AO微创内固定系统治疗胫骨近端骨折

目的探讨应用AO微创内固定系统（less invasive stabilization system，LISS）治疗胫骨近端骨折的临床效果。方法2004年2月至2006年1月间，应用LISS治疗胫骨近端骨折18例，41-A2骨折2例，41-A3骨折6例，41-C1骨折5例，41-C2骨折3例，41-C3骨折2例。其中9例开放骨折均为Ⅱ～Ⅲ级，有4例患者为多发骨折患者，伤后4d（2～7d）应用LISS行内固定治疗。结果所有患者随访3～19个月，骨折均连接，平均骨折愈合时间12周（8～18周），未出现钢板螺钉松动移位、骨折塌陷、复位丢失等。胫骨近端骨折18例，HSS评分优10例，良7例，可1例。膝关节活动范围90°～140°，所有患者膝关节行走无疼痛。结论LISS能有效治疗各种分型的胫骨近端骨折，特别是对于骨质疏松患者具有更好的优越性。     

AO微创内固定系统治疗胫骨近端骨折

目的：探讨应用AO微创内固定系统（less invasive stabilization system,LISS）治疗胫骨近端骨折的临床效果。方法：2005年6月至2008年6月间,应用LISS治疗胫骨近端骨折32例,41-A2骨折5例,41-A3骨折8例,41-C1骨折7例,41-C2骨折6例,41-C3骨折6例。其中9例开放骨折均为Ⅱ-Ⅲ级,有6例患者为多发骨折患者,伤后4d（2-7d）应用LISS行内固定治疗。结果：所有患者随访6-18个月,骨折均连接,平均骨折愈合时间12周（8-18周）,未出现钢板螺钉松动移位、骨折塌陷、复位丢失等。胫骨近端骨折32例,HSS评分优20例,良14例,可2例。膝关节活动范围90°-140°,所有患者膝关节行走无疼痛。结论：LISS能有效治疗各种分型的胫骨近端骨折,特别是对于骨质疏松患者具有更好的优越性。     

微创内固定系统治疗复杂性膝关节周围骨折的近期疗效

目的评价微创内固定系统(LISS)治疗股骨远端和胫骨近端严重粉碎性骨折的近期疗效。方法自2004年2月～2005年2月应用LISS治疗63例复杂性膝关节周围骨折,其中股骨远端粉碎性骨折29例,胫骨近端粉碎性骨折34例,手术均严格按照LISS操作程序进行。术后4周内每周随访1次,以后每月随访一次。结果所有患者均获得随访,平均随访11.5个月(6～17个月)。所有患者术后均无需石膏外固定,第1天始渐进膝关节主、被动功能训练,完全负重时间为14.3周(11～17周)。A、C型骨折术后4周膝关节平均活动范围分别为113°(90°～140°)和101°(60°～130°)。X线所见:52例(82.5%)于术后3周左右可见骨痂形成,骨折愈合时间平均为12.1周(10～14周),63例中57例术后骨折对线满意,6例出现成角畸形,其中4例在矢状面上成角10°,2例在冠状面上成角9°。全组无感染、延迟愈合、断钉、断钢板等并发症。手术时间平均为45min(30～60min),切口长度平均为5.5cm(4～6cm)。按照HSS评分:优47例(74.6%)、良14例(22.2%)、可2例(3.2%)。结论微创内固定系统具有创伤小、骨折愈合快、固定牢靠、可早期功能锻炼等优点,近期疗效满意,该法确系膝关节周围严重粉碎性骨折的最佳疗法之一。     

微创内固定系统治疗复杂的胫骨近端骨折

[目的] 总结微创内固定系统(LISS)治疗复杂的胫骨近端骨折疗效,探讨LISS的理念及操作技术.[方法] 2004年1月～2006年3月应用微创内固定系统治疗复杂的胫骨近端骨折39例,其中男26例,女13例;平均34.8岁(22～54岁).按AO/OTA分型41-A3型19例,41-C2型12例,41-C3型4例,累及近端42型4例.其中7例为开放性损伤(Gustilo Ⅰ型3例,Ⅱ型4例).11例合并有其它部位骨折.[结果] 所有患者均得到随访,平均随访15.6个月(10-21个月).平均手术时间75 min(60～130 min).平均失血量300ml(170-500 ml).所有骨折均愈合,平均愈合时间13周(11～16周).其中33例对线良好,5例在冠状面上有6°～8°外翻成角,1例5°内翻成角;患者完全负重时间平均14.2周(11～18周);膝关节活动范围为100°-120°;所有病例无感染、断钉、钢板断裂、固定失效等并发症.按照HSS评分优26例,良7例,中5,差1例,优良率84.6%.[结论] 微创内固定系统固定牢靠,能够促进骨折早期愈合和功能恢复,是治疗复杂的胫骨近端骨折的理想疗法.正确认识LISS理念及操作原则,并根据具体病例进行调整,是成功治疗的关键.     

