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Year 2020 Vol. 28 No 6

GENERAL & SPECIAL SURGERY

SH.M. ALIEV 1, L.A. NAZIROVA 1, SH.A. ISLAMBEKOVA 1, G.L. PAHOMOV 2

PREDICTING THE RISK OF COMPLICATIONS DEVELOPMENT DURING SURGICAL CORRECTION OF SEPTIC ENDOCARDITIS

Republican Specialized Center of Surgery named after academician V. Vakhidov

Objective. To identify the risk factors for the development of acute renal failure in patients with septic endocarditis.
Methods. A single-center prospective non-randomized and retrospective study was conducted in patients (n=107) with septic endocarditis. There were 60 men (56%) and 47 women (44%) with an average age of 42.4±11.3 years (M±ϭ). Patients were divided into two groups: in group 1 (n=23) blood ultrafiltration (UF) during cardiopulmonary bypass (CPB) was performed; in group 2 (n=84) blood ultrafiltration was not used. 125 factors were included (age, sex, body surface area and clinical and biochemical parameters) for the prognosis of acute kidney injury (AKI). Factors showing a statistically significant association with AKI were included in the analysis to construct a multiple linear regression equation. The construction of the mathematical model was carried out by the method of least squares, with the calculation of Pearson correlation paired coefficients.
Results. There was no reliable difference in the duration of CPB and the duration of myocardial ischemia in the groups (p=0.326, p=0.464). In group 1 a linear relationship was found between the parameters of AKI and with the number of leukocytes according to Nechiporenko (r=0.95), the amount of cryoprecipitate (r=0.69), fresh frozen plasma (r=0.58), the volume of ultrafiltration (r=0.68), proteinuria (r=0.66) аnd blood creatinine (r=0.67). Group 2 showed a linear relationship between AKI and the left ventricular end-diastolic volume (r=0.69), glomerular filtration rate (r=0.51), blood creatinine (r=0.52), CPB temperature (r=0.42) and CPB time (r=0.59). One patient in the group 2 developed AKI after surgery.
Conclusion. Hyperthermia during CPB and an elevation in CPB time increase the risk of AKI in patients with septic endocarditis

Keywords: septic endocarditis, cardiopulmonary bypass, acute kidney injury, risk factors, postoperative complication, ultrafiltration
p. 625-635 of the original issue
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Address for correspondence:
100115, Republic of Uzbekistan,
Tashkent, Chilanzarsky district,
Kichik Khalkayuli str., 10,
Republican Specialized Research Medical Center
of Surgery Named after Academician V. Vakhidov, the Department “Cardiopulmonary Bypass”,
tel.mobile: +99893 5147235,
е-mail: shakhida_cardio@list.ru,
Islambekova Shakhida A.
Information about the authors:
Aliev Sherzod M., MD, Chief Cardiac Surgeon of the Republic of Uzbekistan, Head of the Department of Combined Heart Disease, Republican Specialized Research Medical Center of Surgery Named after Academician V. Vakhidov, Tashkent, Republic of Uzbekistan.
https://orcid.org/0000-0002-4113-8095
Nazirova Lyudmila A., PhD., Head of the Department of Anesthesiology, Republican Specialized Center of Surgery Named after Academician V. Vakhidov https://orcid.org/0000-0003-0303-4110
Islambekova Shakhida A., Perfusionist, the Department of «Cardiopulmonary Bypass», Republican Specialized Research Medical Center of Surgery Named after Academician V. Vakhidov, Tashkent, Republic of Uzbekistan.
https://orcid.org/0000-0002-3788-7819
Pahomov Georgy L., PhD, Thoracic Surgeon, Associate Professor of the Hospital Surgery Department, Tashkent Medical Academy, Tashkent, Republic of Uzbekistan.
https://orcid.org/0000-0002-7150-1473
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