Directed hemodynamics correction during high-risk abdominal surgery is possible and can be effective in restrictive tactics of infusion therapy

Objectives. The goal is to assess the possibility and effectiveness of directed correction of the patient's hemodynamic profile during high-risk surgery with the use of continuous monitoring of stroke output variability and cardiac output. Materials and methods. The investigation consisted of 84 patients, divided into 2 groups. The main group consisted of patients with hemodynamic correction, based on the results of continuous monitoring of central hemodynamics, the control group consisted of patients with correction volemic status and hemodynamics, conducted empirically - on the skin, blood pressure and heart rate. Results. According to the analysis results directed therapy reduces the number of patients with perioperative hypovolemia by 20% or more, in comparison with the control group, allows to achieve the normal indices of cardiac index during the whole operation, in contrast to the control group with the empirical correction hemodynamics. Also, at the main group in comparison with control group, significantly more patients were extubated on an operating table (90% vs. 74%). Conclusions. Directed hemodynamics correction on the basis of continuous monitoring and cardiac output Allows using of an individual approach to each patient and on time to make adequate correction of perioperative patient hemodynamics. In turn it leads to a reduction of postoperative complications and the need of infusion therapy and use of pressor amines.