Intensive therapy for severe post-operative complications in a CAD patient after a bypass surgery
https://doi.org/10.25789/YMJ.2018.61.26
Abstract
The article presents a clinical case of severe postoperative complications with a clinical death episode in a patient with coronary artery disease after a bypass surgery. On the second day after the surgery, the patient, who had underwent a mammary coronary bypass surgery of the anterior descending artery and an aortocoronary bypass surgery of the right coronary artery and circumflex artery with artificial circulation, developed acute kidney injury, requiring renal replacement therapy. In the following days, there was esophageal-gastric bleeding with the development of DIC-syndrome and hemorrhagic shock, resulting in clinical death registered for 2 minutes. After a successful cardiopulmonary resuscitation, a number of other serious complications were observed: acute respiratory distress syndrome and acute destructive calculous cholecystitis, treated with cholecystectomy.
A comprehensive intensive therapy, including vasopressor/inotropic hemodynamic support, aggressive respiratory therapy, efferent methods of detoxification, resulted in successful management of all the complications, stabilization of the patient’s condition, restoration of the functions of organs and systems and recovery of the patient.
About the Authors
A. S. Korostelev
State autonomous institution of the Sakha Republic (Yakutia) “Republic’s Hospital No.1 - National Center of Medicine”
Russian Federation
Russian Federation
Kororstelev Aleksandr Sergeevich - anesthesiologist-resuscitator, Department of Anesthesiology, Resuscitation and Intensive Care (Cardiology)
677000, Sakha Republic (Yakutia), Yakutsk, ul. Oyunskogo, 27. Tel/fax. +7 (4112) 363489. Mob. +7-924-763-9300
A. V. Bulatov
State autonomous institution of the Sakha Republic (Yakutia) “Republic’s Hospital No.1 - National Center of Medicine
Russian Federation
Russian Federation
Bulatov Alkviad Valentinovich – Candidate of Medical Sciences Head, Department of Anesthesiology, Resuscitation and Intensive Care (Cardiology)
S. S. Anisimov
State autonomous institution of the Sakha Republic (Yakutia) “Republic’s Hospital No.1 - National Center of Medicine
Russian Federation
Russian Federation
Anisimov Sergei Stepanovich – anesthesiologist-resuscitator, Department of Anesthesiology, Resuscitation and Intensive Care (Cardiology)
A. F. Potapov
Federal state educational institution of higher professional education “M.K.Ammosov North-Eastern Federal University”
Russian Federation
Russian Federation
Potapov Aleksandr Filippovich - Doctor of Medical Sciences, Head, Department of Anesthesiology, Resuscitation and Intensive Care with Emergency Care Course, Faculty of Post-graduate Studies for Doctors, Institute of Medicine
P. I. Zakharov
State autonomous institution of the Sakha Republic (Yakutia) “Republic’s Hospital No.1 - National Center of Medicine
Russian Federation
Russian Federation
Zakharov Petr Ivanovich – Doctor of Medical Sciences, chief external expert in cardiovascular surgery, Head, Cardiovascular SurgeryDepartment, Clinical Center
A. A. Ivanova A.A.
Federal state educational institution of higher professional education “M.K.Ammosov North-Eastern Federal University”
Russian Federation
Russian Federation
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Review
For citations:
Korostelev A.S., Bulatov A.V., Anisimov S.S., Potapov A.F., Zakharov P.I., Ivanova A.A. A.A. Intensive therapy for severe post-operative complications in a CAD patient after a bypass surgery. Yakut Medical Journal. 2018;(1):87-90. https://doi.org/10.25789/YMJ.2018.61.26
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