International Medical Journal, Vol. 27., Iss. 2, 2021, P. 47−51.
INITIAL CHANGES IN HEMODYNAMICS AND BODY WATER SECTORS IN PATIENTS WITH AVERAGE SURGICAL RISK DURING URGENT ABDOMINAL CAVITY PATHOLOGY
Municipal Enterprise "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine", Dnipro, Ukraine
The abdominal cavity urgent diseases are the largest group in general surgical hospitals and require an emergency surgery. According to systematic reviews of the published reports, a significant influence of age and baseline severity of patients on the level of short− and long−term mortality was found. To analyze the initial state of the body water sectors and hemodynamics in the patients with average surgical risk in acute abdominal pathology, 157 patients underwent urgent surgery in the amount of emergency laparotomy were examined. In the structure of the main disease among the individuals the perforation of gastric and duodenal ulcers, pinched hernia, and acute intestinal obstruction were dominated. Clinical, hardware, laboratory, and computational fluid deficiency methods were used for all the patients. The state of central and peripheral hemodynamics was established instrumentally. There was a decrease in the plasma of patients with K + levels by 14.9 % of normal and an increase in Ca2 + levels by 91.1 % above normal. This coincided with a decrease from the norm of extracellular space by 20.0 % due to a reduction in both the volume of the interstitium and intravascular fluid by 21.0 % and 17.0 %, respectively, an increase in the level of vasopressin by 54.8 % above normal. This caused a decrease in stroke volume and formed a moderately hyperdynamic type of circulation due to an increase in heart rate and total peripheral vascular resistance by 21.2 % and 8.1 %, respectively. Thus, in the patients with an average surgical risk, urgent pathology of the abdominal organs contributes to the development of hypokalemia and hypercalcemia, the formation of a moderately hyperdynamic type of blood circulation on the background of tachycardia, vascular spasm to increase oxygen consumption and utilization.
Key words: central and peripheral hemodynamics, body water sectors, average surgical risk, emergency abdominal surgery.
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