[Central hemodynamics and prognostic significance of circulatory hyperdynamics after interventions for esophageal...

Central hemodynamic parameters were studied by direct catheterization of the pulmonary artery in 70 patients with cancer of the esophagus and cardial portion of the stomach during the early postoperative period after extensive or extensive-combined interventions through the thoracoabdominal access. Analysis of the mean initial and intraoperative parameters at different stages of the operation showed no essential deviations from the norm. Studies of heart production at different stages showed that during transfer of patients from the operation room into intensive care ward, one-third of patients developed low ejection syndrome and another one-third hyperdynamic syndrome, while the mean values looked satisfactory. On days 3-5, circulatory hyperdynamia was detected in 60% patients, which was observed over the entire period of observation in 75% patients. It is noteworthy that polyorgan failure was 4-fold more often observed in patients with normal cardiac output than in those with the hyperdynamic syndrome. Probable causes of this phenomenon are discussed.