Kalp Cerrahisinde Pulsatil ve Nonpulsatil Akımların Preoperatif ve Postoperatif Etkilerinin Karşılaştırılması

Year 2023, Volume: 3 Issue: 3, 24 - 28, 22.12.2023

Özkan Sönmez Duygu Durmaz Sedat Gündöner Başol Bay

https://doi.org/10.58961/hmj.1400797

Abstract

Amaç
Açık kalp cerrahisinde kardiyopulmoner bypass (KPB) sırasında pulsatil veya nonpulsatil olmak üzere iki farklı akış modeli kullanılmaktadır. Ancak bu iki modelin farklılıkları ve üstünlükleri konusunda belirsizlikler vardır. Bu çalışmada izole koroner arter bypass cerrahisinde (CABG) pulsatil ve nonpulsatil akış tiplerinin biyokimyasal ve klinik sonuçlarının karşılaştırılması amaçlanmıştır.
Yöntem
Haziran 2019 ile Haziran 2020 arasında tarihleri arasında yapılan bu prospektif çalışmaya izole CABG ameliyatı yapılan 30 hasta dahil edildi. Hastalar pulsatil (Grup I; n=15) ve nonpulsatil (Grup II; n=15) akış olarak iki gruba ayrıldı. Gruplardan preoperatif, postoperatif 24.saat ve postoperatif 72.saat hemogram örneği ve kreatinin düzeyleri; KPB öncesi, kros klemp 5.dakika, KPB sonu ve postoperatif 2.saat laktat düzeyleri kaydedildi. Her iki grup için postoperatif 24.saat drenaj ve diürez miktarları, yoğun bakım ünitesi ekstübasyon, yoğun bakım ünitesi çıkış ve hastaneden taburculuk süreleri karşılaştırıldı.
Bulgular
İki grup arasında hemogram ve diğer kan örnekleri açısından anlamlı bir farklılık bulunmadı (p>0,05). Gruplar arasında ekstübasyon süresi, yoğun bakım çıkış ve taburculuk süreleri benzerdi (p>0,05). Bununla beraber gruplar arasında drenaj açısından anlamlı farklılık tespit edildi (p<0,05).
Sonuç
İzole koroner arter bypass cerrahisinde pulsatil ve nonpulsatil akış modelinin, biyokimyasal ve klinik sonuçlar açısından majör bir farklılık göstermediği tespit edildi.

Keywords

Kardiyopulmoner bypass, pulsatil akış, nonpulsatil akış

Ethical Statement

Herhangi bir çıkar çatışması yoktur.

Comparison of Preoperative and Postoperative Effects of Pulsatile and Non-Pulsatile Currents in Cardiac Surgery

Abstract

Objective
Two different flow patterns, pulsatile or nonpulsatile, are used during cardiopulmonary bypass (CPB) in open heart surgery. However, there are uncertainties about the differences and superiorities of these two models. The aim of this study was to compare the biochemical and clinical outcomes of pulsatile and nonpulsatile flow types in isolated coronary artery bypass surgery (CABG).
Methods
This prospective study was conducted between June 2019 and June 2020. 30 patients who underwent isolated CABG surgery were included. Patients received pulsatile (Group I; n=15) and nonpulsatile flow (Group II; n=15) were divided into two groups. The groups were divided into preoperative, postoperative 24.hour and 72.hour postoperative hemogram samples and creatinine levels; pre-CPB, cross Lactate levels were recorded at 5 minutes after clamping, at the end of CPB and 2 hours postoperatively. For both groups postoperative 24th hour drainage and diuresis, intensive care unit extubation, intensive care unit discharge and hospital discharge times were compared.
Results
There was no significant difference between the two groups in terms of hemogram and other blood samples (p>0.05). Extubation time, ICU discharge and discharge times were similar between the groups (p>0.05). However, there was a significant difference between the groups in terms of drainage (p<0.05).
Conclusion
It was found that pulsatile and nonpulsatile flow model did not show a major difference in terms of biochemical and clinical outcomes in isolated coronary artery bypass surgery.

Keywords

Cardiopulmonary bypass, pulsatile flow, nonpulsatile flow

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