THE EFFECT OF MAGNESIUM SULFATE IN ORDER TO STABILIZE HEMODYNAMICS IN THE EARLY HOSPITAL STAGE IN PATIENTS WITH MYOCARDIAL CONTUSION ON THE BACKGROUND OF POLYTRAUMA
About the author:
Biletskiy O. V.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
The study included 34 patients with myocardial contusion on the background of polytrauma. The aim of the investigation was to study the effect of adding 25% of the magnesium sulfate solution at the rate of 0.35±0.05 ml/kg of body weight in normal saline to changes in the indices of central and peripheral hemodynamics and hemodynamic stability, as recommended by the Protocols of the Order of the Ministry of Health of Ukraine. Hemodynamic monitoring included heart rate monitoring and heart rate, non-invasive measurement of blood pressure, central venous pressure measurement, and photoplethysmometric determination of the perfusion index, plethysmographic index of variability and saturation capillary blood oxygen. For the solution of the last 3 tasks, the Rainbow monitor, Masimo, USA used. Cardiac ejection in patients studied using tetrapolar thoracic rheography. In connection with the frequent presence of fractures of the limb bones, the need for surgical manipulations in these areas, as well as the use of methods of metal osteosynthesis, the use of the technique of integrated rheography of the body was not possible to monitor the size of cardiac output. The size of the stroke volume of the heart determinate by tetrapolar rheography. All these hemodynamic parameters were registered and processed statistically in 3 stages: 1) immediately upon receipt of patients to the operating room; 2) after fast hemodynamic correction on the operating table – just before the start of surgical intervention; 3) 1 (one) hour from the beginning of the operation. All parameters of the central and peripheral hemodynamics studied measured using air-oxygen mixture with 50% oxygen content against the background of spontaneous respiration (stage 1) and mechanical ventilation (2nd and 3rd stages). To determine the content of cardiac troponin I in blood, the technique of the complex automated enzyme immunoassay of the company Tosoh used, where the analyzer-photometer of the immunofluorescence AIA-600-II firm Tosoh Corporation, Japan used. It was showed that in the early hospital stage, magnesium sulfate therapy in the patients of the main group provided a faster increase in the indices of arterial pressure, cardiac output, volumetric capillary perfusion and saturation of capillary blood with oxygen, as well as more effective elimination of tachycardia, reduction of shock index and hemodynamic instability by compared with patients in the control group
myocardial contusion, polytrauma, hemodynamics, magnesium sulfate, fluid resuscitation
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 1 (148), 2019 year, 96-101 pages, index UDK 616-[001.31:127]:12-008.1/4:073.7-074-073.756.8-092.6