Open AccessThe Protocol-Personalized Perioperative Hemodynamic Management as Part of the ERAS Protocol in Abdominal Surgeries
Author(s) -
К. Е. Харламов,
М. Я. Ядгаров,
В. В. Лихванцев
Publication year - 2021
Publication title -
vestnik anesteziologii i reanimatologii
Language(s) - English
Resource type - Journals
eISSN - 2541-8653
pISSN - 2078-5658
DOI - 10.21292/2078-5658-2021-18-4-55-61
Subject(s) - mace , medicine , perioperative , hemodynamics , psychological intervention , randomized controlled trial , protocol (science) , clinical trial , surgery , anesthesia , myocardial infarction , nursing , conventional pci , pathology , alternative medicine
One of the options for solving the problem of a “non-standard” patient undergoing a major and traumatic operation, perhaps, is the protocol-personalized approach to hemodynamic management. The objective: to study the efficacy and safety of using a modified protocol-personalized approach to hemodynamic management during surgical interventions on abdominal organs in elderly and senile patients. Subjects and Methods. A randomized prospective-retrospective clinical trial was conducted in parallel groups: Group 1 (control) - standard management of the perioperative period; Group 2 - standard management supplemented by the protocol-personalized approach to hemodynamic management. Results. Patients in the main group had the best parameters as per MACE outcomes (RR: 0.462, [95% CI: 0.251-0.850] p = 0.038). In the intra- and postoperative period, patients in the control group had a relatively higher risk of arrhythmias (RR: 2.517 [95% CI: 1.218; 5,200] p = 0.017). Conclusion. The use of the protocol-personalized approach results in better MACE outcomes (RR: 0.462, 95% CI: 0.251-0.850; p = 0.038) during surgical interventions on the abdominal organs in elderly and senile patients, and also, reduces the risk of arrhythmias (RR: 2.517, 95% CI:1.218; 5.200) p = 0.017.