METHOD FOR HEMODYNAMIC INCIDENTS DEVELOPMENT PREDICTION FOR ELDERLY PATIENTS DURING RECRUITMENT-MANEUVER IN PROCESS OF INTRAOPERATIVE MECHANICAL VENTILATION IN ABDOMINAL SURGERY

摘要

FIELD: medicine.;SUBSTANCE: characterization of constant potential (CP) dynamics in response to Stange's test is determined the day before the operation, in the morning prior to premedication. Then, a recruitment maneuver is performed during intraoperative ventilation within an hour after intubation. Then, anesthesia is provided each hour by a stage-by-stage manner: PEEP increase from 4 to 10 cm H₂O for three breaths, then from 10 to 15 cm H₂O for three breaths, and from 15 to 20 cm H₂O for 10 breaths. Then PEEP is reduced to 12 cm H₂O. In case of cardiovascular (CVS) and respiratory systems (RS) areactivity: absence of CP dynamics and high reactivity of CVS and RS (short-latency (5-15 s)) of moderate to severe intensity (6-28 mV) CP changes) a high risk of hemodynamic incidents during RM with the frequency of occurrence of 71.4% and 53% respectively is predicted. In case of low reactivity of CVS and RS (long-latency (25-60 s) moderate and weak intensity (2-12 mV) or medium-latency (15-25 s) low intensity (2-5 mV) CP changes) and at optimum reactivity of CVS and RS (medium-latency (15-25 s) moderate intensity (6-12 mV) CP changes) stable hemodynamics during the recruitment maneuver is predicted, wherein the frequency of hemodynamic incidents does not exceed 31.6% and 20%, respectively.;EFFECT: method allows to prevent cardiovascular complications due to non-invasive evaluation of patient condition.;4 tbl, 4 ex