Механическая поддержка кровообращения у детей: патофизиология педиатрического гемостаза и алгоритмы послеоперационного ведения

Хроническая сердечная недостаточность на фоне врожденных пороков сердца, преимущественно в раннем детском возрасте, или различных форм кардиомиопатий, чаще встречающихся в подростковом возрасте, представляет собой важную причину заболеваемости и смертности среди детского населения [1, 2]. Ввиду увеличения за последние два десятилетия количества пациентов, страдающих терминальной стадией хронической сердечной недостаточности, рефрактерной к медикаментозной терапии, и существующего дефицита донорских органов в педиатрической практике вопрос о применении длительной механической поддержки кровообращения становится все более актуальным. Ведение пациентов представляет собой мультидисциплинарную задачу, так как длительное применение антикоагулянтной и антитромбоцитарной терапии, направленной на предупреждение тромбоза искусственного желудочка сердца, имеет потенциально опасные, жизнеугрожающие осложнения, а именно острое нарушение мозгового кровообращения по геморрагическому типу и кровотечения различной степени тяжести.

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