[Stress-dependent lesions of the gastroduodenal mucosa during operations with cardiopulmonary bypass].

A continuous retrospective study was conducted in order to reveal risk factors and optimal ways of prophylaxis of gastroduodenal hemorrhage after operations with cardiopulmonary bypass. All the 559 cases operated on with cardiopulmonary bypass in Department of Cardiosurgery of Omsk Regional Clinical Hospital between January 2003 and December 2005 were analyzed. Risk factors and the effectiveness of different methods of antisecretory prophylaxis of hemorrhage were evaluated. It was found that the frequency of postoperative gastroduodenal hemorrhage was influenced by the degree of circulatory insufficiency, duration of artificial lung ventilation, cardiopulmonary bypass, and aortal occlusion, as well as application of anticoagulants and the frequency of gastric and duodenal erosions or ulcers prior to operation. The most effective means of prophylaxis was omeprazole administered intravenously during three days followed by oral application during three weeks. A short course of H2-histamine blockers discontinued abruptly increased hemorrhage-related lethality in this group of patients due to withdrawal syndrome.