Tactics of infusion therapy in patients with acute cerebral circulatory disorders in the prehospital stage

Abstract

Objective. To streamline the tactics of infusion therapy in patients with acute cerebrovascular accident (ACVA) in the prehospital stage. Materials and methods. A retrospective, non-randomized study of 49 patients with ACVA who received emergency medical care in the prehospital phase. Results and discussion. Ensuring adequate brain perfusion in the area of ischemia is the main task of emergency medical care ACVA in the prehospital stage (Zozulya I.S., Volosovets A.O., Zozulya A.I. et al., 2019). Among the drugs that effectively improve blood circulation to the brain in the area of ischemia, an important place is occupied by infusion solutions (Semenenko A.I., Kobeliatskyi Yu.Yu., Kondratskyi B.O. et al., 2016). The choice of the optimal qualitative and quantitative composition of infusion solutions in patients with ACVA is one of the most difficult issues of treatment (Halushko O.A., 2017). Infusion therapy for patients with ACVA in the prehospital stage was used according to the Unified Clinical Protocol of Medical Care “Ischemic stroke (emergency, primary, secondary (specialized) medical care, medical rehabilitation)” (Order of the Ministry of Health of Ukraine from 03.08.2012 № 602) according to the following algorithm: 1) providing venous access by standard venous catheterization procedure with asepsis/antiseptics by intravenous catheter № 18; 2) carrying out infusion therapy by introducing 0,9 % sodium chloride solution at a rate of 100 ml×h-1; 3) the introduction of colloidal solutions in patients with ACVA in the prehospital stage was not carried out. Conclusions. The choice of the optimal qualitative and quantitative composition of infusion solutions in patients with ACVA in the prehospital stage is one of the most difficult issues of emergency care. After providing venous access by catheterization of the peripheral vein with a catheter № 18 infusion therapy is carried out by administering 0,9 % sodium chloride solution at a rate of 100 ml×h-1. The introduction of colloidal solutions in patients with acute cerebral circulatory disorders in the prehospital stage is contraindicated.