[Myocardial reserve during filtration detoxification in patients with suppurative peritonitis]

Feasibility of measuring functional reserve of the myocardium under functional loads simulated by extracorporeal circulation was tried in 36 patients with diffuse purulent peritonitis on filtration detoxication. Altogether 49 sessions of hemofiltration and filtration exchange plasmapheresis were performed controlled by tetrapolar rheography. It is demonstrated that persistent decline of systolic and cardiac output, an increase of central blood volume and occurrence of a pathological impedance wave in response to pre- and postload on the myocardium during extracorporeal detoxication may serve an indication of a subclinical myocardial failure. Detection of a reduced myocardial reserve suggests restriction of hemodilution in plasmapheresis and infusion therapy or lasix administration in postfiltration period.