Vatazin A V, Machulina N Iu, Karpova E G
Sov Med. 1991(9):8-11.
Feasibility of measuring functional reserve of the myocardium under functional loads simulated by extracorporeal circulation was tried in 36 patients with diffuse purulent peritonitis on filtration detoxication. Altogether 49 sessions of hemofiltration and filtration exchange plasmapheresis were performed controlled by tetrapolar rheography. It is demonstrated that persistent decline of systolic and cardiac output, an increase of central blood volume and occurrence of a pathological impedance wave in response to pre- and postload on the myocardium during extracorporeal detoxication may serve an indication of a subclinical myocardial failure. Detection of a reduced myocardial reserve suggests restriction of hemodilution in plasmapheresis and infusion therapy or lasix administration in postfiltration period.
对36例弥漫性化脓性腹膜炎行滤过解毒治疗的患者，尝试在体外循环模拟的功能负荷下测量心肌功能储备的可行性。在四极血流图控制下，共进行了49次血液滤过和滤过置换血浆置换治疗。结果表明，体外解毒过程中，心肌前、后负荷作用下，收缩压和心输出量持续下降，中心血容量增加，出现病理性阻抗波，可能提示亚临床心肌衰竭。检测到心肌储备降低提示在血浆置换和输液治疗中应限制血液稀释，或在滤过后阶段给予速尿。
