients of the Group C the mitral and aortal valves prosthesis was conducted, applying the blood-securing technology. The patients, in whom the levels of hemoglobin, hematocrit, erythrocytes, iron were in normal range, were put into Groups A and B.The Group A patients were operated with application of the donor’s blood, and the Group B - without application of the donor’s blood in accordance to the blood-preserving technology. Results. The investigations conducted have shown, that big volumes ot the donor’s blood components - (653.0 ± 118.0) ml of erythrocytic mass and (728.0 ± 63.0) ml of fresh-frozen plasm - were transfused to the Group A patients for stabilization of postoperative level of hemoglobin and hematocrit. Performance of operations of the mitral and aortal prosthesis in accordance to the blood-preserving technology is possible without transfusion of the donor’s blood preparations, but lowering of the hemoglobin level by 19.5%, hematocrit - by 13.2%, erythrocytes - by 15.8%, the serum iron - by 17.9%, thrombocytes - by 31.4% in the Group B patients indicates the necessity for provision of the donor’s blood components preoperatively. Preoperative correction of the serum level of iron in the Group C patients with anemia due to chronic diseases have raised its its preoperative level in 9.8 times and the level of hemoglobin - by 8.0%. Combination of preoperative correction of the blood serum level of the iron with intraoperative application of the blood-preserving technology during procedure for the mitral and aortal valves in patients of Group C have reduced anemia in accordance to data of hemoglobin level in postoperative period by 9.3%, and thrombocytopenia - by 9.5%. Conclusion. Combination of preoperative correction of anemia due to chronic diseases using iron hydroxide (III) with application of the blood-preserving technologies while doing operations of the mitral and aortal valves prosthesis reduces the postoperative anemia level by 9.3%.
Keywords
