Effect of perioperative fluid therapy on ischemia-reperfusion syndrome in elective percutaneous coronary interventions

Objective. To evaluate the incidence of ischemia-reperfusion syndrome (IRS) in elective percutaneous coronary interventions (PCI) in patients with stable coronary artery disease (CAD). Material and methods. A prospective, single-center, randomized study was conducted. The study included 60 patients older than 60 years with stable coronary artery disease with involvement of two or more vessels who underwent elective PCI. The patients were randomized into two groups: a control group that received Ringer’s solution and a test group that received Reamberin solution. Both solutions were administered at a dose of up to 10 mL/kg/day in the preoperative period with a transition to a maintenance infusion daily with a volume corresponding to physiological requirements. The patients were assessed at five timepoints (before surgery, 3 hours after surgery, Day 1, Day 14, and Day 30 after surgery). The key criteria included the duration of hospital stay, complications (arrhythmias, thrombotic events, cardiovascular failure), and the trends in laboratory and instrumental parameters (echocardiography, electrocardiography, troponin, and creatine phosphokinase-MB levels), as well as risk factors for the IRS. Results. The perioperative prophylactic use of Reamberin solution significantly reduced the IRS incidence to 44.1% vs. 73.0% in the control group (p<0.05). In the test group, no significant associations were found between the level of predictors (the number of implanted stents, the Charlson Comorbidity Index) and the IRS risk. No significant intergroup differences in clinical outcomes and complication rates between groups were observed. Conclusion. The perioperative use of the succinate-containing drug, Reamberin, for elective PCIs is associated with a significant decrease in the frequency and severity of IRS manifestations. Further research is needed to clarify the mechanisms of protective action, doses, and dosage regimens.