Year 2013 Vol. 21 No 1

ANESTHESIOLOGY-REANIMATOLOGY

D.V. OSIPENKO

GUIDED HYPOCOAGULATION AS A COMPONENT OF ANESTHESIA SUPPORT AT OPERATIVE INTERVENTIONS IN VASCULAR SURGERY

E Gomel Regional Clinical Cardiology Dispensary
The Republic of Belarus

Objectives. To evaluate efficacy and safety of the unfractionated heparin (UFH) use in the dosage 50 mg per kg of the patient body weight in the vascular surgery with intraoperative dosage correction depending on the severity of hypocoagulation.
Methods. 60 patients underwent the planned surgeries on the arterial bed were included in the study. In the 1st group of patients (n=30) the unfractionated heparin in the dosage of 50 U/kg of the patient body weight was injected before the clip was applied on the operated vessel. Fixed-dose weight-adjusted unfractionated heparin (5000 units) was injected to the patients of the 2nd group (n=30).
In the 1st group the heparin action was controlled by determining the activated time of blood coagulation (ATBC) at the main stages of the study with the subsequent changes analysis and if necessary by additional administration of the UFH in the dosage 25 U/kg. The number of the thrombotic and hemorrhagic complications, intra- and postoperative lethality was also registered in the groups of patients.
Results. The application of the suggested technique of heparin use permitted to get the reliable and stable increase of ATBC value during the vessel clamping at the statistically lower heparin dosage in the investigated group in comparison of fixed-dose weight-adjusted unfractionated heparin (5000 units).
The 1st group patients were divided into 3 subgroups depending on the marked character of changes of ATBC level in 5 minutes after UFH injection.
Conclusions. The conducted study has demonstrated efficacy and safety of the suggested technique of UFH use in the vascular surgery. It is suggested that incidence of hemorrhagic and thrombotic complications depends on the individual reaction of a patients coagulation system to the intravenous UFH injection.

Keywords: vascular surgery, unfractionated heparin, activated time of blood coagulation, individual reaction
p. 78 83 of the original issue
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Address for correspondence:
246012, Respublika Belarus', g. Gomel', ul. Meditsinskaia, d. 4, Uchrezhdenie Gomel'skii oblastnoi klinicheskii kardiologicheskii dispanser, otdelenie anesteziologii i reanimatsii s palatami intensivnoi terapii.
e-mail: Osipenko081081@mail.ru,
Osipenko Dmitrii Vasil'evich
Information about the authors:
Osipenko D.V. A post-graduate student of general and clinical pharmacology chair with the courses of anesthesiology and resuscitation of EE Gomel State Medical University, anesthetist-resuscitator of the anesthesiology and resuscitation department with the wards of intensive care E Gomel Regional Clinical Cardiology Dispensary.
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