Related Experiment Videos
[Heart surgery interventions in risk patients. New possibilities for improving therapeutic results]
H G Wollert1, W Müller, D Fischer
1Klinik und Poliklinik für Chirurgie, Martin-Luther-Universität Halle-Wittenberg, DDR.
Insights
Monitoring the heart
Area of Science:
- Cardiology
- Biochemistry
- Medical Technology
Context:
- Cardiac surgery requires precise patient monitoring.
- Traditional methods for assessing myocardial condition are limited.
- Perioperative metabolic status is crucial for cardiac function.
Purpose:
- To introduce a new objective parameter for myocardial metabolic assessment.
- To evaluate the efficacy of metabolic-energetic condition monitoring (MESM) in optimizing perioperative therapy.
- To compare MESM-guided therapy with standard catecholamine support.
Summary:
- Perioperative arterio-coronary-venous lactate difference (acDL) provides objective myocardial metabolic data.
- Metabolic-energetic condition monitoring (MESM) enables accurate assessment of the heart's energy status.
- MESM-guided therapy, focusing on metabolic stabilization, proved superior to early catecholamine use.
Impact:
- MESM offers a superior approach to perioperative cardiac support.
- Stabilizing myocardial metabolism significantly improves patient recovery.
- This method enhances the optimization of cardiotonic therapies during surgery.
Abstract:
Perioperative therapy in conjunction with cardiac surgery had so far been guided by functional, paraclinical, and clinical parameters which only conditionally enabled objective appraisal of the present condition of the myocardium. Perioperative recording of the arterio-coronary-venous concentration difference of lactate (acDL) has now enabled the use of an objectivated parameter for accurate description of the metabolic-energetic situation of the myocardium. This will be helpful in metabolic-energetic condition monitoring (MESM) to optimise perioperative cardiotonic therapy. Stabilisation of the metabolic-energetic situation of the myocardium, objectivated by MESM, has proved to be superior to premature cardiac support, using catecholamines. It has been associated with improved restitution with high significance (p less than 0.005).