UDK: 616-08-039.71;616-089.5-031.83;616.13-089

PREVENTION OF SHORT-TERM COMPLICATIONS FOR OFF-PUMP CORONARY ARTERY BYPASS GRAFTING IN PATIENTS WITH DIABETES MELLITUS

M.I. Turovets1, P.V. Mozgovoy2,3, A.V. Ekstrem1, S.M. Slakhter1, A.V. Lopushkov3

ФГБОУ ВО «Волгоградский государственный медицинский университет» Министерства здравоохранения Российской Федерации, 1кафедра анестезиологии и реаниматологии, трансфузиологии и скорой медицинской помощи ИНМФО, 2кафедра факультетской хирургии; 3Клиника № 1

Abstract

Diabetes mellitus is an independent risk factor for the development of early postoperative complications in coronary artery bypass grafting without cardiopulmonary bypass (off-pump CABG). A comparative analysis of early postoperative complications for off-pump CABG in patients with diabetes mellitus was made. A randomized study of the results of surgical treatment of patients with coronary heart disease who underwent coronary artery bypass grafting of 2 or more branches of the coronary arteries without the use of cardiopulmonary bypass included 191 patients. In patients of the main group (n = 32), the comorbid background was complicated by diabetes; in patients in the control group (n = 159), this disease was not detected. For statistical processing of the obtained data, nonparametric criteria were used (Fisher test and relative risk (RR) with a 95% confidence interval (CI)). It is proved that in patients of the main group (with diabetes) the relative risk of developing postoperative complications (acute myocardial infarction, pneumonia, acute renal failure, multiple organ failure syndrome, etc.) is significantly higher than in patients in the control group (RR = 1.36–4 .97). The use of combined anesthesia (with prolonged thoracic epidural analgesia) allowed patients of both groups to significantly reduce the risk of developing clinically significant complications (RR = 0.26–0.78). Performing off-pump CABG in patients with diabetes is associated with a significant increase in the risk of postoperative complications, and the use of combined anesthesia effectively reduces the risk of their development in patients of this category.

Keywords

off-pump coronary artery bypass grafting, prevention of complication, diabetes mellitus, thoracic epidural analgesia.

Contacts

Туровец Михаил Иванович – д. м. н., профессор кафедры анестезиологии и реаниматологии, трансфузиологии и скорой медицинской помощи ИНМФО, Волгоградский государственный медицинский университет, e-mail: turovets_aro@mail.ru