SU1503819A1 - Method of treatment of cardiac insufficiency - Google Patents

Abstract

The invention relates to medicine, namely cardiology, and can be used to treat heart failure. The purpose of the invention is to reduce the timing of compensation for circulatory failure. This makes it possible to increase the effectiveness of treatment and reduce the mortality rate of patients with heart failure, especially against the background of acute myocardial infarction. The essence of the invention consists in continuous long-term administration of a solution of nitroglycerin to patients, the concentration of the latter being increased, and the amount of fluid injected is reduced to a level that prevents an increase in circulating blood volume. Clinical trials have shown the high efficacy of the proposed method of treatment compared to traditional ones.

Description

The invention relates to medicine, namely cardiology.

The purpose of the invention is to reduce the timing of compensation for circulatory failure.

The method is explained in the following clinical examples.

Example 1. Patient 3., 72 years old, was admitted to the intensive care unit with complaints of intense tearing pains behind the sternum and bounce. On admission, the condition is severe. Skin moist, cyanosis of the lips. Dyspnea at rest up to 30 in 1 min. In the lungs, hard breathing, medium wheezing on both sides. The percutaneous heart is extended to the left by 2 cm. Auscultatory: 1 tone on the top is weakened, accent II tone on the left edge of the sternum. HR - 100 in 1 min., HELL 150/90 mm Hg. Art., CVP 22 cm aq. Art. The liver is not enlarged. There is no edema. On the ECG, the acute stage of transmural anterior myocardial infarction is acute. Chest X-ray - pulmonary edema.

An infusion of a 0.1% nitroglycerin solution was started using a DLV-1 apparatus at a rate of 1 ml / h, after 10 minutes an optimal injection rate of 3 ml / h (50 µg / min) was reached, while the blood pressure decreased to 2525/80 mm Hg Art., CVP decreased to 15 cm aq. Art., the heart rate was 92 per 1 min., the BCC remained at a stable level. After 1 h after the start of administration, the indices were 120/80, 14, 86, respectively, the number of breaths decreased to 20 in 1 min, cyanosis sharply decreased in the number of moist rales in the lungs, which completely disappeared after 2 h, diuresis 500 ml. Over the next 3 days, the patient was given a continuous nitroglycerin infusion, and there were no signs of heart failure.

Example 2. Patient K., 66 years old, diagnosed with coronary artery disease: acute transmural anterior-posterior myocardial infarction, cardiosclerosis, H P-III, acute cardiac aneurysm, due to the possibility of recurrence of acute left ventricular failure was performed

SP

about

CP 00

with

Infusion of a 0.1% solution of nitroglycerin continuously for 9 days at a rate of 1 to 8 ml / h, in an average dose of 50 µg / min. The patient was successfully rehabilitated, was discharged from the hospital. On the background of the therapy, hemodynamic parameters were stable, there was no increase in BCC.

Simultaneously with the study of the effectiveness of treatment with a new method, the treatment of heart failure in patients with myocardial infarction was performed by traditional administration of a 0.01% solution of nitroglycerin.

The advantages of the proposed method in comparison with the known are shown in the table and

Claims (1)

Invention Formula A method of treating heart failure, including long-term continuous drip of a solution of nitroglycerin, characterized in that, in order to reduce the period of compensation for circulatory failure, the concentration of the administered solution of nitroglycerin is increased, and the amount of the administered solution is reduced to a level that prevents an increase in circulating blood volume. Reduction of congestive wheezing in the lungs Normalization of the number of respiratory movements Time to achieve the optimal therapeutic rate of infusion Normalization of central hemodynamic parameters (SI, my, opss) Hypermyoglobinemia time The amount of the administered solution in 1 day The average dose of injected nroglycerin per day The need for additional administration of diuretic drugs BCC Normalization of CVP. After 15-20 minutes After 1 h  0.01 0.01 g, 0.001 g 0.01 64 ± 6.2 µg / min z.0.01 Decreases Stabilized 1.1 ± 0.1 h 0.01