LISS治疗复杂胫骨近端骨折的疗效分析

[目的]探讨微创内固定系统(less invasive stabilization system,LISS)治疗复杂胫骨近端骨折的疗效.[方法]2007年1月～2009年4月,用LISS手术治疗胫骨平台复杂骨折30例,其中男22例,女8例;年龄18～71岁,平均39.6岁.按AO分型:A3型8例,B3型6例,C1型3例,C2型9例,C3型4例.其中8例为开放性损伤,7例合并有其他部位骨折.受伤至手术时间1～14 d,平均3.5 d,均采用LISS固定.[结果]所有患者均随访11～24个月,平均17.5个月,平均手术时间80 min(60～120 min).所有骨折均愈合,平均愈合时间12周(10～15周),其中1例浅表感染,1例患者出现6°内翻畸形,无深部感染,无深静脉血栓,无骨折复位丢失及骨折不愈合,无钢板断裂.按照HSS评分:优20例,良6例,中3,差1例,优良率86.7%.[结论]LISS微创内固定系统治疗胫骨近端粉碎性骨折固定牢固、创伤小、手术时间短、并发症少、骨折愈合率高,是十分理想的内固定材料.     

微创内固定系统在胫骨近端粉碎性骨折治疗中的应用

目的探讨微创内固定系统（LISS）治疗胫骨近端粉碎性骨折的方法及临床疗效。方法应用LISS治疗胫骨近端骨折21例。结果21例均获得随访，时间12～20（16±4）个月。患者均在14～18周内获得骨性愈合。膝关节功能参照Mechant评分标准：优11例，良8例，可2例。结论LISS是治疗胫骨近端粉碎性骨折的较理想内固定方法。     

微创内固定系统在膝关节周围复杂骨折治疗中的应用

目的探讨AO微创内固定系统(less invasive stab ilization system,LISS)治疗膝关节周围复杂骨折的效果。方法2004年4月~2005年6月对15例干骺端闭合性膝关节周围复杂骨折(左侧9例,右侧6例),分别应用股骨远端LISS或胫骨近端LISS行内固定治疗。结果15例随访5~26个月,平均13.2月。完全负重时间为12~26周,X线骨愈合时间11~24周,无延迟愈合及骨不连。浅表感染1例,皮肤水疱2例,经换药后愈合。无深部感染及皮肤坏死,无骨筋膜室综合征。Johner-W ruhs方法评价功能优11例、良3例、中1例,以优良为满意标准,本组满意率为93.3%(14/15)。1例C3型胫骨平台骨折在术后2周出现胫骨内侧骨块明显移位伴髁间分离,二次手术在胫骨平台内侧加以支撑钢板固定,术后20周骨折愈合,功能评价为良;1例C3型胫骨平台骨折在术后8周出现膝内翻(胫骨平台内翻角为82°),术后20周骨折愈合,功能评价为中。结论LISS适用于单处股骨远端、胫骨近端骨折及骨质疏松性股骨干远端骨折的治疗;对于胫骨平台C3型骨折内侧平台粉碎严重时,不能过分依赖LISS系统,或将接骨板置于内侧,而应该考虑在内侧辅助支撑钢板。     

LISS治疗胫骨近端骨折的并发症

目的 分析使用AO微创内固定系统(less invasive stabilization system,LISS)治疗胫骨近端骨折的并发症.方法 应用LISS治疗45例46侧胫骨近端骨折,男35例,女10例;年龄22～73岁,平均45岁;左28侧,右18侧.高处坠落伤5例,交通事故伤32例,重物砸伤8例.46侧骨折根据AO分类,41A2型4侧、41A3型12侧、41C1型5侧、41C2型19侧、41C3型6侧.9例患者伴有同侧胫骨干骨折,42A3型1例、42B2型4例、42B3型3例、42C3型1例.闭合骨折41侧;开放骨折5侧,根据Gustilo和Anderson分类,Ⅰ型2侧、Ⅱ型3侧.结果 所有病例均获得随访,随访时间为6～25个月,平均11.4个月.所有骨折均愈合,未经额外植骨,无深部感染发生.平均愈合时间为16周,膝关节届曲平均112°,伸直平均-1°.并发症发生率为41.6%,4例(9%)骨折对位不良,1例断端向前成角15°、2例向内成角10°、1例外旋15°畸形.2例(4.3%)骨折术后复位丢失,胫骨平台内翻、塌陷.6侧肢体(13%)出现胫骨近端钢板刺激症状,其中有2侧出现迟发的皮肤软组织全层裂开,行局部胫前肌肌皮瓣转移,伤口愈合.腓浅神经与腓深神经损伤各1例(4.3%),经复查症状改善.9例患者在骨折愈合后行钢板取出,有5例(11%)共5枚螺钉出现"冷焊接现象"(cold-welding)致内固定取出困难.结论 LISS是一种固定胫骨近端骨折有效且可靠的方法.使用过程中需要术者具备精湛的技术和丰富的经验以减少并发症的发生;另外,某些并发症的出现与器械自身因素有关.     

