Aim. This study was aimed at developing biocompatibility of extracorporeal components due to the use of «adaptation composition» (AdC), reducing the negative impact of perfusion on the state of red blood cell due to the use of fructose-1,6-diphosphate (FDP) to decrease intraoperative hemolysis and tissue hypoxia. Material and methods. The study included 225 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The first group included patients who underwent surgery with the treatment of an extracorporeal circuit by AdC, the second group included patients who were administered the drug with the active substance FDP, the third group was the control group. The oxygenator was treated with AdC and PDF was administrated according to the protocol. Patient blood was sampling for complete blood cell count (CBC) and blood smears were at 4 stages of surgery: before CPB, at 10 min. CPB-time, at 60 min. CPB-time (rewarming stage) and after separation from CPB. Several parameters were studied: plasma free hemoglobin (plfHb), the erythrocytes osmotic, mechanical resistance of erythrocytes, erythrocyte membrane permeability (EMP), acid hemolysis, the blood smears were stained according to Pappenheim. Results. The best erythrocyte indices, hemolysis, osmotic, mechanical, acid, urea resistance of erythrocytes were observed in the groups where fructose-1,6-diphosphate and «adaptation composition» were used. At the preoperative stage, hypophosphatemia was detected in 16.8% out of 225 patients and 26.6% out of 225 patients have a clear tendency to ones. After CPB, there was no hypophosphatemia in the group where fructose-1,6-diphosphate was administered. The higher peripheralization of reticulocytes, echinocytes, and spherocytes was observed in the control group after perfusion. Conclusion. The use of AdC and FDP during CPB helps to reduce hemolysis and the better state of erythrocytes. Cardiopulmonary bypass (CPB) can negatively affect the state of red blood cell. The effect of fructose-1,6-diphosphate and «adaptation composition» on the state of erythrocytes during perfusion was studied.

Aim of the study: to analyze the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care from the sources of the modern available literature. Materials and methods. Bibliosemantic, comparative and systems analysis. The proposed recommendations are based on data from the analysis of modern literature, the results of randomized studies and meta-analyzes devoted to the study of the problem of using the beta-1-blocker esmolol for anesthetic management and intensive care. Results and discussion. Esmolol is the only ultrashort-acting selective beta-blocker for parenteral administration, which selectively blocks beta-1-adrenergic receptors mediating the cardiac stimulating effect of catecholamines. To a lesser extent, it affects the β2-adrenergic receptors of the bronchi and smooth muscles. At doses above 300 μg/kg per minute, the β1-selectivity of esmolol decreases, the drug competitively blocks β1- and β2-adrenergic receptors. Esmolol is most indicated in anesthetic practice for limiting the endocrine-metabolic response, reducing the risk of cardiac complications, reducing pain intensity, controlling hemodynamics, including ensuring controlled hypotension. The features of the pharmacokinetics of esmolol make it possible to accurately modulate the degree and duration of the decrease in heart rate and blood pressure, depending on the clinical situation, and make esmolol an "ideal" cardiac drug. Conclusion. The use of ultrashort-acting beta-blockers increases the efficiency and safety of anesthesia, especially in high-risk patients, and creates the prerequisites for ensuring the best treatment results for patients in various fields of surgery.