Optimization of postoperative hypotension correction in thoracic surgery

Abstract

Introduction. Arterial hypotension is the reasonable cause for intravenous injections of crystalloid solutions. However, as far as this statement is fair in the patients that underwent extensive scheduled thoracic operations at that moment is not defined.Aim. To reduce the number of complications in patients following thoracic operations by definition of optimum strategy for correction of postoperative hypotension.Methods. The retrospective analysis of 154 patients who were divided into 2 groups was conducted. In 58 patients, for correction of arterial blood pressure we used noradrenaline, in other cases (96 patients) noradrenaline in combination with infusion therapy was administered. The comparative analysis of the perioperative volemic status, levels of hemoglobin, urea, creatinine, a lactate, glucose, paO2 , paCO2 , ScvO2 , SaO2 , pvCO2 -paCO2 , duration of noradrenaline application and also a range of the postoperative complications was carried out.Results and conclusions. It is revealed that correction of hypotension with crystalloid solutions in thoracic patients results at and conclusions increased risk of pneumonia development. At the same time, infusion therapy in the early postoperative period in thoracic patients did not reduce the risk of intense kidney failure development. Severity of postoperative complications according to Clavien-Dindo classification was higher in patients who had infusion therapy. At the same time, duration of vasopressor support showed no change.

Keywords

• thoracic surgery
• infusion therapy
• intraoperative hypotension
• postoperative complications
• noradrenaline