UDK: 616-089.5:616.1

THE RESULTS OF THE USE OF COMBINED ANESTHESIA FOR CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH DIABETES MELLITUS OR CHRONIC OBSTRUCTIVE PULMONARY DISEASE

A.G. Beburishvili1, M.I. Turovets2, P.V. Mozgovoi1, 3, A.S. Popov2, A.V. Lopushkov3, A.V. Ekstrem2

ФГБОУ ВО «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской Федерации, 1кафедра факультетской хирургии с курсом эндоскопической хирургии ФУВ и с курсом сердечно-сосудистой хирургии ФУВ; 2кафедра анестезиологии

Abstract

Introduction. Coronary artery bypass grafting in patients with diabetes mellitus (DM) or chronic obstructive pulmonary disease (COPD) is often associated with a complicated course of the early postoperative period. Aim. Conduct a comparative analysis of postoperative complications of coronary artery bypass grafting in patients with DM or COPD. Methods. A prospective controlled study of the results of surgical treatment of patients with DM or COPD, who underwent coronary artery bypass surgery of 2 or more branches of the coronary arteries with or without artificial blood circulation. The study included 277 patients. In patients of the main group (n = 60), the comorbid background was complicated by DM or COPD; in the control group (n = 217), these concomitant pathologies were not detected. Non-parametric criteria, Pearson χ2 and relative risk (RR) with a 95 % confidence interval (CI), were used for statistical processing of the obtained data. Results. It is proved that in patients of the main group (with DM or COPD) the relative risk of postoperative complications (acute myocardial infarction, pneumonia, acute renal failure, multiple organ failure syndrome, acute kidney damage, etc.) is significantly higher than in patients of the control group (relative risk (RR) = 1,55–3,62). The use of combined anesthesia (with prolonged gastroenteroanastomosis (GEA)) allowed patients of both groups to significantly reduce the risk of developing clinically significant complications (RR = 0,13–0,59). Conclusions. Carrying out of coronary artery bypass grafting in patients with DM or COPD is associated with a significant increase in the risk of postoperative complications. The use of combined anesthesia (with GEA) reduces the risk of complications of the early postoperative period in patients with DM or COPD.

Keywords

coronary artery bypass grafting, prevention of complication, diabetes mellitus, chronic obstructive pulmonary disease.

Contacts

Туровец Михаил Иванович – к. м. н., ассистент кафедры анестезиологии и реаниматологии с трансфузиологией ФУВ, Волгоградский государственный медицинский университет, e-mail: turovets_aro@mail.ru