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Oxford University Press, European Heart Journal, 22(30), p. 2769-2812, 2009

DOI: 10.1093/eurheartj/ehp337

Stolichnaya Izdatelskaya Kompaniya, Racional?naâ Farmakoterapiâ v Kardiologii, 3(6), p. 391-412

DOI: 10.20996/1819-6446-2010-6-3-391-412

Stolichnaya Izdatelskaya Kompaniya, Racional?naâ Farmakoterapiâ v Kardiologii, 4(6), p. 578-598

DOI: 10.20996/1819-6446-2010-6-4-578-598

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Guidelines for Pre-Operative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery

Journal article published in 2010 by Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery, G. van den Berghe, P. Widimsky, Don Poldermans, Jeroen J. Bax, European Society of Cardiology (Esc), Eric Boersma, Bax Jj, Stefan De Hert, Stefan De Hert, Erik Eeckhout, Gerry Fowkes, Bulent Gorenek, Hennerici Mg, Michael G. Hennerici and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Objective: to experimentally reveal possible systemic hemodynamic changes after maximally allowable liver resection, by determining the time of their formation in the early postoperative period. Materials and methods. The experiments on 22 outbred male albino rats recorded an electrocardiogram, left carotid blood pressure by a direct method, an integral rheogram and its first derivative by the tetrapolar rheographic procedure developed by Sh. I. Ismailov et al. and modified by V. V. Karpitsky et al. 1, 3, 6, and 12 hours and 1, 3, and 7 days after maximally allowable liver resection. Stroke volume, mean blood pressure, cardiac output, and specific peripheral vascular resistance (SPVR) were calculated. Blood loss was estimated by the gravimetric method. The significance of differences was defined by Friedman ANOVA. Results. At postoperative hour 1, the low cardiac output syndrome the basis for which is a considerable reduction in stroke volume developed and persisted during the first 24 hours; an additional contribution was made by moderate bradycardia observed within the first 24 hours. On day 3 postsurgery, the hemodynamic parameters were similar to those at baseline. By 7 day of an observation, cardiac depression changed into moderate myocardial hyperdynamia in the presence of moderate tachycardia and a moderate decrease in SPVR. Conclusion. The critical time found by the authors for the minimum cardiac output was an hour after surgery. The distinctive features of low cardiac output syndrome after maximally allowable liver resection are its reversible pattern and reflectory bradycardia on postoperative day 1. By day 7, cardiac depression changed into moderate myocardial hyperdynamia due to a tendency towards tachycardia. © 2015, V.A. Negovsky Research Institute of General Reanimatology. All rights reserved.