THE ROLE OF ULINASTATIN IN COMPREHENSIVE THERAPY FOR THE PREVENTION OF POSTOPERATIVE COMPLICATIONS IN CORONARY ARTERY BYPASS GRAFTING
Keywords:
coronary artery bypass grafting, postoperative complications, ulinastatin, risk prediction scaleAbstract
Nowadays coronary artery bypass grafting remains the main treatment method for multivessel coronary artery disease caused by ischemic heart disease. Postoperative complications significantly prolong patients’ stay in intensive care units. The study included 160 patients after coronary artery bypass grafting, divided into two groups. In the main group (80 patients), the diagnostic and therapeutic process was supplemented by multifactorial risk prediction of early complications and the use of ulinastatin as anti-inflammatory therapy. In the control group (80 patients), standard management was applied. Patients in the main group were divided into subgroups according to the prognostic scale: patients with low, moderate, high, and very high risk of postoperative complicationsю Seventy-two hours after surgery, patients with very high risk demonstrated hyperthermia and pneumonia in 10–12% of cases; acute respiratory distress syndrome and multiple organ dysfunction syndrome occurred in 1–4%, leading to mortality in 2.5% of the control group. Suppurative wound complications and mediastinitis were less frequent in the main group compared with the control. The findings confirm the effectiveness of multifactorial risk prediction and the use of ulinastatin in reducing the incidence of early postoperative complications after coronary artery bypass grafting.
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