Prophylactic digitalization before hip arthroplasty in so-called elderly and middle-aged patients (CROSBI ID 89004)
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Podaci o odgovornosti
Šakić, Kata ; Duraković, Zijad ; Šakić, Šimun
engleski
Prophylactic digitalization before hip arthroplasty in so-called elderly and middle-aged patients
In order to reduce perioperative cardiac complications in 141 hospitalized orthopedic middle-aged and older patients schedules for arthroplasty, we have distinguished 3 geroups of patients:group I-with suspected heart failure, group II-with chronic myocardial insufficiency, group III-with normal heart condition. All observed parameters established before and after operation as well as analyzed complications, have been compared with the same parameters of 120 patients with already performed hip arthroplasty who were not cardiologically selected and medically treated with digoxin. Preoperative, the arm exercise testing was applied in ptients with dispnoea at strain and with cardiac enlargement. Patients with impaired functional aerobic capacity and reduced cardiac reserve, before operation received small doses of digoxin. Special attention has been paid to the values of the corrected QT interval in an electrocardiogram, to which the specificities of changes conditioned by the digoxin are atributted, as well as to ST segment depression as sign of ischemic heart disease in non-digitalized patients and digitalis effect (non toxicity)(P<0.05). By the operative use of digitalis glycosides in patients with bordering compensation in latent cardiac failure, efforts were made to increase inotropic cardiac reserve and to reduce negative inotropic effect of anesthetic agents to the myocardium and to reduce the cardiac morbidity and mortality in orthopedic patients, caused by the early ischemic cardiac disease and congestive heart failure.
perioperative complications; arm ergometry; latent heart failure; prophylactic digitalization; hip arthroplasty
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Podaci o izdanju
479 (29)
2000.
41-50
objavljeno
1330-5301