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MONITORING OF CENTRAL HEMODYNAMICS IN PATIENTS WITH MULTIPLE ORGAN DYSFUNCTION SYNDROME

Objective: comparative analysis of the use of PiCCO monitoring for correction of the intensive care in patients with multiple organ dysfunction syndrome (MODS) after abdominal and cardiac surgery. Material and methods. A prospective cohort study was carried out in 19 patients with MODS after abdominal (n=10) and cardiac (n=9) interventions. Of these, 13 men and 6 women, aged 63 (58-69) years, their height was 176 (174-180) cm, body weight - 90 (80-100) kg. Central hemodynamic parameters were monitored in these patients by the PiCCO method. Several steps have been distinguished in the study: 1st stage - 1st day after surgery, 2nd stage - 2nd day after surgery, etc. Results. In patients after cardiac surgery, compared with the group of patients after abdominal surgery, significantly (p <0.001) lower preload indices (global end-diastolic volume and index, intrathoracic blood volume and index) were noted at 1-2 stages, as well as significantly (p<0.05) lower rates of contractility (continuous cardiac output and index at 1-4 stages, stroke volume and index at 1-5 stages). When analyzing the treatment in patients after cardiac surgery, the frequency of dobutamine use (p=0.017) and the frequency of simultaneous use of 3 vasoactive substances (p=0.0495) were statistically significantly higher than in patients undergoing abdominal surgery. Conclusions. Monitoring of central hemodynamics enables to individualize infusion therapy, vasopressor and inotropic support in patients with MODS after abdominal and cardiac surgery.