Impedance cardiography potentials in the system of safety monitoring for large joint endoprosthetics

Aim of the Study – to determine the information value of impedance cardiography in providing the safety monitoring of endoprosthetics of the lower limb large joints. Material and Methods. Hemodynamic status monitoring based on the technique of impedance cardiography (ICG) has been used in 42 patients with the hip and the knee injuries during the surgeries of total endoprosthetics of the lower limb large joints. The surgeries were made under combined spinal-epidural anesthesia with sedation by propofol or midazolam hypnotics. Results. The main factors determining intraoperative hemodynamic status of surgery-undergo patients have been established to be the following: a technique of providing anesthesia, pharmacological effects of the preparations used for anesthetic protection, the performed perioperative infusion-transfusion therapy, the degree of bone cement negative effect, surgery duration and blood loss volume. No dangerous deviations of hemodynamic parameters beyond the range of permissible physiological variations were registered thereby evidencing the effectiveness and adequacy of anesthesiological and infusion-transfusion supply of the surgeries made. ICG-monitoring has made it possible to estimate the degree of hydration of lung interstitial space for invasive endoprosthetics surgeries which are often accompanied by increased intraoperative blood loss in patients with the compromised cardiopulmonary system. The use of ICG technique allows to increase the safety level of the patients operated on. Conclusions. ICG technique allows to obtain useful clinically significant information about the character of changes in systemic circulation of patients undergoing rather complex surgeries of endoprosthetics of the lower limb large joints.