微创内固定系统治疗下肢粉碎性骨折

目的探讨微创内固定系统（LISS）治疗股骨远端及胫骨近端复杂骨折的疗效。方法使用LISS闭合复位治疗股骨远端及胫骨近端复杂骨折16例。观察术后软组织恢复及骨折愈合情况。结果16例随访4～12个月,术后骨折复位、对线良好,无内固定松动或失效等并发症。结论LISS治疗膝关节周围骨折具有创伤小、固定牢固、骨折愈合时间短、最大程度保护膝关节功能的优点。     

微创内固定系统治疗胫骨近端骨折疗效分析

目的探讨微创内固定系统(LISS)治疗胫骨近端骨折的疗效。方法对45例胫骨近端骨折行LISS治疗,记录手术时间、术中透视次数、术中出血量、术中输血量、术后下肢力线畸形程度、骨折愈合时间、HSS评分及并发症发生率。结果手术时间为45~91(68±10.5)min;术中透视次数为18~44(27±6)次;术中出血量为50~210(130±29)ml;术中输血量为0~300(56±13)ml。术后下肢力线畸形程度:内外翻畸形0°~5°(1°±0.3°),旋转畸形0°~7°(2°±0.7°),肢体长度误差0~0.8(0.3±0.1)cm。6例失访,39例获得随访,时间6~24(11±3.2)个月。骨折愈合时间2.5~6.5(3.8±1.5)个月。HSS评分:优20例,良15例,中4例,优良率89.7%。术后总体并发症发生率为15.4%(6例),其中浅表感染1例,内固定激惹2例,复位丢失出现内翻畸形(5°)2例,内旋畸形(7°)1例。结论 LISS是治疗胫骨近端骨折(特别是严重粉碎性骨折)安全、简单、有效的方法。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Is the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?

Background: The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. Methods: In 50 patients anaesthetised with thiopental, isoflurane and fentanyl, the effect of bolus doses of 0.15 or 0.25 mg . kg^?1 mivacurium (MIV 15, MIV 25), 0.3 or 0.5 mg . kg^?1 atracurium (ATR 30, ATR 50) and 0.06 or 0.1 mg . kg^?1 vecuronium (VEC 06, VEC 10) were measured on both arms (evoked response of the adductor pollicis to train-of-four stimulation every 12 s), a tourniquet being applied on one arm just before and during 3 min after the muscle relaxant bolus. Results: Tourniquet inflation of 3 min almost abolished the neuromuscular effect of mivacurium. In the vecuronium groups and in the ATR 50 group, tourniquet inflation did not modify the maximum degree of depression of the twitch response. Also, the duration of action of vecuronium was unaffected by the tourniquet. In the ATR 30 group, times to return of the twitch response to 25% (duration 25%) and 75% (duration 75%) of control response were significantly shorter in the cuffed arm, 23 min vs 27 min, and 41 min vs 45 min, respectively. In the ATR 50 group, only duration 25% was significantly shorter in the cuffed arm (41 min vs 45 min). Conclusion: The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.     

Membranes in Artificial Organs

Abstract: Membrane processes play a pivotal and enabling role in modern replacement therapy for acute and chronic organ failure and in the management of immunologic diseases. In fact, virtually all contemporary extracorporeal blood purification methods employ membrane devices, and the next generation of artificial organs and tissue engineering therapies are almost certain to be similarly grounded in membrane technology. In this short essay, we comment on the similarities and differences among synthetic membranes and their natural counterparts and also provide a critical overview of the demographics and technology of hemodialysis, hemofiltration, apheresis, oxygenation, and emerging membrane technologies and applications.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Dilemma of Membrane Biocompatibility and Reuse

Abstract: Numerous articles have been published on the multiple use of dialyzers and on the effect of different reprocessing chemicals and techniques on the dialyzer biocompatibility and performance. The results often appear contradictory, especially those comparing standard biocompatibility parameters. Despite this confusion, a discerning review of the published works allows certain limited conclusions to be drawn. Reprocessing of used hemodialyzers changes the biocompatibility profile of a dialyzer as defined by the parameters complement activation. leukopenia, and cytokine release. The effect of reprocessing depends on the chemicals and reprocessing technique applied and also on the type of membrane polymer being subjected to the reprocessing procedure. Reports of pyrogenic reactions indicate that the flux of the membrane also influences how suitable it is for safe reuse. An increased risk of allergic and pyrogenic reactions appears to be associated with dialyzer reuse. Furthermore, there has been a lack of investigations into the immunologic effect of the layer of adsorbed and chemically altered proteins that remains on the inner surface of reprocessed dialyzers. We conclude that the clinical benefit of dialyzer reuse cannot be generally accepted from a biocompatibility point of view.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.