CHANGES IN CARBON EXCHANGE IN POST-OPERATIVE DISORDERS OF THE COGNITIVE FUNCTION

The purpose of this study is to determine the content of the main monitoring indicators of carbohydrate metabolism in patients with surgical pathology, depending on the age after general anesthesia. The study of 130 patients was conducted in surgical departments of different profiles at the Kharkov City Clinical Hospital for Emergency and Emergency Medical Services. prof. A.I. Meshchaninov. Surgery was performed under conditions of gen-eral multicomponent anesthesia with artificial ventilation using propofol and fentanyl, thiopental sodium and fentanyl. The patients were divided into three groups, respectively: 1 group (n = 46) - young patients (18-43 years); mean age 30.1 ± 1.0 years, 24 people, 22 women. Group 2 (n = 43) were middle-aged patients (44-59 years); mean age 49.3 ± 5.1 years, 18 males, 25 females. Group 3 (n = 41) - elderly patients (60-80 years); mean age 74.4 ± 6.1 years, 22 people, 19 women. According to the purpose and objectives of the study, the blood biochemical markers of carbohydrate metabolism - glucose, pyruvate and lactate content - were determined in patients' blood. Patients in the first group have changes from immediately after surgery and anesthesia: a decrease in pyruvate on the background of hyperlactatemia and a significant decrease in the ratio of pyruvate to lactate (3.9 times). This indicates the switch of the aerobic glucose oxidation pathway to anaerobic, where the final product is lactate. This process helps to reduce the formation of a macroergic compound - ATP - the main source of energy in the body to ensure the processes of life. However, the adaptive capacity of the young organism is more pronounced compared to the more age groups. A week after receiving anesthesia and surgery, the content of pyruvate increases and the lactate content decreases, the ratio increases by 2 times compared with these indicators in healthy people. In the second group of patients changes in the basic monitoring indicators of carbohydrate metabolism are observed, in all studies, depending on the periods of the disease, hyperglycemia is observed. On the first day after surgery, a decrease in pyruvate was observed on the background of hyperlactatemia, the ratio of pyruvate / lactate decreased by 2.54 times and 1.46 times, respectively, on the first day and after a week. The indicators do not change as much as in the 18-43 age group, but they do not recover so quickly. Patients in the third group have more pronounced hyperglycemia than other age groups. Hyper pyruvate and hyperlactatemia, the pyruvate / lactate ratio remains 2-fold and does not return to normal one month after surgery and anesthesia. Increasing the content of lactate and PVC indicates the development of an imbalance between the ratio of anaerobic and aerobic glucose oxidation processes and the violation of energy supply against the depletion of adaptation mechanisms after anesthesia. The absence of changes in the blood levels of patients in the first group indicate that humoral mecha-nisms of regulation of the content of this monosaccha-ride, which is necessary for the energy supply of the processes of vital activity of the organism, operate at a sufficient level to ensure glucose homeostasis. Hypergly-cemia in patients of the second group before surgery and in the first week after anesthesia and surgery may be caused by an increase in blood hormones of stress: adrenaline, cortisol. As for the indicator of the state of carbohydrate metabolism - blood glucose in patients of the third group, they have hyperglycemia in all periods of the study. A month later, it practically returns to the values before surgery. In the study of metabolites of anaerobic glycolysis, such as pyruvate and lactate, in the serum of patients of different age groups revealed certain features of changes in these indicators, the severity of which depended on age and duration after anesthesia and surgery.