METHOD FOR REPLACEMENT OF MASSIVE PERIOPERATIVE BLOOD LOSS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to anesthesiology and resuscitation, and can be used in states accompanied by massive blood loss. For this purpose, 5 and 3 days prior to a surgery, autoblood is sampled in amount 10 % of circulating blood volume (CBV) in each sampling to be divided on plasma and erythrocyte concentrate. For 5 preoperative days, iron preparations are administered in a therapeutic dose. Also, the surgery is preceded with analysing patient's fluid deficiency. 40 minutes prior to the surgery, 12.5 % dicynone 500 mg, one volume of autoplasma are introduced, and infusion of a rated dose of 5 % glucose and 6 % hydroxyethyl starch (HES) 500 ml is started. If the intraoperative blood loss is suggested to be 15-30 % of the CBV, additionally 6 % HES 250 ml, prednisolone in dosage 2-4 mg/kg of body weight and one volume of erythrocyte concentrate are administered. If the estimated intraoperative blood loss exceeds 30 % of the CBV, the second volumes of autoplasma and erythrocyte concentrate, another introduction of dicynone in the same dosage, 6 % HES 250 ml, prednisolone in dosage 7 - 10 mg/kg of body weight are required. Within 30 and 60 minutes after the surgery, dicynone is injected in the same dosage. 5 hours after the surgery, filter drainage fluid is returned. 6 hours after the surgery, coagulation time is determined, and if observing no hypocoagulation, Clexane is introduced in a preventive dose.;EFFECT: method allows to provide early activation of erythropoiesis combined with improved erythrocyte morphology and blood haemostatic function, considerably reduced risk of complications connected with massive transfusion of donor blood products, as well as prevented edema of interstitial spaces and development of multiple-organ-failure syndrome due to maintained effective transcapillary exchange.;5 tbl, 1 ex