The Effect of Smoking Addiction on Non-invasive Perfusion Parameters in Asymptomatic Smokers

Abstract

Purpose: Tobacco use is one of the leading causes of illness and premature death. According to the estimates of the World Health Organization, tobacco is responsible for approximately 9% of deaths worldwide. However, most of the smokers think that they have no abnormal findings due to smoking, especially in the asymptomatic period. In our study, it was aimed to determine whether there
is an early deterioration in some perfusion parameters in asymptomatic cigarette addicts.

Materials and Methods: The study was carried out randomized and prospectively on 140 people with 70 volunteers in each group. Measurements were made with the Masimo rainbow SET device. Basic perfusion parameters were recorded.

Results: Heart rate, methemoglobin (SpMet) and carboxyhemoglobin (SpCO) levels were found to be significantly higher in the smoking group (p<0.05). No significant difference was found between the two groups in perfusion Index (PI) and pleth variability index (PVI) measurements (p≥0.05). No correlation was found between the duration of dependence and basic perfusion parameters
in smokers (p≥0.05).

Conclusion: Smokers may have high spCO and SpMet and heart rate even when they are still in the asymptomatic period, and these findings may be a predictor of future major organ dysfunctions.

Keywords

• cigarette
• perfusion
• methemoglobinemia
• carboxyhemoglobin

Asemptomatik İçicilerde Sigara Bağımlılığının Noninvaziv Perfüzyon Parametrelerine Etkisi

Abstract

Amaç: Tütün kullanımı, hastalıkların ve erken ölümlerin önde gelen nedenlerinden biridir. Dünya Sağlık Örgütünün tahminlerine göre tütün, dünya çapındaki ölümlerin yaklaşık %9'undan sorumludur. Ancak çoğu sigara tiryakisi özellikle asemptomatik dönemde iken sigaraya bağlı hiçbir anormal bulgularının olmadığını düşünmektedirler. Çalışmamızda asemptomatik sigara bağımlılarında, bazı perfüzyon parametrelerinde erken dönemde bozulma olup olmadığının tespit edilmesi amaçlanmıştır. 

Araçlar ve Yöntem: Çalışma randomize ve prospektif olarak her grupta 70 gönüllü olmak üzere toplam 140 kişi üzerinde gerçekleştirildi. Ölçümler Masimo rainbow SET cihazı ile gerçekleştirildi. Temel perfüzyon parametreleri kayıt altına alındı.

Bulgular: Kalp atım hızı, methemoglobin (SpMet) ve karboksihemoglobin (SpCO) düzeyinin sigara kullanan grupta anlamlı düzeyde yüksek olduğu görüldü (p<0.05). Perfüzyon indeksi (PI) ve Plet değişkenlik indeksi (PVI) ölçümlerinde ise her iki grup arasında anlamlı düzeyde fark bulunamadı (p≥0.05). Sigara kullananlarda bağımlılık süresi ile temel perfüzyon parametreleri arasında korelasyona rastlanmadı (p≥0.05). 

Sonuç: Sigara kullanan bireyler henüz asemptomatik dönemde bile olsalar, yüksek düzeyde spCO, SpMet ve kalp atım hızına sahip olabilir. Bu bulgular, ilerde oluşabilecek önemli organ disfonksiyonlarının bir ön habercisi olabilir.

Keywords

• SİGARA
• PERFÜZYON
• METHEMOGLOBİN
• KARBOKSİHEMOGLOBİN

References

1. 1. Health U, Services H. The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease 2014.
2. 2. Dinardo P, Rome E. Vaping: The new wave of nicotine addiction. Cleveland Clin J of Med. 2019;86(12):789-798.
3. 3. Organization WH. Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organization; 2009.
4. 4. Ezzati M, Lopez A. Estimates of global mortality attributable to smoking in 2000. The Lancet. 2003;362(9387):847-852.
5. 5. Mons U, Müezzinler A, Gellert C. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults. BMJ (Clinical research ed). 2015;350:h1551.
6. 6. Amato M, Frigerio B, Castelnuovo S. Effects of smoking regular or light cigarettes on brachial artery flow-mediated dilation. Atherosclerosis. 2013;228(1):153-160.
7. 7. Moazed F, Burnham L, Vandivier W . Cigarette smokers have exaggerated alveolar barrier disruption in response to lipopolysaccharide inhalation. Thorax. 2016;71(12):1130-1136.
8. 8. Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS: for version 22.0. Nelson Education; 20149.

9. 9. Turner J, McNicol M, Sillett RJT. Distribution of carboxyhaemoglobin concentrations in smokers and non-smokers. BMJ. 1986;41(1):25-27.
10. 10. Borgerding M, Klus HJE. Analysis of complex mixtures–cigarette smoke. Exp and Tox Pathology. 2005;57(1):43-73.
11. 11. Warren GW, Alberg AJ, Kraft AS, Cummings KM. The 2014 Surgeon General's report: "The health consequences of smoking--50 years of progress": a paradigm shift in cancer care. Cancer. 2014;120(13):1914-1916.
12. 12. Broch O, Bein B, Gruenewald M, et al. Accuracy of the pleth variability index to predict fluid responsiveness depends on the perfusion index. Acta anaesth. Scand. 2011;55(6):686-693.
13. 13. Le Guen M, Follin A, Gayat E, Fischler MJM. The plethysmographic variability index does not predict fluid responsiveness estimated by esophageal Doppler during kidney transplantation: A controlled study. Medicine. 2018;97(20):e10723.
14. 14. Wajima Z, Shiga T, Imanaga K. Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia? Bios. trends. 2018;11(6):667-674.
15. 15. Haire-Joshu D, Glasgow RE, Tibbs TLJDc. Smoking and diabetes. 1999;22(11):1887-1898.
16. 16. Shelley KH, Murray WB, Chang DJJocm. Arterialpulse oximetry loops: a new method of monitoring vascular tone. Jour of Clin. Monitoring. 1997;13(4):223-228.
17. 17. Karakaya O, Barutcu I, Kaya D, et al. Acute effect of cigarette smoking on heart rate variability. Angiology. 2007;58(5):620-624.
18. 18. Cımbız A, Manisalıgil Ü, Kesgin K, Beydemir F, Bayazıt. Genç Bireylerde Sigaranin Hemodinamik Etkilerinin Değerlendirilmesi. DPÜ Fen Bilim Enstitüsü Dergisi. 2004;(6):1-15.
19. 19. Rose JJ, Wang L, Xu Q, et al. Carbon Monoxide Poisoning: Pathogenesis, Management, and Future Directions of Therapy. American jour of resp and crit care med. 2017;195(5):596-606.
20. 20. Palmeri R, Gupta V. Carboxyhemoglobin Toxicity. United States: Stat Pearls Publishing LLC; 2020.
21. 21. Zeidan RK, Rachidi S, Awada S, et al. Carbon monoxide and respiratory symptoms in young adult passive smokers: a pilot study comparing waterpipe to cigarette. Int jour of occupational med and env health. 2014;27(4):571-582.
22. 22. Ludlow JT, Wilkerson RG, Nappe TM. Methemoglobinemia. United States: Stat Pearls. Publishing LLC.;2020.