The development of rational methods of intraoperative protection of the brain is an extremely important issue in cardiac anesthesiology, the solution of which will help reduce the incidence of cerebral disorders. Abnormal blood circulation operations are known to be accompanied by destruction of platelets and proteins, because of a long-term contact of blood with biocompatible, but exterior surfaces. Erythrocytes deformity in these conditions is reduced after 30 minutes of abnormal blood circulation apparatus work. At the same time reducing the deformity of erythrocytes in operated patients is accompanied by an increase in the frequency of dysfunction of the liver, kidneys and heart after surgery in more than 20% case. The purpose of the work was to analyze the dynamics of the functional state of erythrocyte markers as a reaction of patients with surgical aortic pathology surgery using cardiopulmonary bypass. Material and methods. We conducted the study of 118 patients with surgical pathology of the aorta. The patients were divided into 2 groups according to the principle of using additional substances as a part of intensive care, 46 patients were included in group I, and in addition to the intensive care algorithm, meglumin sodium succinate (reamberin) was prescribed. Group II included 46 patients who additionally the intensive care algorithm was assigned a solution of D-fructose-1.6-diphosphate sodium salt of the hydrate (esophosphine). Results and discussion. Before surgery, plasma viscosity, erythrocyte aggregation index, erythrocyte deformation index were determined in patients with surgical pathology of the aorta. We also studied morphometric and functional properties of erythrocytes such as red blood cell count, hemoglobin concentration, hematocrit, hemolysis level, mean erythrocyte volume, average hemoglobin content in a single erythrocyte, average erythrocyte, the width of the distribution of erythrocytes in volume, and cytoarchitecture of erythrocytes with the definition of indices. The analysis of the dynamics of the indices was carried out at three control points on the day before the operation, 12 hours after the operation and on the third day of staying in hospital. Conclusions. The concentration of Hb-free in patients of group II compared with groups K and I made the appointment of a solution of D-fructose-1,6-diphosphate sodium salt of hydrate in addition to the main treatment protocol of patients with surgical pathology of the aorta pathogenetically determined, improved the hemolytic stability of erythrocytes and recovery their condition.

Keywords: erythrocyte functional state markers, surgical aortic pathology, surgery, extracorporeal circulation

Full text: PDF (Ukr) 297K

1. Kadoi Y, Goto F. Sevoflurane anesthesia did not affect postoperative cognitive dysfunction in patients undergoing coronary artery bypass graft surgery. Journal of Anesthesiology. 2007; 21(3): 330-5. https://www.ncbi.nlm.nih.gov/pubmed/17680184. https://doi.org/10.1007/s00540-007-0537-7
2. Isaev SV, Likhvantsev VV, Kichin VV. Vliyanie perioperatsionnykh faktorov i vybora metoda anestezii na chastotu kognitivnykh rasstroystv v posleoperatsionnyy period [The influence of perioperative factors and the choice of anesthesia method on the frequency of cognitive disorders in the postoperative period]. Vestnik intensivnoy terapii. 2004; 3: 67-9. [Russian]
3. Loepke AK, Soriano SG. An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesthesia & Analgesia. 2008; 106(6): 1681-707. https://www.ncbi.nlm.nih.gov/pubmed/18499597. https://doi.org/10.1213/ane.0b013e318167ad77
4. Rasmussen LS, Jonson T, Kuipers HM, Kristensen D, Siersma VD, Vila P, et al. Does anesthesia cause postoperative cognitive dysfunction? A randomized study of regional versus general anesthesia in 438 elderly patients. Acta Anesth Scand. 2003; 47(9): 1188-94. https://www.ncbi.nlm.nih.gov/pubmed/12648190. https://doi.org/10.1034/j.1399-6576.2003.00057.x
5. Warner DS, Sheng H. Anesthetic Neuroprotection? It’s Complicated. Anesthesiology. 2017; 126(4): 579-81. https://www.ncbi.nlm.nih.gov/pubmed/28182586. https://www.ncbi.nlm.nih.gov/pmc/articles/5350058. https://doi.org/10.1097/ALN.0000000000001535
6. Xu D, Wang B, Zhao X, Zheng Y, Du JL, Wang YW. General anesthetics protects against cardiac arrest-induced brain injury by inhibiting calcium wave propagation in zebrafish. Molecular Brain. 2017; 10(1): 44. https://www.ncbi.nlm.nih.gov/pubmed/28870222. https://www.ncbi.nlm.nih.gov/pmc/articles/5583756. https://doi.org/10.1186/s13041-017-0323-x
7. Abraham M. Protecting the anaesthetized brain. Journal of Neuroanaesthesiology & Critical Care. 2014; 1: 20-39. https://doi.org/10.4103/2348-0548.124841
8. Suliman NA, Mat Taib CN, Mohd Moklas MA, Adenan MI, Baharuldin MTH, Basir R. Establishing Natural Nootropics: Recent Molecular Enhancement Influenced by Natural Nootropic. Evidence-Based Complementary and Alternative Medicine. 2016; 2016: Article ID 4391375. https://doi.org/10.1155/2016/4391375
9. Ciruela F, Sotelo E. Special Issue: Adenosine Receptors. Molecules. 2017; 22(7): 1220. https://doi.org/10.3390/molecules22071220
10. Tamura R, Ohta H, Satoh Y, Nonoyama Sh, Nishida Y, Nibuya M. Neuroprotective effects of adenosine desaminase in the striatum. Journal of Cerebral Blood Flow & Metabolism. 2016; 36(4): 709-20. https://doi.org/10.1177/0271678X15625077
11. Scharbarg E, Daenens M, Lemaitre F, Geoffroy H, Guille-Collignon M, Gallopin T, et al. Astrocyte-derived adenosine is central to the hypnogenic effect of glucose. Scientific Reports. 2016; 6: 19107. https://doi.org/10.1038/srep19107
12. Komiyama T, Katsyama K, Sudo M, Ishida K, Higaki Y, Ando S. Cognitive function during exercise under severe hypoxia. Scientific Reports. 2017; 7: 10000. https://www.ncbi.nlm.nih.gov/pubmed/28855602. https://www.ncbi.nlm.nih.gov/pmc/articles/5577198. https://doi.org/10.1038/s41598-017-10332-y