[Approaches to prevention and treatment of arterial hypoxemia in the pre-perfusion period of radical correction of Fallot's tetrad].

Examination of central hemodynamics in patients in the preperfusion period of radical correction of Fallot's tetrad has demonstrated that after pericardiotomy and the onset of surgical manipulation on the heart there was a depression of circulation both during the use of intravenous total anesthesia on the basis of ketamine and ataralgesia. The depression was more manifest under ataralgesia. The depression of circulation was paralleled by the deepening of initial hypoxemia. Analysis of the efficacy of medicamentous agents with regard to the specific features of intracardiac anatomy of the outlet of the right ventricle, estimated intraoperatively, has established that administration of phenylephrine at a rate of 3 micrograms/kg favoured an increase of partial oxygen pressure and arterial blood saturation with hemoglobin whatever the anatomo-morphological type of stenosis of the outlet of the right ventricle. Propranolol promoted the improvement of arterial blood oxygenation but in the muscular type stenosis of the outlet of the right ventricle. Meanwhile the use of the drugs possessing a beta-adreno-stimulating effect brought about the deepening of hypoxemia.