Периоперационное использование левосимендана в кардиохирургии


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Аннотация


Продемонстрировано, что низкий сердечный выброс в послеоперационном периоде служит предиктором развития органной дисфункции и летальности у кардиохирургических пациентов. В течение многих лет стандартом терапии служили катехоламины, несмотря на то что они обладают значительным риском нежелательных явлений со стороны сердца и других органов, а их применение сопровождается повышением смертности. С другой стороны, показано, что левосимендан, действие которого заключается в повышении чувствительности к ионам кальция и открытии калиевых каналов, улучшает функцию сердца, не нарушая баланс потребления кислорода, а также оказывает защитные эффекты в отношении других органов. В ряде клинических исследований обнаружены благоприятные кардиогенные и некардиогенные эффекты периоперационного использования левосимендана. Целью обзора явилось рассмотрение механизмов действия левосимендана, а также обобщение современных данных клинического применения препарата.


В. В. Ломиворотов
ФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава России
Россия

д-р мед. наук, проф., заместитель директора по научной работе, руководитель центра анестезиологии и реаниматологии

А. А. Еременко
ФГБУ «Российский научный центр хирургии им. акад. Б.В. Петровского»
Россия

д-р мед. наук, проф., заведующий отделением кардиореанимации и интенсивной терапии, заслуженный врач РФ

В. А. Бобошко
ФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава России
Россия

канд. мед. наук, врач-анестезиолог-реаниматолог

М. Н. Абубакиров
ФГБУ «ННИИПК им. акад. Е.Н. Мешалкина» Минздрава России
Россия

клинический ординатор по специальности анестезиология – реаниматология

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Ломиворотов В. В., Еременко А. А., Бобошко В. А., Абубакиров М. Н. Периоперационное использование левосимендана в кардиохирургии. Патология кровообращения и кардиохирургия. 2015;19(2):113-123. http://dx.doi.org/10.21688/1681-3472-2015-2-113-123


DOI: http://dx.doi.org/10.21688/1681-3472-2015-2-113-123

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