The Extracorporeal Circulation Implemention Capacity Of Goal-directed Therapy In Patients With Coronary Artery Bypass Graft Surgery Clinical Research

Objective:Evaluate the extracorporeal circulation of coronary artery bypass grafting (OPCABG) intraoperative hemodynamic changes, based on the classics esophagus supersonic and Violeo FloTrac/technical implementation capacity of goal-directed therapy, trying to provide reference for individualized treatment capacity.Methods:included 60 names of routine execution of extracorporeal circulation of coronary artery bypass surgery in patients with coronary heart disease, were randomly divided into 2 groups:SVV TEE group 30 cases,30 cases in the control group, experimental group patients and perioperative treatment with ICU24H goal-directed capacity, namely the SVV stroke variation degree, individualized treatment capacity under TEE index;Control the amount of fluids is calculated according to the traditional law of 4/2/1.Comparison of perioperative and postoperative 3 days statistical amount and type of liquid supplement, blood loss, and urine output, lactic acid content, oxygen content, record the extubation time, ICU stay time, length of hospital stay, postoperative cardiac adverse events and the inciden. Results:compared with control group, test group patients in the operation process, more stable blood stream dynamics. At the end of operation in the test group serum lactic acid content was lower than that of control group(0.28±0.03mmo/L)VS (2.21±0.12mmo/L) (P<0.05). In the test group total infusion volume(2912±632ml VS 3641±723ml), the use of crystal were significantly less than the control group (1543±331ml VS 2334±323ml), and the colloid use amount is much more than that in control group (1012±221ml VS 797±249ml),(P<0.05). The test group patients hospital stay and ICU stay were lower than the control group. (17±4) D vs(27±7) D (p<0.05),(38±13) H VS (54±22) H,(P>0.05).Conclusion:the patients with coronary heart disease (CHD) implementation of the implementation of extracorporeal circulation during coronary artery bypass graft surgery, capacity of goal-directed therapy can obviously reduce the incidence of all kinds of adverse cardiac events, improve heart function and shorten the length of hospital stay, postoperative treatment effect of its capacity is superior to the conventional treatment capacity.