Effects Of NaHCO₃of Treatment In Adult Cardiac Surgery Of Vascular Paralysis Syndrom Of Hemodynamics And Renal Function

Background: Vascular paralysis syndrome caused by cardiopulmonary bypass （CPB）has become one of the causes of postoperative complications and death.Reported inChina, major vascular paralysis syndrome manifestations of systemic vascular responseto vasoconstrictor and vasodilator reduced or no reaction, causing blood pressure cannot effectively improve tissue perfusion is difficult to improve, hypoxia and injurieswere aggravated. Studies have shown that inflammatory cytokines during CPB,intraoperative hypothermia, inhibition of ion channels, and a variety of kinase activationinduced enhancement of gene expression, excessive diastolic contraction causes bloodvessels to inhibit vascular smooth muscle cells （aorticsmooth muscle cells, ASMCs）,showing blood vessels low reactivity. After cardiac surgery in patients withhemodynamic instability, to maintain hemodynamic stability, improve the patient’sblood pressure, you need to use large doses of vasoactive drugs. The vasoactive drugsapplications will lead to the emergence of increased tissue oxygen reduced renal andmesenteric blood flow, increased pulmonary resistance postoperative dangerous. Thisarticle is to explore the impact on the patients hemodynamics and renal function inpatients after cardiac surgery after the application of sodium bicarbonate in patients withvascular paralysis syndrome.Objective: Changes in mean arterial blood pressure of the patient’s blood PH value,urine output, and vasoactive drugs concentration differences observed after cardiacsurgery the use of NaHCO₃and vasoactive drugs, research NaHCO₃blood flowdynamics in patients after cardiac surgery, vascular paralysis syndromeand renal function analysis, clinical reference for clinical cardiopulmonary bypass in patients aftertreatment.Method: Unified inclusion criteria, exclusion criteria, The Anhui Provincial Hospital ofAnhui Medical University2011.6-2013.1cardiac surgery underwent cardiac surgeryand surgery using cardiopulmonary bypass technical support after surgery in theintensive care units appear vascular paralysis syndrome patients with a total of149cases,statistical patient’s age, weight, LVEF, surgery time, in vitro time, ICU time, dividedinto two groups （NaHCO₃, small doses of vasoactive drugs group and vasoactive druggroup）, mean arterial blood pressure monitoring patients after treatment,blood PH value,changes in urine volume and vasoactive drug concentration, analysis of vascularparalysis syndrome patients blood flow dynamics, the impact of renal function.Results: Accept NaHCO₃treatment in all patients,2patients had severe renaldysfunction and dialysis treatment （3.5%）; NaHCO₃treatment of patients who did notreceive a total of seven cases of varying degrees of renal dysfunction （7.5%）, which5patients received dialysis treatment （5.3%）.Conclusion: After CPB hemodynamic instability in patients prone to vascular paralysissyndrome. The use of large doses of vasoactive drugs prone to vascular paralysissyndrome, the subject NaHCO₃reduce vascular paralysis syndrome caused acute renalinjury found that the use of a partially effective.